Hoarseness is defined as an abnormal voice caused by interruption of vocal cord closure and vibration. Most commonly, hoarseness develops from benign causes such as upper respiratory infections, vocal abuse, gastroesophageal reflux disease, and advancing age. Vocal cord nodules, polyps, granulomas, paralysis, and cancer are less common causes.

Symptoms and Types

Unexplained hoarseness lasting more than three weeks should usually prompt an evaluation as to its cause. An ear, nose, and throat specialist will first obtain a history of the complaint, including the quality of the hoarseness, its severity, the length of time the hoarseness has been present, and any factors that either aggravate or alleviate it.

Diagnosis and Tests

After obtaining the history, the physician reviews any pertinent medication history and social history that may affect the voice, including tobacco and alcohol use.

A thorough head and neck examination, including inspection for neck masses or surgical scars, the state of oral hydration, or the presence of any nasal or postnasal drainage, is then performed.

Finally, the physician examines the larynx, or voice box, to determine whether any visible pathology exists. This is usually accomplished using fiberoptic laryngoscopy—a simple procedure performed in the office, usually requiring only a few minutes.

Based on the specific findings on this examination, the specialist can present a diagnosis and treatment plan to the patient.

Treatment and Care

To prevent and treat mild hoarseness:

  • Do not smoke; avoid noxious fumes and secondary smoke
  • Hydrate
  • 8 glasses of water a day
  • Chew gum, suck on hard candies
  • Keep environment humid
  • Avoid caffeine and alcohol – these cause the body to lose water
  • Treat Gastroesophageal Reflux Disease (GERD) if present
  • Avoid loud or prolonged voice use
  • Do not clear throat
  • Get plenty of sleep
  • Avoid over the counter antihistamines that cause dryness
  • Avoid menthol throat lozenges that dry the throat
  • “Warm-up” vocal muscles before prolonged use
  • Rest your voice after vigorous use
  • Use a microphone where you need to project your voice
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