A hoarse voice sounds raspy, strained, or breathy and may include changes in volume or pitch. While often temporary, persistent hoarseness can significantly impact communication and quality of life.
What causes hoarseness?
Knowing how your voice works can help you understand why it sometimes sounds hoarse. Speech relies on your vocal cords and larynx (voice box), which sits above the trachea (windpipe). The trachea is a long tube that connects the larynx to the lungs. When you speak, air from your lungs makes your vocal cords vibrate and create sound waves. Anything that affects your vocal cords and larynx can make you sound hoarse.
Many conditions can make you sound hoarse, including:
Laryngitis: Inflamed, swollen vocal folds (vocal cords) caused by a cold, upper respiratory infection, or allergies is one of the most common reasons for hoarseness.
Overusing your voice: Making a long speech, cheering, or yelling at an event can cause temporary hoarseness.
Nasal allergies: Postnasal drip from allergies can irritate the larynx.
Aging: Your vocal cords get thin and lax as you age, affecting your voice.
Laryngopharyngeal reflux (LPR): Often called silent reflux or atypical symptoms of gastroesophageal reflux disease (GERD), LPR causes hoarseness when stomach contents rise through the throat and irritate the tissue. The condition is often worse in the morning and improves throughout the day.
Growths on the vocal cords: Benign lesions such as nodules, polyps, or cysts interfere with the normal vibration of the vocal cords.
Vocal fold hemorrhage: When a blood vessel on the surface of the vocal fold ruptures and the tissues fill with blood, it can affect your voice.
Vocal fold paralysis: This occurs when one or both vocal folds don’t open or close properly. It can be caused by tumors or surgeries in the neck or chest, a head injury, or even a viral infection.
Smoking: Tobacco use irritates the vocal cords and can cause long-term voice changes.
Other causes of hoarseness include thyroid problems and injury to the larynx. Hoarseness can also be a symptom of laryngeal cancer. If you have a stroke or Parkinson’s disease, your condition may affect the part of your brain that controls the muscles in your larynx.
When To See a Physician
Most hoarseness occurs either because you overuse your voice or because of a viral infection, and it goes away on its own. But you should talk to a healthcare provider if your voice has been hoarse for 3 weeks or longer or if you have other concerning symptoms.
An ENT doctor spends 4 years at college, 4 years at medical school, and then 5 to 7 years after that in a residency program specializing in otolaryngology — head and neck surgery. Our board-certified ENTs pass written and oral exams and participate in continuous education to maintain their certification. When you visit one of our Arizona locations, you can trust you're seeing one of the most qualified specialists in the region and that your care will be second to none.
Diagnosing Hoarseness Causes
One of our ENT specialists will examine your voice box and surrounding tissue by inserting a small, lighted, flexible instrument called a laryngoscope through your nose. Throat imaging tests, such as a CT scan or MRI, may also be ordered. Your voice quality can suggest different reasons for hoarseness. For example, the causes usually differ if you have a breathy voice versus a raspy voice or a high, shaky voice.
Based on the physical exam findings, your ENT specialist may order tests such as a biopsy, X-ray, or thyroid function.
Treating Hoarseness
Treatment approaches vary depending on the reason for your hoarseness. Possible treatments include:
Resting your voice: If you suffer from acute laryngitis caused by strained vocal cords, voice rest and avoiding environmental irritants are usually sufficient.
Medications: These may include antibiotics for infections, antihistamines for allergies, or antacids for LPR. In some cases, corticosteroids can reduce inflammation.
Lifestyle changes: Quitting smoking, reducing alcohol intake, and managing LPR can improve voice quality. Staying hydrated is also important.
Humidifier: Using a humidifier, especially in dry environments, can help maintain vocal cord moisture.
Surgery: Surgical intervention may be necessary for vocal cord growths or paralysis.
Being prepared will help you get the most out of your appointment. Please bring a list of medications you're currently taking and any pertinent test results—such as labs or imaging—to your appointment. Additionally, let your provider know of any drug allergies or medical conditions you have or for which you are being treated and if you've had any prior surgical procedures.
Visit Our ENT Specialists
While hoarseness is often temporary, an ear, nose, and throat specialist should evaluate persistent voice changes. Early diagnosis and appropriate treatment can prevent long-term voice problems and promptly address any serious underlying conditions. If you’re struggling with persistent hoarseness, consult an ENT specialist at Valley ENT to explore the best management options for your specific situation.