Hoarseness : Causes, Types, Treatment and Symptoms

When your voice gets hoarse, it sounds rough, raspy, strained, or like you’re out of breath. When the vocal cords in the larynx (voice box) get irritated or inflamed, this change happens. Hoarseness usually goes away on its own, but if it lasts a long time or is very bad, it could be a sign of a more serious health issue.

Most common hoarseness symptoms:

• Rough or raspy tone that appears as if you are struggling to talk
• Voice fatigue and reduced volume
• A breathy or strained quality occurs when air escapes too quickly through the vocal cords.
• Lower or higher pitch voice
• A scratchy or sore throat that gives you a constant urge to clear your throat
• Pain when speaking or swallowing

Common, Uncommon or Underlying Causes of Hoarseness

Hoarseness, a common symptom of vocal cord issues, can stem from a wide range of causes, from temporary, everyday conditions to more serious underlying medical issues like neurological disorders or systemic diseases. If hoarseness is persistent or severe, it’s crucial to consult a healthcare professional to identify the correct cause and ensure appropriate treatment.

• Benign growths of nodules, polyps, or cysts in the vocal cords
• Stomach acid that rises into the throat (Laryngopharyngeal acid reflux) can irritate the vocal cords and make you sound worse, especially in the morning.
• Smoking may lead to chronic laryngitis and may lead to laryngeal cancer
• Cheering loudly, speaking in an unnatural tone, and prolonged singing
• Viral infections like the common cold cause acute laryngitis
• Hoarseness can also be caused from thyroid problems, allergies and other neurological issues like
• Parkinson’s and age-related vocal changes

When to Seek a Specialist for Your Hoarseness?

If your hoarseness persists for more than three to four weeks or is accompanied by other severe symptoms, you should consult a specialist, usually an otolaryngologist (ENT). A professional evaluation is necessary to rule out serious underlying issues, such as cancer, even though many cases of hoarseness are caused by transient conditions like a cold or excessive voice use.

• If the hoarseness is persistent for three to four weeks
• If it gets progressively worse and doesn’t improve with treatments
• Interferes with your profession
• Accompanied by other symptoms, such as:
  – Coughing up blood
  – Lump in the neck
  – Difficulty swallowing or breathing
• Pain when speaking or swallowing
• Complete loss of voice for more than a few days
• Appears after a surgery or trauma
• Drooling in a small child may indicate epiglottitis

Don’t wait for signs to grow severe. Consult our ENT specialists today

Diagnostic Approach for Hoarseness

You must be particularly vigilant and seek medical attention from a voice specialist, such as an ENT specialist or a laryngologist, who can conduct a comprehensive examination to identify the cause of hoarseness.

• They ask you about your symptoms, complete medical history, and lifestyle habits (smoking), and evaluate your voice based on how you use your voice for work, home and other scenarios.
• The vocal cords are directly examined for inflammation, growths, or paralysis using an endoscope, a thin, flexible tube equipped with a camera. Videostroboscopy, a type of advanced imaging, provides a slow-motion view of vocal cord vibrations for more detailed information.
• Based on your diagnosis, they may create an appropriate treatment plan, including voice therapy, medication, and if required, surgery for any benign growths and vocal cord conditions.

Types of Hoarseness

Hoarseness is an umbrella term for a variety of changes in voice quality. Doctors and speech-language pathologists classify hoarseness based on the underlying cause, which can be related to inflammation, vocal cord growths, neurological issues, or muscular problems.

Some common types of Hoarseness include:

• Inflammatory/Irritant Hoarseness:
  – Acute laryngitis – due to a cold, viral infection, or yelling
  – Chronic laryngitis – long-term exposure to smoking, acid reflux, or pollutants.
• Lesional Hoarseness:
  – Reinke’s edema – caused by fluid buildup due to heavy smoking
  – Recurrent respiratory papillomatosis (RRP) – from human papillomavirus
• Neurological Hoarseness:
  – Vocal cord paralysis – caused by a neck surgery or a neurological disease
  – Hoarseness from systemic diseases – seen in Parkinson’s, multiple sclerosis, and myasthenia gravis.
  -Spasmodic dysphonia – involuntary spasm of the vocal cords.
• Functional Hoarseness:
  – Muscle tension dysphonia – muscles surrounding the voice box are too tight.
  – Psychogenic dysphonia – occurs during severe psychological stress or trauma.
• Age-related Hoarseness (Presbyphonia): the muscles around the vocal cords lose their mass and elasticity.
• Husky or Breathy Hoarseness: when air leaks between the vocal cords as they are not closed properly.
• Rough or Raspy Hoarseness: when the vocal cords vibrate at different pitches.

How to Treat Hoarseness Symptoms?

To treat hoarseness, you can use home care remedies, make lifestyle adjustments, or seek medical treatment, depending on the cause. Acute hoarseness from a cold or overuse often resolves on its own, but persistent or severe cases require professional medical attention.

For underlying causes, treatments & management strategies include:

• Try to avoid whispering to allow less strain on the vocal cords
• Breath moist air through a humidifier, or inhale hot shower steam
• Rest your vocal cords as much as possible
• Stay hydrated to keep your vocal cords moist
• Avoid irritants and certain beverages
• Drink warm herbal teas or ginger teas
• If any underlying conditions are identified, make sure you consult your specialist before
• making the final decision.

What If Hoarseness are Left Untreated?

Leaving hoarseness untreated can lead to permanent voice damage, vocal cord growths, and a worsening of the underlying condition, which in rare cases can be cancer. While temporary hoarseness often resolves on its own, chronic cases require a medical evaluation to prevent these complications.

Some possible complications of an untreated Hoarseness include:

• Untreated vocal strain can lead to the formation of benign tumors on the vocal cords, including nodules, polyps, and cysts.
• Permanent changes in the voice quality, making it rough and weak.
• If acid reflux is left untreated, it can cause scarring, chronic inflammation, or even ulcers.
• If laryngitis is left untreated, it can lead to respiratory distress.
• If laryngeal cancer is left undiagnosed, the early-stage cancer can become fatal and metastasise.
• Interferes with the person’s ability to communicate effectively
• Social anxiety, reduced self-esteem, and social withdrawal

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