Hoarseness or raspy voice is a symptom with a number of different causes.
- Hoarseness is an abnormal change in the voice.
- The most common cause of hoarseness is
- The underlying cause of hoarseness can usually be diagnosed by a
health care professional based on the patient’s history and physical exam.
- The treatment for hoarseness depends on the underlying cause.
- Hoarseness can be prevented by avoiding excessive strenuous voice use and
What is hoarseness?
Hoarseness is an abnormal change in the voice caused by a variety of
conditions. The voice may have changes in pitch and volume, ranging from a deep,
harsh voice to a weak, raspy voice.
What causes hoarseness?
Hoarseness is generally caused by irritation of, or injury to, the vocal cords. The larynx (also referred to as the voice box), is the portion of the respiratory (breathing) tract containing the vocal cords. The cartilaginous outer wall of the larynx is commonly referred to as the "Adams apple." The vocal cords are two bands of muscle that form a "V" inside the larynx. When we sing or speak, the vocal cords vibrate and produce sound.
Picture of the Larynx
Hoarseness can be caused by a number of conditions. The most common cause of hoarseness is acute laryngitis (inflammation of the vocal cords) caused most often by an upper respiratory tract infection (usually viral), and less commonly from overuse or misuse of the voice (such as from yelling or singing).
Other causes of hoarseness include:
- benign vocal cord nodules, cysts or polyps,
- vocal cord paralysis
- gastroesophageal reflux (GERD),
- inhalation of respiratory tract irritants,
- thyroid problems,
- trauma to the larynx/vocal cords,
- neurological conditions (such as Parkinson's disease and strokes), and
- cancer of the larynx.
GERD is the back up of stomach acid into the esophagus.
What are the signs and symptoms of hoarseness?
Hoarseness typically gives the voice a raspy and harsh
quality, though it may also cause a change in the pitch or volume of the voice.
The rapidity of onset
and any associated symptoms will depend on the underlying cause leading to
How are the causes of hoarseness diagnosed?
A health care professional will ask the patient questions
about their hoarseness and any other associated symptoms. A physical exam will
focus on the head and neck. Often times, a diagnosis can be made based on this
initial assessment. In some instances, a long lighted flexible tube (fiberoptic
scope) will be inserted into the throat to directly visualize the vocal cords if no other cause is initially
identified. Individuals with hoarseness that lasts longer than 2 to 3 weeks should
have a consultation with an otolaryngologist
in order to exclude any serious causes of hoarseness.
What is the treatment for hoarseness?
The treatment for hoarseness depends on the underlying
cause, for example:
- Acute laryngitis caused by an upper respiratory tract infection will
usually improve on its own as the infection clears the body. Conservative
treatment with cough
suppressants and humidified air can be helpful.
- Voice rest is also recommended
in order to avoid further irritation or injury to the vocal cords.
are not indicated for most cases of acute laryngitis.
- Smoking cessation is
suggested for those individuals that smoke.
- Individuals with hoarseness caused by vocal overuse or misuse should adhere
to voice rest, as serious injury (such as vocal cord hemorrhage can occur to the vocal cords if the voice is
strenuously used during episodes of acute laryngitis.
- Medications for gastroesophageal reflux (GERD) or
allergies can treat hoarseness if either of these is found to be the underlying
- In some instances, surgery may be necessary for benign nodules or polyps, trauma to the
larynx/vocal cords and for cancer of the larynx.
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How is hoarseness prevented?
Hoarseness can be prevented in some instances, for example:
- Avoid situations that require
excessive strenuous voice use, and if a person needs to project their voice, use a microphone
- Voice therapists or singing teachers may be helpful in
certain cases to assist individuals with vocal training and voice modification.
- Smoking cessation can prevent hoarseness or the
development of cancer of the larynx.
- Individuals with hoarseness caused
by gastroesophageal reflux (GERD) can benefit from medications and dietary
modification (such as avoiding alcohol,
caffeine, and spicy foods).