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A teacher's voice turns hoarse every term — vocal nodules; voice therapy, not surgery first. Screamer's/singer's nodes (bilateral nodules at cord midpoint — voice abuse): voice therapy + rest resolves; polyps (unilateral — smokers/hemorrhagic: microlaryngeal excision). Laryngitis (viral — hoarseness; voice rest, hydration; chronic — smoking, GERD, shouting). Vocal cord palsy (recurrent laryngeal nerve — thyroid surgery, lung/esophageal cancer, idiopathic: breathy hoarseness; paramedian — stridor if bilateral). Stridor (croup — children barking cough, nebulized adrenaline; epiglottitis — drooling, toxic, don't examine throat — secure airway). Hoarseness >3 weeks in smokers = laryngoscopy — cancer until proven.