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Voice Disorders


Hoarseness refers to abnormal voice changes. 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). There are many causes of hoarseness. Fortunately, most are not serious and resolve 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 excessive voice use. 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) or polyps (more acute swelling of the vocal cords). Vocal nodules are common in children and adults who raise their voice in work or play. Rarely, polyps or nodules may lead to cancer.

A common cause of hoarseness in adults is gastroesophageal reflux, wherein stomach acid ascends 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 globus sensation or mucus sticking in the throat, and/or frequent throat clearing.

Smoking may also 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.

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

How is hoarseness evaluated? Doctor Kantu will use a very small lighted flexible tube called a fiberoptic laryngoscope in order to fully assess your larynx. This brief examination will fully evaluate the vocal cords and their motion as well.

Some guidelines to minimize hoarseness: minimize cigarette or cigar use. Avoid agents that dehydrate the body, such as alcohol and caffeine. Avoid secondhand smoke. Drink plenty of water. Humidify your home. Avoid overly spicy foods. Try not to use your voice over prolonged periods and/or talk too loudly. Avoid speaking or singing when your voice is injured or hoarse.

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