Hoarseness

Hoarseness can be a temporary disruption caused by vocal strain or a more persistent issue related to acute laryngitis or damage to structures within your throat.

• Treatment for hoarseness will depend on what’s causing it.
• While over-the-counter decongestants and resting your voice for a few days may help, recurring or persistent hoarseness often results in a referral to an ear, nose, and throat doctor to identify the source of the problem.

Causes of Hoarseness

It’s some type of irritation or damage to the vocal cords that often causes hoarseness. Located in the larynx (“voice box”), vocal cords are bands of muscle that vibrate to produce sounds. If the vocal folds become severely inflamed, it’s a condition called laryngitis, which may contribute to hoarseness. Vocal cords can also be affected by upper respiratory tract infections, benign (non-cancerous) nodules, cysts or polyps, or neurological conditions such as Parkinson’s disease. Contributing factors or underlying issues may also include:

• Seasonal or chronic allergies
• Thyroid conditions
• Vocal cord trauma or injury
• Cancer affecting the voice box or vocal cords
• Inhaled respiratory tract irritants
• Gastroesophageal reflux (GERD)

Signs and Symptoms

Having a harsh or raspy voice is usually the first noticeable sign of hoarseness. It’s possible for vocal tone or quality to suddenly change, as may be the case with vocal strain or hoarseness that develops after a fit of coughing. Symptoms sometimes develop slowly or become progressively worse as you speak.

Evaluation and Diagnosis

Diagnosis of hoarseness typically starts with a physical examination of your neck and throat. A lighted fiberoptic scope may be inserted orally to visually inspect your vocal cords and nearby structures. If growths are discovered during an initial examination, additional testing for throat cancer may be done.

Treatments for Hoarseness

Hoarseness caused by acute laryngitis or an upper respiratory tract infection may resolve itself with little or no treatment. Cough suppressants may ease discomfort from coughing as the vocal cords heal. If the underlying cause is vocal cord irritation, making changes to your diet and resting your voice for a few days sometimes resolves the problem.

When the primary source of the problem is smoking, cessation treatments are usually recommended. Adapting a low-calorie diet and exercise regimen during the process of quitting smoking may help to prevent weight gain smokers sometimes experience during the process of quitting. If hoarseness was caused by vocal misuse, you may be advised to consider voice therapy.

Medications can help with hoarseness related to GERD or allergies. Antibiotics are usually used to treat bacterial throat infections. Surgery may be necessary if the underlying cause is benign nodules or polyps. If cancer is detected with a biopsy, the affected vocal cord tissues may need to be removed. With situations like this, reconstructive surgery is often done to restore the ability to speak.

If hoarseness isn’t related to an underlying condition, it may be preventable by avoiding excessive vocal strain. For instance, if your job requires regular speaking or you are professional singer, drinking more water and practicing proper breathing techniques may help. Avoiding smoking and alcoholic beverages can also be helpful since chemicals in cigarettes and the potency of alcohol can irritate mucous membranes. Using a humidifier during cooler months when you are indoors more often may minimize issues with seasonal hoarseness caused by airborne irritants.