Hoarseness is a general term to describe a change in the voice which sounds scratchy, raspy, weakened or strained. Hoarseness is a common medical complaint that is caused by injury or irritation of the vocal cords, and is often a result of vocal disorders. Once a physician determines the underlying issue, the patient will be treated accordingly, whether it be rest, antibiotics or even surgery.
When a patient experiences hoarseness, the physician will first ask about the timing of the vocal change. If it has occurred for less than two weeks, it is defined as acute hoarseness. If the problem lasts more than two weeks, it is defined as chronic hoarseness.
Acute hoarseness is also known as laryngitis, which occurs when the vocal cords are inflamed. This can result from a viral upper respiratory infection, or vocal trauma, like screaming. Symptoms generally include a weak and scratchy voice, and a mild sore throat. Laryngitis is often accompanied by a cough and low-grade fever. Treatment for laryngitis might include taking Tylenol or ibuprofen to reduce the pain, as well as resting the voice for one week.
Chronic hoarseness is often a result of gastric reflux disease and posterior nasal drainage. Symptoms for chronic hoarseness also include a raspy or scratchy voice, with symptoms typically worse in the mornings. This is due to patients lying flat in bed while sleeping, which allows gastric reflux or nasal drainage to irritate the vocal cords.
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Those experiencing chronic hoarseness will repeatedly clear their throat, have a non-productive cough and the feeling of a foreign substance in the throat. To treat chronic hoarseness, a physician will first treat the patient’s gastric reflux or nasal drainage with antibiotics.
When a patient experiences hoarseness, has trouble swallowing liquids, and the voice is weak or breathy, it is often due to weakness in vocal fold mobility. This can occur after recent intubation during surgery or a viral infection. However, this could also be a sign of something more concerning, such as a chest or lung tumor.
Patients who use tobacco will often develop chronic laryngitis and have an increased risk of benign vocal cord lesions, such as polyps. There is also an increased risk of cancer development. If a mass or suspicious lesion is identified during an exam, the physician will typically order a biopsy. A patient who uses tobacco and has chronic hoarseness should be evaluated by an otolaryngologist.
Children can also have vocal changes that warrant an examination. The most common cause of hoarseness in children is benign vocal nodules, known as “screamer’s nodules.” This often resolves over time without any long-term problems, but the physician will examine the child to rule out other causes, such as vocal fold weakness or benign tumors (polyps).
You can help prevent hoarseness by avoiding smoking, drinking plenty of water, humidifying your home, not using your voice too loudly or too long, and abstaining from spicy foods, alcohol and caffeine. If experiencing hoarseness, contact a physician for further examination.
Dr. Robert Wilson, Otolaryngology, Saint Joseph ENT Center, KentuckyOne Health