This study is designed to determine the most common causes of hoarseness in patients above 40 years of age and the relationship between hoarseness causes and its duration. The study is prospective in nature. It considers 80 patients with hoarseness who were assessed between April 2006 and April 2008 at my own clinic and at E.N.T. outpatient clinic, Department of Otolaryngology in AL-Diwiania Teaching Hospital, in Al-Diwaniya City, Iraq.Out of the 80 patients, 57 had hoarseness because of non neoplastic causes, giving an incidence of 71.25% (Infective laryngitis n=23,28.75%, Acid laryngitis n=17,21.25% , Allergic laryngitis n=13,16.25%, Vocal cord palsy n=2,2.5%, Psychogenic n=2,2.5% Traumatic n=0,0%, Rienke’s oedema n=0,0% ) while hoarseness occurs in the remaining 23 patients due to neoplastic causes, giving an incidence of 28.75% (laryngeal carcinoma n=12,15%,Polyp n=6,7.5%, Nodule n=3,3.75%, Cyst n=1,1.25%, Granuloma n=1,1.25%, Benign tumor n=0,0%). We also found that hoarse patients for a duration of more than one month were likely to have a neoplastic cause more than non neoplastic cause. The incidence of non neoplastic causes of hoarseness in patients more than 40 years old are more common than neoplastic causes. Moreover, hoarse patients who have a longer duration of hoarseness have a more chance to have neoplastic cause than non neoplastic cause.
