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==References==
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=== Observations of abnormal voice and relevant morbidities ===
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Clinical observations in change of voice can be suggestive of probable underlying morbidities.<ref name="Mamidi P."/> These are summarized in the following table 4.
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{| class="wikitable"
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|+ Table 4: Bad prognostic factor related to change in voice 
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|-
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!  Abnormal voice!! Relevant disease or pathology
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|-
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| | Hoarseness or raspyness like a sheep [Cha.Sa.[[Indriya Sthana]] 1/14]  || Due to structural changes of vocal cords (Acute or chronic laryngitis, Polyps etc);
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|-
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| |  Feeble [Cha.Sa.[[Indriya Sthana]] 1/14]  ||  Aphonic palilalia; Hypophonia; Paresis of vocal cords; LMN (lower motor neuron) lesions;
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|-
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| | Subdued or Inaudible) [Cha.Sa.[[Indriya Sthana]] 1/14]  || Aphonia; Hypophonia; LMN (lower motor neuron) lesions; ALS (Amyotrophic lateral sclerosis); MG (Myasthenia gravis); TIA (Transient ischemic attack) etc;
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|-
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| |  Indistinct  or Indistinguishable)  [Cha.Sa.[[Indriya Sthana]] 1/14]  ||  Aphonia; Aphonic palilalia; Progressive supranuclear palsy; Bilateral upper brainstem lesions;
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|-
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| |  Chocked or stammering [Cha.Sa.[[Indriya Sthana]] 1/14]  || Spastic or Spasmodic dysphonia; Dysarthria (bilateral cerebral lesions, cerebral glioma of parietal origin etc);
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|-
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| | Hoarse or rough [Cha.Sa.[[Indriya Sthana]] 1/14]  ||  Hyperkinetic dysarthria; Structural lesions and inflammatory conditions of larynx;
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|-
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| | Faint or painful [Cha.Sa.[[Indriya Sthana]] 1/14]  || Dysphasia; Dysphonia; Motor or Broca’s Aphasia; Inflammatory lesions of the pharynx and larynx; Neoplasms of larynx, pharynx, lungs, and thyroid; Lymphoma; Mediastinal metastases pressing laryngeal nerves; Unilateral vocal cord palsy (UVCP) etc;
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|-
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| | Stuttering or stammering [Cha.Sa.[[Indriya Sthana]] 1/14]  ||  Spastic paralysis; Dysarthria; Rigidity; Spasms of muscles of articulation;
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|-
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| | Other abnormal voices  [Cha.Sa.[[Indriya Sthana]] 1/15]  ||  Migraine Aura; TIA; MG; ALS; LMN lesions; UVCP; Multiple sclerosis (MS); Epilepsy; Carcinomas of larynx, pharynx, lungs, and thyroid; Lymphoma; Mediastinal metastasis; Cancer cachexia etc;
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|-
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|}
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=== Acknowledgement ===
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The contributors acknowledge support of Dr. M. Prasad and Dr.G.Kshama for providing tables from their published article referred in this chapter.
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== References ==
    
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