An examiner, starting with the complaint of hoarseness, can easily move stepwise to an accurate diagnosis of the cause of hoarseness. A successful approach is to listen to the patient's history of the onset and evolution of the hoarseness. Then the examiner elicits a variety of vocal tasks, recording the voice. Finally, an endoscopic camera is used to visualize the larynx and vocal cords. These three parts provide a logic for accurately assessing the human voice. The following three sections; Foundation, Hoarseness and Examination are both essential and sufficient for understanding and diagnosing voice problems.
This section of the website is essentially an update of the 2012 book "Why is there a Frog in my Throat?"
The final section, Reflux, is a short essay on the illusion of acid as a cause of hoarseness.
An examiner benefits from thinking about how sound is created in a human. This section includes words and definitions that are important to understanding voice disorders as well as an overview of endoscopic anatomy.
This section describes the various ways a voice can be impaired. The two primary impairments are air leak between the vocal cords (huskiness) and two sound sources simultaneously (roughness).
The physical examination of the human voice consists of two parts:
- Hearing a sound impairment
- Visualizing a sound impairment with an endoscope and stroboscopy.
Reflux has its own section because if you have been hoarse, someone will almost certainly tell you that you have invisible reflux.