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DYSPHONIA RELATED TO MEDICAL THERAPY
Journal article   Peer reviewed

DYSPHONIA RELATED TO MEDICAL THERAPY

Joseph R. Spiegel, Mary Hawkshaw and Robert Thayer Sataloff
Otolaryngologic clinics of North America, v 33(4), pp 771-784
2000
DOI: https://doi.org/10.1016/S0030-6665(05)70243-7
PMID: 10918660
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Iatrogenic dysphonias are common and must be considered in the differential diagnosis of any patient with a voice disorder. Some causes are obvious, such as dysphonia caused by scarring that follows vocal fold stripping, or the xerophonia that may occur after radiation therapy to the larynx. Voice disturbance associated with medications may be less obvious but equally important. It is essential to recognize medication-induced iatrogenic dysphonias so as to provide accurate, timely diagnosis and treatment and to avoid unnecessarily complex, costly, and protracted evaluations. A comprehensive voice assessment must carefully differentiate between dysphonias caused by medical treatment and those caused by the underlying medical condition for which the treatment was prescribed. Medications are used to treat many problems commonly encountered in voice professionals. Some are illnesses located in the head and neck, whereas others occur elsewhere in the body. Almost all medications have some potential effect on the voice. 21,31 In many cases, the effects are minor and are not clinically significant. All physicians and others caring for professional voice users should, however, be familiar with drug-induced phenomena that may affect voice function. (Professional voice users are discussed in this article because they are most sensitive to medication-induced voice changes and are most likely to report symptoms, but the same principles used to manage this challenging group of patients apply to the care of all patients who have dysphonia caused by medical therapy.) Biologic variability must be considered in trying to predict or recognize vocal consequences of pharmacologic agents. The effects of medication are influenced by sex, age, body size, metabolic status, individual biologic response, and concurrent use of other medications or recreational drugs. Recommended dosages are the amounts of drug generally required to achieve the desired balance between effect and side effect. They are, however, merely guidelines based on average responses in test populations. Optimizing the relationship between desired effect and undesirable side effect requires dosage individualization, especially for professional voice users for whom “minor” side effects may be disabling.

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17 citations in Web of Science
19 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Otorhinolaryngology
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