Hoarseness: Management challenges in Osogbo, Osun State, Nigeria.

Abstract

Background: Hoarseness is a symptom of utmost significance and calls for a separate consideration because of the frequency of its occurrence.
Objective: This study highlighted some challenges
militating against effective management of the condition in resource poor environment
Methods: A retrospective descriptive study between December 2006 and November 2012
Results: A total of 151 patients consisting of 99 males and 52 female. The age of the patients ranged from 9 months to 85 years with a mean± SD of 41.13 ± 18.45 years. Inflammation 63 (41.7%) andtumour47 (31.1%) were the leading causes. Sixty three (41.7%) presented within the first six months, 112 (74.2%) presented within the first year and 39 (25.9%) presented after the first year of onset. Large proportion 10/14 (71.4%)of patients with laryngeal papillomatosis presented late, they presented due to airway obstruction that necessitated emergency tracheostomy at presentation. Most 27 (81.8%) cases of laryngeal cancer presented late and in advanced stage. Only 6 (18.8%) patients with laryngeal cancer consented to total laryngectomy and 13(39.4%) opted for chemoradiation therapy. Three (9%) defaulted after emergency tracheostomy and direct laryngoscopy and biopsy. Nine patients (27.3%) defaulted after emergency tracheostomy before histological diagnosis.
Conclusion: There are challenges associated with management of patients with hoarseness in our locality. Most patients presented late and in critical situations. Suggestions for better management and strategies for better outcome were discussed

Keywords: Hoarseness, management challenges, laryngoscopy, laryngeal cancer, resource poor environment