Hoarseness
Hoarseness (dysphonia) is any change in the quality, pitch or strength of the voice. Voice is produced by the vibration of the two vocal cords in the larynx; anything that disturbs their vibration changes the voice. Most hoarseness is simple and temporary — but any hoarseness lasting more than 3 weeks requires direct visual examination of the larynx.
Common causes
- Acute laryngitis: accompanies upper respiratory infections; the most common cause, usually resolving within 1–2 weeks.
- Voice abuse: shouting or prolonged loud speaking; an occupational problem for teachers, salespeople and singers.
- Vocal nodules: callus-like thickenings from cord friction; typical in talkative children and professional voice users.
- Vocal polyps and cysts: cause more persistent, one-sided voice change.
- Reflux laryngitis: stomach acid reaching the larynx; morning hoarseness, a lump-in-the-throat feeling and constant throat clearing.
- Smoking: the leading cause of chronic laryngitis, Reinke's edema and laryngeal cancer.
- Vocal cord paralysis: after thyroid/chest surgery or from nerve compression; produces a weak, breathy voice.
- Laryngeal cancer: hoarseness may be the only early sign. In current or former smokers, persistent hoarseness must be examined without delay — laryngeal cancer caught early is very treatable.
Diagnosis
The larynx is examined painlessly with a mirror, a rigid telescope or a thin flexible endoscope passed through the nose. This shows the structure and movement of the vocal cords directly; recording and further assessment are added when needed.
Treatment
- Acute laryngitis: voice rest, fluids and steam usually suffice. Whispering does not rest the cords — it strains them.
- Nodules: the mainstay is voice therapy; most nodules resolve without surgery.
- Polyps, cysts and suspicious lesions are removed by microsurgery under the microscope, with pathological examination.
- Reflux: lifestyle measures and medication.
- Stopping smoking is part of treatment at every stage.
Frequently Asked Questions
What causes hoarseness?
Voice is produced by the vibration of the two vocal cords in the larynx, so anything that disturbs this vibration changes the voice. The most common causes are acute laryngitis from an upper respiratory infection, voice abuse, vocal nodules, reflux laryngitis and smoking.
How long does hoarseness last?
Most hoarseness is simple and temporary; acute laryngitis that comes with an upper respiratory infection usually clears up on its own within 1-2 weeks. However, any hoarseness lasting more than 3 weeks requires direct visual examination of the larynx.
When should I see a doctor for hoarseness?
You should see an ENT specialist for any hoarseness lasting more than three weeks. This is especially important in current or former smokers, because hoarseness can be the only early sign of laryngeal cancer, which is very treatable when caught early.
How is the cause of hoarseness examined?
The larynx is examined painlessly with a mirror, a rigid telescope or a thin flexible endoscope passed through the nose. This shows the structure and movement of the vocal cords directly, and recording or further assessment is added when needed.
Can vocal cord nodules heal without surgery?
Yes, the mainstay of treatment for nodules is voice therapy and most nodules resolve without surgery. By contrast, polyps, cysts and suspicious lesions are removed by microsurgery under the microscope and sent for pathological examination.
Would you like to book an appointment?
You can call our office or pick a convenient time slot on DoktorTakvimi.