Hoarseness, also known as dysphonia, is a condition characterized by an abnormal change in the quality of the voice. It can make the voice sound raspy, strained, breathy, weak, higher or lower in pitch, inconsistent, or fatigued, which can make it harder to speak. Hoarseness occurs when there is a problem in the vocal cords of the voice box (larynx) that affects the production of sound. The vocal cords, which are normally separated during breathing, come together and vibrate when making sound. Any factor that alters the vibration or closure of the vocal cords can lead to hoarseness.
There are various causes of hoarseness, including acute laryngitis, which is commonly caused by viral infections or voice strain. Non-cancerous vocal cord lesions, such as nodules, polyps, and cysts, can develop from prolonged trauma to the vocal cords due to factors like excessive talking or poor technique. Pre-cancerous or cancerous lesions on the vocal cords can also cause hoarseness and require medical evaluation. Neurological diseases or disorders, like Parkinson’s disease or stroke, can affect the vocal muscles and result in hoarseness. Vocal cord atrophy, a natural thinning and weakening of the vocal cords with age, can also contribute to hoarseness. Additionally, vocal cord hemorrhage, typically caused by strenuous vocal activity, can lead to temporary loss of voice.
Certain factors or conditions may be related to hoarseness. Reflux, where stomach acid flows up into the throat or voice box, known as laryngopharyngeal reflux (LPR), can contribute to hoarseness. Smoking is a significant risk factor for throat cancer and can cause permanent changes to the vocal cords, leading to hoarseness and airway obstruction in severe cases. Other factors like allergies, thyroid problems, trauma to the voice box, and hormonal changes during menstruation can also contribute to hoarseness.
The treatment for hoarseness depends on the underlying cause. Acute laryngitis usually resolves with rest and supportive care, while non-cancerous vocal cord lesions may require voice therapy or surgery. Pre-cancerous or cancerous lesions typically require surgical intervention and may be followed by radiation therapy or chemotherapy. Neurological disorders causing hoarseness may be managed with vocal cord augmentation or specialized voice techniques. Vocal cord atrophy can be addressed with voice therapy and sometimes vocal cord injection. In cases of vocal cord hemorrhage, resting the voice and avoiding blood thinners is usually sufficient.
It is important to seek medical evaluation from an ear, nose, and throat (ENT) specialist if hoarseness persists for more than four weeks, is accompanied by severe changes in voice, difficult breathing, pain when speaking, or if you are a vocal professional unable to perform your job. Prompt diagnosis and appropriate treatment can help prevent complications and ensure optimal vocal health