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From the JAMA Network
May 12, 2015

Hoarseness and Laryngopharyngeal Reflux

Author Affiliations
  • 1Harvard Medical School, Boston VA Healthcare System, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA. 2015;313(18):1853-1854. doi:10.1001/jama.2014.17969

Hoarseness is a common presenting complaint to generalist physicians. Symptoms include altered vocal quality, pitch, or loudness.1 The lifetime prevalence of hoarseness is approximately 30%, and it is more common in women, middle age, and specific professions (singers and teachers) and is associated with repeated upper airway infections and gastroesophageal reflux disease (GERD).2 Recent neck operations (eg, carotid endarterectomy and thyroid surgery), radiation treatment, endotracheal intubation, tobacco abuse, and neurologic disorders (such as Parkinson disease, multiple sclerosis, and stroke) are also associated with hoarseness.1 Among patients presenting to primary care clinicians, the most common cause of hoarseness is viral laryngitis, which should resolve with symptomatic treatment in 2 to 3 weeks. If hoarseness persists for a longer time, a referral to a specialist is appropriate, but there is no consensus regarding when this should be done. The Table summarizes the main causes for hoarseness and their associated clinical features.3

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