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JOURNAL READING
Etiopatholgical Study of 100 Patients of

Hoarseness of Voice:
In Rural Based Hospital
Presented by:
Hana Indriyah Dewi G99162140
Lina Nurhana G99162146
Ana Erdina G99162148
Trisna Rizki Prasetyo G99172017
General Description
CRITICAL APPRASIAL
Design : Original article
Subject : 100 patients having hoarseness of voice
Title : Interesting, concise and straightforward
Authors : Clearly written constitution and there are correspondence address
Abstract : Clear and appropriate rules
Introduction : Clearly explain the background, the purpose and the importance of study
Level of Evidence
2 A (evidence from one well designed case control study with the good level of evidence)
P-I-C-O Analysis
Population : 100 patients having hoarseness of voice
Intervention : No intervention
Comparison : Include sex and age ranged groups
Outcome : Smoking (33 %) was the commonest predisposing factor for hoarseness of voice
followed by URI (24 %) alcohol/tobacco chewing (22 %), vocal abuse (17 %)
cases. Stroboscopy is helpful in establishing a diagnosis and/or improving the
clinical assessment of patients with chronic voice disorders.
CRITICAL APPRASIAL . . . .
V-I-A Analysis
Validity :
a. The pathophysiology of hoarseness has not been described well in this article.
Therefore, there is lack of basic science or solid arguments explained how can
predisposing factors lead the occurance of hoarseness.
b. The method of this study was a case control, as the study assesses predictor variables
retrospectively there is great potential for a biased assessment of their presence and
significance by the patient or the investigator, or both.
c. The study has already focused on addressing the predisposing factors that lead the
occurance of hoarseness.
Importance:
a. The article showed predisposing factors of hoarseness are smoking, upper respiratory
infections, alcohol, tobacco chewing, vocal abuse, endotracheal tube intubation,
thyroidectomy and trauma to neck.
b. The article conclude stroboscopy is helpful examination in establishing a diagnosis
and/or improving the clinical assessment of patients with chronic voice disorders.
c. The reader is confident in the truth of the results of this study because the authors
had elaborated and analyzed all the results well, had published their original article,
and had also provided the correspondence address.
CRITICAL APPRASIAL . . . .
V-I-A Analysis (cont’d)
Applicability :
a. The article may be valuable to prevent the occurance of hoarseness by controlling the
etiology and predisposing factors.
b. Stroboscopy which is examination suggested in the article may be applicable in
establishing a diagnosis and/or improving the clinical assessment of patients with
chronic voice disorders.
ABSTRACT
Hoarseness of voice is one of the commonest symptoms in otolaryngological
practice and it indicates diseases ranging from totally benign condition to the most
malignant condition. This is a study to know the etiology, predisposing factor, and clinical
profile of patients having hoarseness of voice. The study was carried out in the department
of ENT, Mahatma Gandhi Institute of Medical Sciences, Sewagram. Patients coming to our
OPD were selected. All the patients then underwent detailed history and routine
investigations. Stroboscopic evaluation was done to reach to a diagnosis. A total of 100
patients having hoarseness of voice with male to female ratio 1.50:1 were analysed. Age
group varied from 12 to 82 years. Largest group comprised of labourer (33 %) followed by
house wives (30%) and vocal paralysis was found in 33% of the cases. Upper respiratory
tract infection (24%) and smoking (33%) were found to be the common predisposing factors.
Functional disorders were found in 14% of the cases.
Keywords:
Hoarse voice, Organic voice disorders, Nonorganic voice disorders, Vocal professionals, Stroboscopy
INTRODUCTION
Hoarseness is a coarse, scratchy sound most often associated
with abnormalities of the vibratory margins of the vocal folds, in
condition like laryngitis, vocal fold hemorrhage, mucosal
disruption, mass lesions and carcinoma.
Hoarseness of voice is one of the commonest symptoms in

otolaryngological practice and it indicates diseases ranging from
totally benign condition to the most malignant condition.
AIMS & OBJECTIVE
The study was aimed to study the clinicopathological profile

and associated symptoms of hoarseness of voice
To find out association of common predisposing factors

leading to hoarseness
MATERIALS & METHODS
In department of ENT and Head & Neck
surgery during the year 2009–2011.
All patients with voice disorder were evaluated by

stroboscopy.
All patients underwent complete preliminary work-up,

routine investigations and examination of suspected
malignancies were done whenever required.
OBSERVATIONS & RESULTS
Among 100 cases
Sex : ♂ 60 (60 %), ♀ 40 (40 %)
Age : 12-82 years

Occupation : labourer/farmer (33 %), housewives (30 %),
private job/businessman (15 %), student (10 %),
teacher (9 %), singer (3 %)
Vocal professionals were categorised according to classification
by Koufman and Isaacson
Predisposing factors : Smoking (33%),
upper respiratory infections (URI) (24%)
OBSERVATIONS & RESULTS
ETIOLOGY AND PREDISPOSING FACTORS OF HOARSENESS OF VOICE
DISCUSSION
Majority of patients 31–40 years (24 %) and 51–60 years (21 %) followed by 3rd decade (18 %).
 Baitha et al & Hansa et al also found majority of patients in the age group of 31–40 years.
A M:F ratio of 1.50:1 with male predominance was observed in this study.
 Male to female ratio in Baitha et al, Mehta, Parikh, Deshmukh, with 2:1, 1.8:1, 2:1 and 1.5:1 respectively.
In our study, labourer/farmer comprised majority of cases (33 %) followed by 30 % of housewives.

 Ghosh et al found majority of patients (29 %) were housewives.
Koufman and Isaacson evolved a classification of vocal professionals based on their voice use and risk.
Level I (elite vocal performers)
Level II (professional voice users)
Level III (nonvocal professionals)
Level IV (nonvocal/nonprofessionals)
DISCUSSION
In our study, most of the presenting complaints were having duration of 3 months (57.86%),
3–6 months (24.29 %) and 6–12 months (10.67 %) and 7.30 % complaints were having
duration of more than 1 year (Table 1).
 Hansa et al found (61.35 %) were seen with 3 months duration, 25.1 % with 3–6 months
and 10.76 % with 6–12 months duration. 20.72 % complaints were of more than 1 year
duration.
SUMMARY & CONCLUSION
• The incidence of hoarseness of voice showed male to female ratio as 1.50:1
• Labourer was the largest group (33 %) of patients with hoarseness of voice.
• Around 73 % were nonvocal nonprofessionals according to Koufman and
Isaacson classification.
• Vocal cord paralysis comprised the largest group (33 %) followed by
functional voice disorder (14 %).
• Smoking (33 %) was the commonest predisposing factor for hoarseness of
voice followed by URI (24 %) alcohol/tobacco chewing (22 %), vocal abuse
(17 %) cases.
• Hoarseness of voice is just a symptom with a very diverse etiology.
• Stroboscopy is helpful in establishing a diagnosis and/or improving the
clinical assessment of patients with chronic voice disorders.
THANK YOU

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JOURNAL READING

Etiopatholgical Study of 100 Patients of

Hoarseness of voice is one of the commonest symptoms in

The study was aimed to study the clinicopathological profile

To find out association of common predisposing factors

All patients with voice disorder were evaluated by

All patients underwent complete preliminary work-up,

Age : 12-82 years

In our study, labourer/farmer comprised majority of cases (33 %) followed by 30 % of housewives.

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