• Sinus & Allergy
• Plastic Surgery
• Snoring & Sleep Apnea
• Hearing & Balance
• Hoarseness & Swallowing
• Head & Neck
• Ear Disease

Hoarseness refers to abnormal voice changes. When hoarse, the voice may sound breathy, raspy, or strained. There may be changes in volume (loudness) or pitch (how high or low the voice is). The changes in sound are usually due to disorders related to the vocal folds that are the sound-producing parts of the voice box (larynx).

What Are the Causes?

Acute Laryngitis: There are many causes of hoarseness. Fortunately, most are not serious and tend to go away in a short period of time. The most common causes include acute laryngitis, which usually occurs due to swelling from a common cold, upper respiratory tract infection, or irritation caused by excessive voice use such as screaming at a sporting event or rock concert. Prolonged hoarseness may result from using one's voice either too much, too loudly, or improperly over extended periods of time. These habits can lead to vocal nodules (often seen in singers and teachers), which are callous-like growths, or polyps (more extensive swelling on the vocal cord).

Vocal nodules: are common in children and adults who raise their voice in work or play. Rarely, polyps or nodules may lead to cancer.

Gastroesophageal reflux: A common cause of hoarseness in adults is gastroesophageal reflux, wherein stomach acid comes up the swallowing tube (esophagus) and irritates the vocal folds. Many patients with reflux-related changes of voice never experience heartburn. Affected patients may have a sensation of a lump in their throat, mucous sticking in their throat or an excessive desire to clear their throat.

Smoking: Smoking may cause prolonged hoarseness. Cancers of the voice box or lung may even cause paralysis of the vocal cord.

Allergies and hayfever can easily result in hoarseness as a result of post-nasal drip. Those with allergies produce more mucus in their nose as a result of heightened allergic sensitivity, leading to mucus dripping into the back of the throat with subsequent hoarseness and throat-clearing.

Thyroid Disease: Hypothyroidism is another documented cause of hoarseness and lowered voice pitch.

Neurological disorders such as stroke may lead to problems in articulation and speech production. Vocal cord paralysis may result, warranting otolaryngologic evaluation.

Trauma to the voice box or neck can cause hoarseness.

Advanced age: Many people experience mild hoarseness with advancing age as a result of weaker vocal folds.

How Is Hoarseness Evaluated?

Doctor Kantu will generally use a very small lighted flexible tube called a fiberoptic laryngoscope in order to fully assess your larynx (voice box). This brief 1 to 2 minute examination will fully evaluate the vocal cords and their motion as well.

Preventive Measures to Treat Mild Hoarseness

• If you smoke, quit.
• Avoid agents that dehydrate the body, such as alcohol and caffeine.Avoid secondhand smoke.
• Drink plenty of water.
• Humidify your home.
• Watch your diet. Avoid overly spicy foods.
• Try not to use your voice too long or too loudly.
• Avoid speaking or singing when your voice is injured or hoarse.

Swallowing Difficulties

Difficulty in swallowing (dysphagia) is common among all age groups, especially the elderly. The term dysphagia refers to the feeling of difficulty passing food or liquid from the mouth to the stomach. This may be caused by a variety of factors:

Gastroesophageal reflux: A common cause of dysphagia is gastroesophageal reflux. Reflux occurs when acid from the stomach lining travels up the swallowing tube (esophagus) and irritates the throat. Classic heartburn may be felt in the chest or lower neck. In addition, the patient may have a sensation of a "lump in the throat", mucus sticking in the throat, or an excessive desire to clear the throat.

Stroke or progressive neurologic disorder: Dysphagia in this group of patients is common since the complex coordination of muscles involved in swallowing may be affected. Vocal cord paralysis from nerve injury may lead to cough and aspiration of food into the lungs.

Throat infection: tonsillitis, laryngitis, or any beacterial throat infection is included.

Tumor in the mouth, throat, larynx, or esophagusTumor anywhere in the upper aerodigestive tract may occur secondary to smoking and/or alcoholism.

As a result of their specialized training, board-certification, and vast clinical experience, Drs. Kanhaiyalal, Sanjay, and Manoj Kantu are experts in the proper evaluation and treatment of dysphagia and hoarseness. They carefully elicit a full history of the problem before conducting a complete head and neck examination. A flexible laryngoscope may be utilized in order to better examine the back of the tongue, throat, and larynx (voice box). If necessary, a direct examination of the esophagus with the small flexible scope by Dr. Kantu is performed with minimal patient discomfort.

Dr. Kantu may recommend X-rays of the swallowing mechanism, called a barium swallow, which is done by a radiologist. He may also request the consultation of a speech and swallowing therapist for diagnostic and/or therapeutic purposes.