Dysphonie - Principales étiologies

<table border="1" cellpadding="5"><tbody><tr><td colspan="2" style="background-color: #e03623; text-align: center;"><span style="color: #ffffff;"><strong>Messages clés</strong></span></td></tr><tr><td colspan="2"><ul><li>Toujours rechercher une dyspnée et/ou une dysphagie associée (urgences),</li><li>Examen buccal, examen neurologique, recherche d'adénopathie et palpation thyroïdienne systématiques,</li><li>Tout patient présentant une dysphonie <strong>&gt; 8-15 jours</strong> doit être adressé en <strong>consultation <abbr data-tooltip="Oto-rhino-laryngologie">ORL</abbr></strong> pour réalisation d'une fibroscopie nasopharyngée.</li></ul></td></tr><tr><th colspan="2" style="text-align: center;"><strong>Principales étiologies</strong></th></tr><tr><td style="text-align: center;"><p data-automation-id="dyn-item-diagnostics-input" data-w-id="f27d2501-1f56-f448-3a92-48ff16835f7e" data-wf-id='["f27d2501-1f56-f448-3a92-48ff16835f7e"]'><strong>Lésions malignes et suspectes</strong></p></td><td><ul><li>Terrain éthylo-tabagique,</li><li>Apparition insidieuse,</li><li><strong>Biopsie.</strong></li></ul></td></tr><tr><td style="text-align: center;"><p data-automation-id="dyn-item-diagnostics-input" data-w-id="a7a3e137-2b2d-1884-b5e6-a56c3ead72e5" data-wf-id='["a7a3e137-2b2d-1884-b5e6-a56c3ead72e5"]'><strong>Lésions d'allure bénigne</strong></p></td><td><ul><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3d7e1c0c-6929-4806-b7c0-501385c2cc61" data-wf-id='["3d7e1c0c-6929-4806-b7c0-501385c2cc61"]'>Nodules des cordes vocales,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="e38baa6c-81ba-1cb0-0cb0-9447cb1d214d" data-wf-id='["e38baa6c-81ba-1cb0-0cb0-9447cb1d214d"]'>Granulomes du tiers postérieur des cordes causés par une intubation ou un <abbr data-tooltip="Reflux gastro-œsophagien">RGO</abbr>,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="bf6d22df-fbc0-162f-6635-3882c5ea28bf" data-wf-id='["bf6d22df-fbc0-162f-6635-3882c5ea28bf"]'>Papillomatose laryngée juvénile.</li></ul></td></tr><tr><td style="text-align: center;"><p data-automation-id="dyn-item-diagnostics-input" data-w-id="87a83878-1119-4534-addc-fe22922a4ca3" data-wf-id='["87a83878-1119-4534-addc-fe22922a4ca3"]'><strong>Immobilité d'une ou des cordes vocales</strong></p></td><td><ul><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Blocage articulaire : blocage de l'espace paraglottique :<ul><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Cancer,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Lésion post-traumatique après intubation,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Polyarthrite rhumatoïde,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Fibrose post-radique</li></ul></li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Atteinte de la voie motrice :<ul><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Chirurgie sur le trajet du X,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Envahissement du trajet du X par une tumeur,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Neuropathie diabétique,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Maladie mitrale,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Syndrome de Guillain-Barré,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Myasthénie,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'><abbr data-tooltip="Sclérose Latérale Amyotrophique">SLA</abbr>.</li></ul></li></ul></td></tr><tr><td style="text-align: center;"><p data-automation-id="dyn-item-diagnostics-input" data-w-id="2c511560-7687-bf28-7d24-dbc63d25af58" data-wf-id='["2c511560-7687-bf28-7d24-dbc63d25af58"]'><strong>Cordes vocales normales et mobiles</strong></p></td><td><ul data-automation-id="dyn-item-diagnostics-input" data-w-id="37ee2060-eab3-e9c7-ccce-bc963c662bdc" data-wf-id='["37ee2060-eab3-e9c7-ccce-bc963c662bdc"]' role="list"><li data-automation-id="dyn-item-diagnostics-input" data-w-id="82fe864b-1561-69a3-6d0a-8073eba5361f" data-wf-id='["82fe864b-1561-69a3-6d0a-8073eba5361f"]'>Troubles endocriniens : hypothyroïdie, hyperandrogénie,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="ba79f963-f74e-e93a-03e4-c7d406f76442" data-wf-id='["ba79f963-f74e-e93a-03e4-c7d406f76442"]'>Dysphonie par surmenage vocal,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="26a68d77-0122-5988-7f7b-51b3ba8a6a12" data-wf-id='["26a68d77-0122-5988-7f7b-51b3ba8a6a12"]'>Dysphonie d'origine psychique,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="68392f80-2192-e5d7-8a23-3bf24290b721" data-wf-id='["68392f80-2192-e5d7-8a23-3bf24290b721"]'>Dysphonie spasmodique,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="fb02c03f-c146-96da-6fc3-465d956437b5" data-wf-id='["fb02c03f-c146-96da-6fc3-465d956437b5"]'>Dysphonie myasthénique.</li></ul></td></tr></tbody></table>

<table border="1" cellpadding="5"><tbody><tr><td colspan="2" style="background-color: #e03623; text-align: center;"><span style="color: #ffffff;"><strong>Messages clés</strong></span></td></tr><tr><td colspan="2"><ul><li>Toujours rechercher une dyspnée et/ou une dysphagie associée (urgences),</li><li>Examen buccal, examen neurologique, recherche d'adénopathie et palpation thyroïdienne systématiques,</li><li>Tout patient présentant une dysphonie <strong>&gt; 8-15 jours</strong> doit être adressé en <strong>consultation <abbr data-tooltip="Oto-rhino-laryngologie">ORL</abbr></strong> pour réalisation d'une fibroscopie nasopharyngée.</li></ul></td></tr><tr><th colspan="2" style="text-align: center;"><strong>Principales étiologies</strong></th></tr><tr><td style="text-align: center;"><p data-automation-id="dyn-item-diagnostics-input" data-w-id="f27d2501-1f56-f448-3a92-48ff16835f7e" data-wf-id='["f27d2501-1f56-f448-3a92-48ff16835f7e"]'><strong>Lésions malignes et suspectes</strong></p></td><td><ul><li>Terrain éthylo-tabagique,</li><li>Apparition insidieuse,</li><li><strong>Biopsie.</strong></li></ul></td></tr><tr><td style="text-align: center;"><p data-automation-id="dyn-item-diagnostics-input" data-w-id="a7a3e137-2b2d-1884-b5e6-a56c3ead72e5" data-wf-id='["a7a3e137-2b2d-1884-b5e6-a56c3ead72e5"]'><strong>Lésions d'allure bénigne</strong></p></td><td><ul><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3d7e1c0c-6929-4806-b7c0-501385c2cc61" data-wf-id='["3d7e1c0c-6929-4806-b7c0-501385c2cc61"]'>Nodules des cordes vocales,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="e38baa6c-81ba-1cb0-0cb0-9447cb1d214d" data-wf-id='["e38baa6c-81ba-1cb0-0cb0-9447cb1d214d"]'>Granulomes du tiers postérieur des cordes causés par une intubation ou un <abbr data-tooltip="Reflux gastro-œsophagien">RGO</abbr>,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="bf6d22df-fbc0-162f-6635-3882c5ea28bf" data-wf-id='["bf6d22df-fbc0-162f-6635-3882c5ea28bf"]'>Papillomatose laryngée juvénile.</li></ul></td></tr><tr><td style="text-align: center;"><p data-automation-id="dyn-item-diagnostics-input" data-w-id="87a83878-1119-4534-addc-fe22922a4ca3" data-wf-id='["87a83878-1119-4534-addc-fe22922a4ca3"]'><strong>Immobilité d'une ou des cordes vocales</strong></p></td><td><ul><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Blocage articulaire : blocage de l'espace paraglottique :<ul><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Cancer,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Lésion post-traumatique après intubation,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Polyarthrite rhumatoïde,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="3a653f86-88e4-cd92-2102-6977d3a9940b" data-wf-id='["3a653f86-88e4-cd92-2102-6977d3a9940b"]'>Fibrose post-radique</li></ul></li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Atteinte de la voie motrice :<ul><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Chirurgie sur le trajet du X,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Envahissement du trajet du X par une tumeur,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Neuropathie diabétique,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Maladie mitrale,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Syndrome de Guillain-Barré,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'>Myasthénie,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="652cd6d9-ddbc-8b5b-8480-846c9763c95b" data-wf-id='["652cd6d9-ddbc-8b5b-8480-846c9763c95b"]'><abbr data-tooltip="Sclérose Latérale Amyotrophique">SLA</abbr>.</li></ul></li></ul></td></tr><tr><td style="text-align: center;"><p data-automation-id="dyn-item-diagnostics-input" data-w-id="2c511560-7687-bf28-7d24-dbc63d25af58" data-wf-id='["2c511560-7687-bf28-7d24-dbc63d25af58"]'><strong>Cordes vocales normales et mobiles</strong></p></td><td><ul data-automation-id="dyn-item-diagnostics-input" data-w-id="37ee2060-eab3-e9c7-ccce-bc963c662bdc" data-wf-id='["37ee2060-eab3-e9c7-ccce-bc963c662bdc"]' role="list"><li data-automation-id="dyn-item-diagnostics-input" data-w-id="82fe864b-1561-69a3-6d0a-8073eba5361f" data-wf-id='["82fe864b-1561-69a3-6d0a-8073eba5361f"]'>Troubles endocriniens : hypothyroïdie, hyperandrogénie,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="ba79f963-f74e-e93a-03e4-c7d406f76442" data-wf-id='["ba79f963-f74e-e93a-03e4-c7d406f76442"]'>Dysphonie par surmenage vocal,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="26a68d77-0122-5988-7f7b-51b3ba8a6a12" data-wf-id='["26a68d77-0122-5988-7f7b-51b3ba8a6a12"]'>Dysphonie d'origine psychique,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="68392f80-2192-e5d7-8a23-3bf24290b721" data-wf-id='["68392f80-2192-e5d7-8a23-3bf24290b721"]'>Dysphonie spasmodique,</li><li data-automation-id="dyn-item-diagnostics-input" data-w-id="fb02c03f-c146-96da-6fc3-465d956437b5" data-wf-id='["fb02c03f-c146-96da-6fc3-465d956437b5"]'>Dysphonie myasthénique.</li></ul></td></tr></tbody></table>