title: What's new in differential diagnosis and treatment of hoarseness?
abstract: OBJECTIVE
  To review the literature published over the past year (2008) regarding the diagnosis and management of patients with hoarseness.
  
  
  RESULTS
  There has been a lack of large, controlled, prospective studies regarding diagnosis and management for dysphonic patients. High-speed digital imaging is gradually becoming a useful adjunct to stroboscopy in patients with hoarseness and aperiodicity. Presence of blood vessels in vocal fold lesions may help distinguish otherwise similar entities. Early speech therapy has been useful for patients with suspected reflux who did not respond to an initial antacid trial. Voice break analysis can help differentiate between hyperfunctional speech disorders. Fibroblast growth factor may be an effective new treatment for presbylaryngis. Bilateral botox injection has been effective and well tolerated for refractory vocal granuloma and abductor spasmodic dysphonia.
  
  
  CONCLUSIONS
  Hoarseness is a frequently encountered symptom that may result from many local and systemic disease processes. Differentiating subtle vocal fold pathologies and treatment of often ill-defined disorders remains a challenge. New approaches are described in the recent literature, but further studies are required for validation.
authors.affiliation: Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, Yale New Haven Hospital, New Haven, Connecticut, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Ulis
authors.forename: Eiji
authors.initials: E
authors.lastname: Yanagisawa
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D003937:Diagnosis, Differential; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D019317:Evidence-Based Medicine; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000628:therapy; D006685:Hoarseness / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007828:Laryngoscopy; D012815:Signal Processing, Computer-Assisted; D013064:Speech Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D049489:Stroboscopy; D014741:Video Recording
chemical_list: D019274:Botulinum Toxins, Type A