Hoarseness

Hoarseness is caused by an issue with the vocal cords and may involve an inflamed larynx. A hoarse voice may have a raspy, weak or airy quality that makes it difficult to make smooth vocal sounds. Persistent hoarseness that lasts for more than 10 days may be a sign of a serious underlying medical condition.

The main cause of hoarseness is a viral infection in the upper respiratory tract. Other factors that may cause, contribute to, or worsen hoarseness include:

• Stomach acid reflux
• Tobacco smoking
• Allergies
• Drinking caffeinated and alcoholic beverages
• Inhaling toxic substances
• Coughing excessively
• Screaming, prolonged singing, or overuse of the vocal cords
• Common cold or upper respiratory tract viral infection
• Rheumatoid arthritis
• Other less common causes:
  • Throat, thyroid or lung cancer
  • Polyps (or abnormal growths) on the vocal cords
  • Deepening of the voice during male adolescence
  • Poorly functioning thyroid gland
  • Damage to the throat, such as from the insertion of a breathing tube
  • Nerve or muscle condition that weakens the voice box function
  • Thoracic aortic aneurysm

Hoarseness may be a sign of a serious condition if:

• It lasts for more than 7 days in a child or 10 days in an adult
• It is accompanied by drooling (in a child) and difficulty swallowing or breathing
• The individual is suddenly unable to speak clearly

If an individual is struggling with breathing, the physician may offer a breathing treatment (such as a mask) or insert a breathing tube into the airway to assist in breathing. The physician will then observe and record the patient’s symptoms and review the patient’s medical history.

Next, the physician will ask about:

• The quality and strength of the voice
• The frequency and duration of symptoms
• Factors that worsen symptoms

A breathy voice may indicate poor vocal cord function, which may be caused by a polyp, benign tumor or larynx cancer.

A raspy voice may suggest vocal cord thickening due to swelling, a chemical irritant, voice abuse, inflammation from infection, or paralysis of the vocal cords.

A high, shaky or soft voice may indicate difficulty getting enough breathing force or air.

An examination of the throat with a light and tiny mirror may help reveal inflammation or abnormalities. The physician may take a throat culture and order an X-ray exam or a CT scan of the throat.

Patients without a serious underlying medical condition may remedy their hoarseness by:

• Resting the voice for a few days.
• Drinking plenty of hydrating fluids.
• Avoiding caffeine and alcohol.
• Using a humidifier to add moisture to the air.
• Taking a hot shower.
• Quitting or limiting smoking.
• Improving indoor air quality.
• Moistening the throat by sucking on lozenges or chewing gum.
• Avoiding the use of decongestants.

Individuals who don’t experience relief after taking these steps should see their doctor for medical treatment.

Treatment for hoarseness will depend on the condition causing the hoarseness. Patients with nodules or polyps on the vocal folds may need surgery.