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What Causes Hoarse Voice And Difficulty In Swallowing?

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Posted on Thu, 15 Jun 2017
Question: I have a follow-up question to the one posted below. I forgot to mention I have developed a hoarse voice, and difficulties with my singing voice. Both my upper and lower registers are impaired, to the point where I can no longer sing in my choir. Could there be any connection to my swallowing difficulties, as outlined below?
Thanks.

Hello, I recently had a barium swallow for dysphagia; in my case it presents as food being stuck high up in my throat so I have to wash it down. This has been going on for 6-9 months. The report came back saying: "There is apparent discoordination of swallowing function, resulting in reflux of the barium from the pharynx superiorly, reaching the hard palate and a small amount of barium even reaches the nasopharynx....Large amounts of residue seen in the vallecula requiring multiple swallows." The report said all structures were normal, no significant findings of cervical spondylosis, no Zenker's diverticulum, Cricopharyngeus muscle not hypertrophied. Cervical and thoracic oesophagus fully distensible. No mucosal based abnormality seen in the thoracic oesophagus, no stricture identified, no significant motility abnormality seen in the oesophagus. No hiatal hernia, no demonstrable reflux.

I'm being referred to a speech language pathologist for a detailed swallow analysis, and to a neurologist - which is the part that scares me, especially after seeking out Dr. Google. There is a familial tendency for dysphagia: both my mother and aunt developed choking problems in their 50s. As far as I know, those problems were neither investigated nor treated. I am wondering if there are less frightening possibilities than a neurological cause. Is there such a thing as idiopathic familial dysphagia?

I won't get to see a neurologist for quite a while - in Canada, you wait your turn. This is making me very anxious.

Thank you.
doctor
Answered by Dr. Priyanka Aggarwal (4 hours later)
Brief Answer:
Dysphagia

Detailed Answer:
Hi
Thanks for the information.
The contrast being held up in the vallecula points towards some pathology there. It can be a growth also. as you have symptoms both of dysphagia and hoarseness, I would advise you to get an endoscopic examination of the throat done by an ENT SPECIALIST to rule out any such cause.
The cause can be neurological also but It is far less common. In familial dysphagia there is no change in voice at all. So my advise is you should get yourself examined by an ENT SPECIALIST as early as possible.
Another thing that should be done is CECT neck and thorax.
Any further questions are always welcome.
Wish you get well soon.
Thanks and regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Priyanka Aggarwal (13 hours later)
I did have an endoscopic examination of my throat by an ENT - or at least I think I did. A small camera on a tube through my nose and down my throat. All looked normal. The report from the barium swallow said all structures were normal, and the ENT said there were no masses. I do not get a followup appointment with the ENT unless the speech language pathologist recommends it.
doctor
Answered by Dr. Priyanka Aggarwal (10 hours later)
Brief Answer:
Dysphagia

Detailed Answer:
Hi
Thanks for the information.
You have got endoscopic examination of the throat done. As the results of both barium swallow study and endoscopy rule out any growth or mass, my advice is you should consult a neurologist to rule any functional cause of dysphagia. As you have complaints concerning both swallowing and voice, it can be a higher centres lesion. So you should visit a neurologist for this.
The treatment will be according to the diagnosis. Any neural loss is to be managed by physiotherapy that includes speech and swallowing assistance.
Any further questions are always welcome.
Wish you get well soon.
Thanks and regards
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Priyanka Aggarwal

ENT Specialist

Practicing since :2008

Answered : 1389 Questions

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What Causes Hoarse Voice And Difficulty In Swallowing?

Brief Answer: Dysphagia Detailed Answer: Hi Thanks for the information. The contrast being held up in the vallecula points towards some pathology there. It can be a growth also. as you have symptoms both of dysphagia and hoarseness, I would advise you to get an endoscopic examination of the throat done by an ENT SPECIALIST to rule out any such cause. The cause can be neurological also but It is far less common. In familial dysphagia there is no change in voice at all. So my advise is you should get yourself examined by an ENT SPECIALIST as early as possible. Another thing that should be done is CECT neck and thorax. Any further questions are always welcome. Wish you get well soon. Thanks and regards