Hoarseness is an abnormal deep, harsh voice caused by a variety of conditions. Hoarseness is simply a term used to describe a voice that sounds raspy, strained or deeper in pitch. Changes in the voice are usually caused by a swelling, lump or bump on the vocal folds, the sound-producing portion of the larynx (or voice box). The vocal folds remain apart when breathing, but the sound is created when the vocal folds vibrate together. Swelling or other conditions which keep the vocal folds from coming together to vibrate properly can cause hoarseness or a change in voice pitch. These vocal fold conditions can be caused by straining the voice or by a relatively benign illness such as laryngitis. However, chronic, prolonged or reoccurring hoarseness may be a symptom of a more serious condition, such as a tumor of the larynx, and should be checked out by an otolaryngologist.
What causes hoarseness?
Hoarseness is generally caused by irritation of, or injury to, the vocal cords. The larynx (also referred to as the voice box), is the portion of the respiratory (breathing) tract containing the vocal cords. The cartilaginous outer wall of the larynx is commonly referred to as the “Adam’s apple.” The vocal cords are two bands of muscle that form a “V” inside the larynx. When we sing or speak, the vocal cords vibrate and produce sound. Hoarseness can be caused by a number of conditions. The most common cause of hoarseness is acute laryngitis (inflammation of the vocal cords) caused by an upper respiratory tract infection (usually viral), and less commonly from overuse or misuse of the voice (such as from yelling or singing).
What are the signs and symptoms of hoarseness?
Hoarseness typically gives the voice a raspy and harsh quality, though it may also cause a change in the pitch or volume of the voice. The rapidity of onset and any associated symptoms will depend on the underlying cause leading to hoarseness.
How are the causes of hoarseness diagnosed?
Your Otolaryngologist will ask questions about hoarseness and any other associated symptoms. A physical exam will focus on the head and neck. Often times, a diagnosis can be made based on this initial assessment. In some instances, a long lighted flexible tube (fiberoptic scope) will be inserted into the throat to directly visualize the vocal cords if no other cause is initially identified.
What is the treatment for hoarseness?
The treatment for hoarseness depends on the underlying cause, for example:
- Acute laryngitis caused by an upper respiratory tract infection will usually improve on its own as the infection clears the body.
- Voice rest is also recommended in order to avoid further irritation or injury to the vocal cords.
- Antibiotics are not indicated for most cases of acute laryngitis.
- Individuals with hoarseness caused by vocal overuse or misuse should adhere to voice rest, as serious injury can occur to the vocal cords if the voice is strenuously used during episodes of acute laryngitis.
- Medications for gastroesophageal reflux (GERD) or allergies can treat hoarseness if either of these is found to be the underlying cause. In some instances, surgery may be necessary for benign nodules or polyps, trauma to the larynx/vocal cords and for cancer of the larynx.
How is hoarseness prevented?
Hoarseness can be prevented in some instances, for example:
- Avoid situations that require excessive strenuous voice use, and if a person needs to project their voice, use a microphone if possible.
- Voice therapists or singing teachers may be helpful in certain cases to assist individuals with vocal training and voice modification.
- Smoking cessation can prevent hoarseness or the development of cancer of the larynx.
- Individuals with hoarseness caused by gastroesophageal reflux (GERD) can benefit from medications and dietary modification (such as avoiding alcohol, caffeine and spicy foods).