Hoarseness can be described as abnormal voice changes that make your voice sound raspy and strained and higher or lower or louder or quieter than normal. These changes are usually the result of disorders of the vocal folds which are the sound-producing parts of the voice box (larynx).
The most common cause of hoarseness is laryngitis (inflammation of the vocal folds) which is usually associated with a viral infection but can also be the result of irritation caused by overuse of your voice e.g. excessive singing, cheering, loud talking.
Other causes of hoarseness include:
- nodules on the vocal folds – these may develop after using your voice too much or too loudly over a long period of time
- gastro-oesophageal reflux disease (GORD) – when stomach acid comes back up the oesophagus and irritates the larynx and vocal folds
- masses, cysts or polyps on the vocal folds
- endocrine gland (thyroid) problems
- tumours (benign and malignant) in the head and neck region
- injuries to the neck - such as in sport or in a fight.
Diagnostic tests will include viewing the vocal folds by inserting a small flexible tube (endoscope) through your nose under local anaesthesia. If a more detailed examination of your voice and larynx is needed then videostroboscopy will be required to analyse the larynx in more detail. In some case, assessment by the Speech and Language Therapists and computer voice analysis will be needed.
Treatment depends on the cause of the hoarseness and may include resting your voice or changing how it is used (arranged with Speech and Language Therapy), avoiding smoking, improving lubrication in the voice box and taking medication to correct acid reflux. Sometimes surgery is also required.