Overview
Hoarseness, also known as dysphonia, is a condition characterized by alterations in the tone or characteristics of the voice, resulting in a voice that may appear feeble, raspy, or husky. This condition can originate from various factors such as voice misuse or excessive use, viral infections, and the development of growths like cysts, papillomas, polyps, and nodules on the vocal cords. Additionally, hoarseness can be attributed to acid reflux from the stomach. The appropriate treatment for hoarseness depends on the underlying cause of the condition.
Symptoms
Hoarseness Symptoms:
- Unusually weak, breathy, or coarse voice: Your voice may sound feeble or rough.
- Voice pitch changes: Your voice might become higher or lower.
- Increased effort or easy fatigue when speaking: Talking may feel harder and tire you out quickly.
- Additional symptoms: The cause of hoarseness can bring other signs. For instance, a viral illness may lead to a sore throat, coughing, or sneezing. Sometimes, hoarseness can affect swallowing or breathing too.
Causes
Hoarseness can have a number of causes. Many are without risk. some causes are:
- Excessive voice use: They might become hoarse if they talk too much, shout too loudly, sing too much, or speak at a higher or lower pitch than usual.
- Laryngitis: Allergies, a cold, or an upper respiratory infection can cause the vocal folds to momentarily enlarge, a condition known as laryngitis.
- Infection: A sinus infection or cold. Within two weeks, this expected to go away on its own.
- Vocal fold hemorrhage: When a person’s voice abruptly disappears or when they can speak but not sing, they may have experienced a vocal fold hemorrhage. This occurs when a blood artery on a vocal fold burst, allowing blood to flow into the muscle tissues.
- Gastroesophageal reflux disease (GERD): Also referred to as heartburn, is a condition where the stomach acids enter the throat. Laryngopharyngeal reflux (LPR) is the term for when the acids can occasionally go as high as the vocal folds.
- Neurological condition: The area of their brain that regulates the muscles in their larynx may have been affected by Parkinson’s disease or a stroke, among other conditions.
- Nodule, cysts, polyps development: On the vocal folds, there can develop nodules, polyps, and cysts that are not malignant. They develop as a result of excessive pressure or friction.
- Vocal cord paralysis: If one or both of the vocal cords are paralyzed, it signifies that they aren’t functioning properly. It’s possible that neither of them will open nor close. Most of the time, there is no known reason, although occasionally an injury, lung or thyroid cancer, infection, multiple sclerosis, stroke, Parkinson’s disease, or tumors are to blame.
- Muscle tension dysphonia: Dysphonia caused by excessive muscle tension in and around the voice box is known as muscle tension dysphonia. Their voice is unable to function effectively because of this stress. A pattern of muscular use known as muscle tension dysphonia can emerge during laryngitis and persist long after the vocal cord swelling has subsided. It can also be brought on by stress and coexist with other illnesses.
- Recurrent respiratory papillomatosis (RRP) or laryngeal papillomatosis: The airways in the lungs develop non-cancerous tumors as a result of this condition.
- Laryngeal cancer: A laryngeal cancer symptom that lasts longer than three weeks is hoarseness.
Risk factors
Hoarseness can affect people of any age. Smokers and those who use their voices professionally, such as instructors, singers, salespeople, and contact center agents, are more likely to experience this symptom.
Diagnosis
In the evaluation of hoarseness, a specialist in otolaryngology, or ENT (ears, nose, and throat), follows a systematic approach. Here’s an overview:
- History taking: The ENT will initiate the assessment by obtaining pertinent information, including:
- Duration of hoarseness.
- Onset (sudden or gradual).
- History of recent upper respiratory infections.
- Presence of associated symptoms.
- Smoking history, including duration.
- Alcohol consumption.
- Physical examination: A thorough examination of the head and neck region will be conducted to identify any palpable abnormalities or masses.
- Voice evaluation: The specialist will assess the quality of your voice for any anomalies or irregularities.
- Laryngoscopy: Utilizing a laryngoscope, a specialized instrument, the ENT will perform a direct examination of the vocal cords. This instrument is introduced through the nostrils to provide a detailed view of the larynx.
- Diagnostic test:
- Biopsy: In cases of concern, a tissue biopsy may be recommended to obtain a definitive diagnosis.
- Imaging: Computed tomography (CT) scans or magnetic resonance imaging (MRI) may be ordered to further investigate the condition.
These comprehensive steps enable the ENT specialist to establish an accurate diagnosis and formulate an appropriate treatment plan for the patient’s hoarseness.
Treatment
The treatment for hoarseness depends on its underlying cause:
- Overuse of voice: Rest your voice and drink plenty of water.
- Cold or sinus infection: Allow the cold to run its course or use over-the-counter cold medicines.
- Laryngitis: Consult your healthcare provider; you may need antibiotics or corticosteroids.
- Gastroesophageal reflux (GERD): Treat with antacids or proton pump inhibitors.
- Vocal fold hemorrhage: Rest your voice.
- Neurological diseases/disorders: Personalized treatments for specific conditions.
- Vocal nodules, cysts, polyps: Dietary changes and voice therapy. Surgery may be considered.
- Vocal fold paralysis: ENT procedure or surgery as needed.
- Laryngeal cancer: Options include radiation, chemotherapy, immunotherapy, and surgery.
- Recurrent respiratory papillomatosis: Removal of growths to clear airways.
- Muscle tension dysphonia: Observation or voice therapy with a speech-language pathologist.
If hoarseness is a recurring issue due to excessive voice use, consider voice therapy with a speech-language pathologist to learn voice-saving techniques and exercises.
