Hoarseness of Voice

What is Hoarseness?


Hoarseness is the pathology that refers to the difficulty when trying to speak. Vocal sounds may be weak, high-pitched, or hoarse, and the pitch or quality of the voice may change.

It is a disease caused by problems inside the vocal cords, which are part of the larynx and are located in the throat. When they have an infection, they swell, which can cause hoarseness. When there is hoarseness, the voice may sound breathless, raspy, strained, or there are changes in loudness or pitch.

There are two types of hoarseness; the acute, which is short-term and is caused by diseases such as a cold, and the chronic, long-term, and most common cause is laryngeal cancer.

What are the causes?


There are many causes of hoarseness. Fortunately, most are not severe, and they tend to go away after a short time. The most common reasons are acute laryngitis, which usually occurs due to inflammation of the upper respiratory tract or irritation caused by excessive use of the voice, such as cheering at a sporting event or a rock music concert.


Chronic hoarseness is usually due to using your voice too much or using it inappropriately and excessively loud for long periods. These habits can produce vocal nodules, cysts, polyps etc. due to phonotrauma.


Smoking is another cause of hoarseness. Since this habit is the leading cause of throat cancer, if a smoker is hoarse, he should immediately consult a specialist. Other unusual causes of hoarseness include allergies, thyroid problems, neurological disorders&trauma to the larynx. Many people experience hoarseness with old age.



The quantitative and qualitative alteration of phonation is accompanied by a series of vocal characteristics (signs) that differ according to the type, be it of organic or functional origin.

The most frequent symptoms seen in clinical practice are hoarseness, monotonous voice, trembling voice, aphonia episodes, variations in intensity, regular loss of treble, or feeling of shortness of breath when speaking.

Also, the patient usually reports or presents the following non-phonatory symptoms: cough, itching, use of throat-clearing to clear the voice, foreign body sensation when swallowing, and mild or moderate throat pain when speaking.




A physical examination of the larynx is necessary for all patients presenting with change in voice that is recurrent or lasts for more than 15 days, especially if there is a smoking habit. It can show the existence of a vocal cord mass.

A simple OPD procedure known as Videolaryngoscopy will help to identify and confirm the diagnosis.



Cause-specific treatment is advised.

The treatment caused by infectious processes only requires rest of the voice and, on occasion, anti-inflammatory drugs.


Treatment of vocal cord nodules consists of carrying out speech therapy and, if it persists, completing it with microlaryngoscopic excision.

For vocal cord polyps & cysts, the fundamental treatment is surgical excision and subsequent speech rehabilitation.

The treatment of vocal cord cancer depends on the stage. Surgery and radiotherapy may be required.

Neurological problems such as vocal cord paralysis and spasmodic dysphonia may require surgery, botox injections and speech therapy.

Most voice disorders need simultaneous voice/speech therapy and good vocal hygiene.