Hoarseness

What is hoarseness?

Hoarseness is a symptom of irritation of the voice box. When you are hoarse, your voice sounds unnaturally low or deep.

How does it occur?

Hoarseness is caused most often by a viral upper respiratory tract infection, such as a cold. Often the other symptoms of the infection have gone away and only the hoarseness remains. It can also occur from exposure to dust, chemicals, or pollutants, or after too much singing, yelling, or cheering.

Hoarseness that does not go away in a week or two may be caused by smoking, hypothyroidism, rheumatoid arthritis, or other diseases of the voice box and surrounding tissue.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you.

If you have had hoarseness for more than 2 to 3 weeks, your provider may examine your voice box and surrounding tissues. A flexible laryngoscope is a special tool with a light used to look behind your tongue at the voice box and throat.

Your healthcare provider will also examine your thyroid gland and lymph nodes.

If you have chronic hoarseness, your healthcare provider may order lab tests, depending on the findings of your physical exam. These may include a test for thyroid function and tests for other illnesses that sometimes cause hoarseness.

Your provider may refer you to an ear, nose, and throat (ENT) specialist if your hoarseness continues. The specialist will check for growths on your voice box that could cause hoarseness. When there are growths, they are usually benign (not cancerous). If a growth is found, the specialist will take a small sample for lab tests. This is called a biopsy. Or the specialist may remove the growth completely and then have it tested.

How is it treated?

Treatment varies depending on the condition causing the hoarseness.

If you are a smoker and develop hoarseness, your healthcare provider will advise you to stop smoking immediately and to rest your voice. If you keep being hoarse for more than 2 to 3 weeks, you must see your provider again to make sure that the hoarseness is not being caused by something else.

If you have acute laryngitis (inflammation of the vocal cords), your provider may recommend breathing humidified warm or cool air and resting your voice. Your provider may prescribe a steroid spray for your throat.

If nodules have formed on your vocal cords, your provider may prescribe medicine and recommend that you rest your voice. If your hoarseness does not get better after drug therapy and rest, you may need surgery to remove the nodules. Sometimes nodules need to be biopsied or removed to be sure they are not cancerous.

Other treatments may be necessary if other illnesses, for example, thyroid disease, are causing the hoarseness.

How long will the effects last?

Hoarseness is usually gone in a week or two unless it is caused by an underlying disease.

How can I take care of myself?

Follow the instructions your healthcare provider gives you. In addition, you can:

• Quit smoking if you are a smoker.
• Avoid being in smoky places (secondhand smoke).
• Rest your voice (no loud talking, shouting, or singing).
• Drink extra fluids (water, fruit juices, tea).
• Use a vaporizer or humidifier to add moisture to the air.
• Take hot, steamy showers and breathe in the warm, moist air.

If you have hoarseness for more than 2 weeks, see your healthcare provider.

How can I help prevent hoarseness?

Avoid smoking, straining your voice, and exposure to chemical irritants.