The hoarse voice is a general term that describes abnormal change of voice. In this situation, the voice may sound breathy, scratched, tense or there may be changes in the intensity or tone. Changes in sound mainly occur in disorders of the vocal cords. When you breathe, the vocal cords remain apart. When we speak or sing they contract and as the air leaves the lungs vibrate and produce sound.
There are many causes of hoarseness. Fortunately, most are not serious and disappear after a short period of time.
The most common causes are acute laryngitis (swelling of the vocal cords), which usually happens in the common cold, upper respiratory infections or intense voice (scream) e.g. on the sports field or in a concert. Prolonged hoarseness can occur when you use the voice much or too loudly, or improperly for long periods. These habits can cause a callus (callus) in the vocal cords (e.g. singers) or polyps (more extensive swelling of the vocal cords). The calluses are common in children or adults who cry aloud to play or work.
Another common cause of hoarseness in older adults is gastro-oesophageal reflux, i.e. when the gastric juice of the stomach and oesophagus reciprocates irritates the vocal cords. Usually the voice is worse in the morning and improves during the day. These people may have a feeling of a foreign body stuck in the throat, mucus or a strong desire to clear the throat.
Smoking is another cause of hoarseness. Because smoking is a major risk factor in cancer of the larynx if smokers are persistent hoarseness is advisable to visit the ENT doctor.
Other causes of hoarseness, not so common are allergies, thyroid diseases, injuries laryngeal, neurological disorders and rarely within the normal range, menstruation.
WHEN TO VISIT ENT?
1) If hoarseness lasts longer than two weeks.
2) If the hoarseness is accompanied by
• Difficulty swallowing
• A palpable mass in the neck
3) Total loss of voice or sudden change in voice lasting longer than a few days.
HOW IS HOARSENESS EXAMINED?
The ENT will examine the vocal cords by placing a mirror at the back of the neck. Sometimes you may need endoscopy of the larynx with flexible or rigid endoscope.
Treatment of hoarseness depends mainly on the cause. Most heal with rest, hoarse of voice (aphonia), or changing the use of the voice. If it is a vocal cord polyp it may need surgical removal. Avoidance of smoking or passive smoking is recommended for all patients. Good hydration (plenty of fluids) can help. The speech therapy in case of bad or hoarseness extensive use of voice can help.
WHAT CAN I DO FOR PROTECTION OR TREATMENT FOR MILD HOARSENESS?
• Stop or reduce smoking as much as possible.
• Avoid substances that dehydrate the body, such as alcohol and caffeine.
• Avoid passive smoking.
• Get plenty of fluids especially water.
• Use home humidifiers.
• Attention to diet (not many spicy).
• Try not to use your voice strongly for a long time.
• Avoid talking and singing when your voice is hoarse.