Identifying Concomitant Health Conditions in Individuals With Chronic Voice Problems

  • Charles Lenell
    Department of Communicative Sciences and Disorders, New York University, New York

    Department of Otolaryngology – Head and Neck Surgery, New York University, School of Medicine, New York
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  • Qianhui Shao
    Department of Otolaryngology – Head and Neck Surgery, New York University, School of Medicine, New York
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  • Aaron M. Johnson
    Address correspondence and reprint requests to Aaron M. Johnson, NYU Voice Center, Department of Otolaryngology – Head and Neck Surgery, New York University, School of Medicine, 345 East 37th Street, Suite 306, New York, NY 10016.
    Department of Otolaryngology – Head and Neck Surgery, New York University, School of Medicine, New York
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Published:January 28, 2020DOI:



      Current clinical practice guidelines recommend a laryngoscopic referral for patients who present with hoarseness for longer than 28 days and earlier for patients with certain high-risk factors. The goal of this study was to identify additional possible concomitant health conditions in individuals with chronic (>28 days) hoarseness to improve early detection of chronic voice problems.


      Using data from the 2012 National Health Interview Survey, four health conditions were selected: Swallowing problems, respiratory problems, hormonal-cycle problems, and physical activity limitations. Multivariable logistic regressions controlling for age, gender, race, and smoking status, were used to calculate the odds ratios for the association of each of these four health conditions to chronic versus acute voice problems.


      Of the 2,746 respondents who reported a voice disorder within the last year, 736 reported a voice problem lasting longer than 4 weeks in duration. After controlling for covariates, individuals reporting swallowing problems and physical activity limitations were more likely to report a chronic voice problem versus an acute voice problem, odds ratios with 95% confidence intervals of 1.983 (1.619, 2.430) and 1.716 (1.355, 2.173), respectively. No significant associations were found for respiratory or hormonal-cycle problems.


      Individuals who present with both a voice problem and a swallowing problem or physical activity limitation may be at increased risk for developing a chronic voice problem. Therefore, these two health conditions should be included as high-risk factors when determining the escalation of care for a patient presenting with acute dysphonia.

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