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Hoarseness, an abnormal change in your voice, can be the result of a disorder in the vocal cords (sound producing parts) of the larynx (voice box). Your voice may sound strained and raspy when you are hoarse. There may also be changes in pitch and volume of your voice.

Causes and Concerns

When you breathe, the vocal cords normally remain separated. By comparison, when you speak or sing, the cords come closer together. When air escapes from the lungs, the vocal cords vibrate and produce sounds. Lumps or swelling of the cords hampers these vibrations changing your voice’s volume, pitch and/or quality. Acute laryngitis is the most prevalent cause of hoarseness and is defined as an inflammation of your larynx. This inflammation can be caused by voice strain, common colds or other upper respiratory tract infections. Chronic hoarseness can also be caused by problems with the voice box, smoking and reflux. Other causes of hoarseness include:

  • Benign vocal cord lesions: Hoarseness can result when overusing your voice or speaking too loudly for a prolonged period. These practices can result in the formation of polyps, cysts or nodules. The latter are characterized by callus-like vocal cord growths. Cysts and polyps can develop whether you misuse your voice or not.
  • Vocal hemorrhage: If you suddenly lose your voice after yelling or some other strenuous use of your voice, you may have suffered a vocal cord hemorrhage. This happens when a blood vessel ruptures on the surface of the cords and soft tissues fill with blood. Considered a vocal emergency, total voice rest and examination by a throat specialist (otolaryngologist) is required.
  • Gastroesophageal reflux disease (GERD): Another cause of hoarseness is gastro-esophageal reflux. Stomach acids back up into the esophagus (swallowing tube) irritating the vocal cords. Other symptoms of GERD are regurgitation and/or heartburn. A patient’s voice will be worse in the morning and then usually recover. They can have the feeling of a lump and/or mucus in the throat and a constant urge to clear it.
  • Laryngopharyngeal reflux disease: When the reflux makes it into the back part of the throat, it is known as LPRD. The larynx, pharynx and lungs are very sensitive to stomach acids/digestive enzymes, so small amounts of reflux can cause more damage.
  • Smoking: Smoking also causes hoarseness. It is the main cause of cancer of the throat. Therefore, if smokers develop hoarseness, they should consult a throat specialist.
  • Neurological disorders: Hoarseness can develop in individuals who have neurological disorders like Parkinson’s, stroke or spasmodic dysphonia (a rare neurological disorder affecting the voice and occasionally breathing). Paralyzed vocal cords could be the reason for a weak voice. If hoarseness lasts for longer than three months and other reasons are disproven, you need to consider seeing a throat specialist.
  • More causes: Larynx damage, allergies and thyroid conditions all can lead to hoarseness. Dangerous conditions, including laryngeal cancer, can cause hoarseness. This is why it is very important to have prolonged hoarseness evaluated as soon as possible.

Symptoms and Signs

There are many other symptoms and signs that accompany hoarseness. Some of these are indicators of a serious underlying health problem. You should see a throat specialist if you have any of the following:

  • Hoarseness persisting for more than three weeks, especially if you are a smoker
  • No other symptoms of a cold/flu
  • Coughing up blood
  • Difficulty swallowing
  • A lump in your neck or throat
  • Changes in your voice which last for more than a few days
  • Pain when speaking and swallowing
  • Difficulty breathing along with your voice change(s)
  • A singer who cannot perform

Solutions and options

To find a solution and offer you options, one of our ear, nose and throat specialists will take a complete history and do a physical examination. Afterwards, an evaluation of your voice is done. An examination of the vocal cords by laryngoscopy will likely be advised. This procedure should be performed immediately if your doctor is especially concerned that there is a serious underlying cause for your hoarseness.

Treatment for hoarseness is cause dependent. Generally, hoarseness can be addressed by simple voice rest or voice use modifications. The doctor may recommend that you use modification behaviors or may refer you to other specialists if necessary.

Regardless of the cause of your hoarseness, not smoking and staying away from secondhand smoke is always in your best interest. If you or someone you love has hoarseness or any of the symptoms associated with this condition, contact our office for an appointment. Our caring ear, nose and throat specialists can help you find a solution to your symptoms.