Hoarseness refers to difficulty making sounds when trying to speak. Vocal sounds may be weak, breathy, scratchy, or husky, and the pitch or quality of the voice may change.

Considerations

Hoarseness is most often caused by a problem with the vocal cords. The vocal cords are part of your voice box (larynx) located in the throat. When the vocal cords become inflamed or infected, they swell. This can cause hoarseness.

The most common cause of hoarseness is a cold or throat infection, which most often goes away on its own within 2 weeks.

A rare but serious cause of hoarseness that does not go away in a few weeks is cancer of the voice box.

Voice box

The larynx, or voice box, is located in the neck and performs several important functions in the body. The larynx is involved in swallowing, breathing, and voice production. Sound is produced when the air which passes through the vocal cords causes them to vibrate and create sound waves in the pharynx, nose and mouth. The pitch of sound is determined by the amount of tension on the vocal folds.

Causes

Hoarseness may be caused by:

• Acid reflux (gastroesophageal reflux disease or GERD)
• Allergies
• Breathing in irritating substances
• Cancer of the throat or larynx

  Cancer of the throat or larynx

  Throat cancer is cancer of the vocal cords, larynx (voice box), pharynx, or other areas of the throat.

  

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• Chronic coughing

  Coughing

  Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...

  

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• Colds or upper respiratory infections
• Heavy smoking or drinking, particularly together
• Overuse or abuse of the voice (as in shouting or singing), which, over time, may cause swelling or growths on the vocal cords called vocal cord nodules

Less common causes include:

• Injury or irritation from a breathing tube or bronchoscopy

  Bronchoscopy

  Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.

  

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• Damage to the nerves and muscles around the voice box (from trauma or surgery)

  Damage to the nerves and muscles around...

  Throat cancer is cancer of the vocal cords, larynx (voice box), pharynx, or other areas of the throat.

  

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• Foreign object in the esophagus or trachea
• Swallowing a harsh chemical liquid
• Changes in the larynx during puberty
• Thyroid or lung cancer

  Thyroid

  Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located in the front of your lower neck.

  

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  Lung cancer

  Lung cancer is cancer that starts in the lungs. The lungs are located in the chest. When you breathe, air goes through your nose, down your windpipe...

  

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• Underactive thyroid gland
• Immobility of one or both vocal cords

Home Care

Hoarseness may be short-term (acute) or long-term (chronic). Vocal rest and time may improve hoarseness. Hoarseness that continues for more than 4 weeks should be checked by a health care provider.

Things you can do at home to help relieve the problem include:

• Talk only when you need to until hoarseness goes away.
• Drink plenty of fluids to help keep your airways moist. (Gargling does not help.)
• Use a vaporizer to add moisture to the air you breathe.
• Avoid actions that strain the vocal cords such as whispering, shouting, crying, and singing.
• Take medicines to reduce stomach acid if hoarseness is due to GERD.
• Do not use decongestants which can dry out the vocal cords.
• If you smoke, cut down, or stop at least until hoarseness goes away.

When to Contact a Medical Professional

Contact your provider if:

• You have trouble breathing or swallowing.
• Hoarseness occurs with drooling, particularly in a small child.
• Hoarseness occurs in a child less than 3 months old.
• Hoarseness has lasted for more than 1 week in a child, or 2 to 3 weeks in an adult.

What to Expect at Your Office Visit

The provider will examine your throat, neck, and mouth and ask you some questions about your symptoms and medical history. These may include:

• To what extent have you lost your voice (all or partially)?
• What kind of vocal problems are you having (making scratchy, breathy, or husky vocal sounds)?
• When did the hoarseness start?
• Does hoarseness come and go or get worse over time?
• Have you been shouting, singing, or overusing your voice, or crying a lot (if a child)?
• Have you been exposed to harsh fumes or liquids?
• Do you have allergies or a post nasal drip?
• Have you ever had throat surgery?
• Do you smoke or use alcohol?
• Do you have other symptoms such as fever, cough, sore throat, difficulty swallowing, weight loss, or fatigue?

You may have one or more of the following tests:

• Laryngoscopy
• Throat culture
• Throat examination with a small mirror
• X-rays of the neck or CT scan

  CT scan

  A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...

  

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• Blood tests such as a complete blood count (CBC) or white blood cell differential

  CBC

  A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...

  

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  White blood cell differential

  The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are...

  

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