Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-26T12:57:37.506Z Has data issue: false hasContentIssue false

Hoarseness secondary to haemodialysis: case report and literature review

Published online by Cambridge University Press:  29 June 2012

M Santhirakumar*
Affiliation:
Department of ENT Surgery, Tameside General Hospital, Ashton-under-Lyne, UK
C Q Phua
Affiliation:
Department of ENT Surgery, Tameside General Hospital, Ashton-under-Lyne, UK
Y Karagama
Affiliation:
Department of ENT Surgery, Tameside General Hospital, Ashton-under-Lyne, UK
*
Address for correspondence: Dr M Santhirakumar, Tameside General Hospital, Fountain Street, Ashton-under-lyne, OL6 9RW, UK Fax: +44 (0)161 331 6457 E-mail: [email protected]

Abstract

Introduction:

Hoarseness is common and can have a major impact on patients’ quality of life. We report a rare case of hoarseness secondary to haemodialysis.

Case report:

A 62-year-old man described developing transient hoarseness after haemodialysis sessions, which he underwent three times weekly. Fibre-optic nasendoscopy showed incomplete glottis closure due to bowing of the vocal folds. A computed tomography scan of the neck and thorax was unremarkable. Speech therapy was unhelpful. The renal physicians concluded that no change could be made to his dialysis regime. The patient subsequently underwent injection laryngoplasty with calcium hydroxylapatite, with marked improvement of his symptoms.

Discussion:

A literature search found one relevant article reporting that 60 per cent of patients suffered post-dialysis hoarseness and decreased vocal fold thickness. It is postulated that dialysis causes dehydration of Reinke's space, affecting vocal fold thickness and the patient's voice.

Conclusion:

Hoarseness caused by haemodialysis is uncharted territory. Further research is required to determine its prevalence and contributing factors.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Laryngology Conference, 20–22 June 2011, London, UK

References

1 Schwartz, S, Cohen, S, Dailey, S, Rosenfeld, R, Deutsch, E, Gillespie, M et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck 2009;141:131 CrossRefGoogle ScholarPubMed
2 Carding, P. Voice pathology in the United Kingdom. BMJ 2003;327:514–15CrossRefGoogle ScholarPubMed
3 Ulis, J, Yanagisawa, E. What's new in differential diagnosis and treatment of hoarseness? Curr Opin Otolaryngol 2009;17:209–15CrossRefGoogle ScholarPubMed
4 Hopkins, C, Yousaf, U, Pedersen, M. Acid reflux treatment for hoarseness. Cochrane Database Syst Rev 2006;(1):CD005054CrossRefGoogle ScholarPubMed
5 Rosen, C, Anderson, D, Murry, T. Evaluating hoarseness: keeping your patient's voice healthy. Am Fam Physician 1998;57:2775–82Google ScholarPubMed
6 Fisher, K, Ligon, J, Sobecks, J, Roxe, D. Phonatory effects of body fluid removal. J Speech Lang Hear R 2001;44:354–67CrossRefGoogle ScholarPubMed
7 Solomon, N, DiMattia, M. Effects of a vocally fatiguing task and systemic hydration on phonation threshold pressure. J Voice 2000;14:341–62CrossRefGoogle ScholarPubMed
8 Verdolini, K, Min, Y, Titze, I, Lemke, J, Brown, K, van Mersbergen, M et al. Biological mechanisms underlying voice changes due to dehydration. J Speech Lang Hear R 2002;45:268–81CrossRefGoogle ScholarPubMed
9 Yurdakok, K, Ozmert, E. Hoarse cry: a sign of dehydration. Lancet 1995;346:1306CrossRefGoogle ScholarPubMed
10 Ori, Y, Sabo, R, Binder, Y, Weinstein, T, Korzets, A, Ori, G et al. Effect of hemodialysis on the thickness of vocal folds: a possible explanation for postdialysis hoarseness. Nephron Clin Pract 2006;103:144–8CrossRefGoogle ScholarPubMed
11 Kwon, T, An, S, Ahn, J, Kim, K, Sung, MW. Calcium hydroxylapatite injection laryngoplasty for the treatment of presbylaryngis: long-term results. Laryngoscope 2010;120:326–9CrossRefGoogle ScholarPubMed
12 Rosen, C, Gartner-Schmidt, J, Casiano, R, Anderson, T, Johnson, F, Remacle, M et al. Vocal fold augmentation with calcium hydroxylapatite: twelve-month report. Laryngoscope 2009;119:1033–41CrossRefGoogle ScholarPubMed