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Even with attention to good vocal hygiene, if you have a vocally demanding job you may still find yourself with hoarseness. What are some common hoarseness-causing voice disorders, and when should you see a doctor about them?
Hoarseness is a condition when your voice sounds breathy, raspy, or strained. It is a symptom of a condition, not a condition itself. Common voice disorders include acute or chronic laryngitis, vocal fold lesions, and vocal fold weakness.
The most common cause of hoarseness is laryngitis. This is an inflammation of the vocal cords caused by a virus or allergies. Acute laryngitis is inflammation of the vocal folds that commonly accompanies illnesses such as colds, upper respiratory infections, or bronchitis. Chronic laryngitis is when you have longstanding irritation and swelling of the vocal folds or larynx. Your voice may sound raspy or hoarse for a very long period of time. Contributing factors may include unproductive throat clearing, coughing, dehydration, smoking or smoky environments, excessive voice use, excessive alcohol or caffeine consumption, acid reflux, or allergies.
In cases where hoarseness is caused by a virus, often the best treatment is rest. If the hoarseness is allergy related, medicines like nasal sprays can help. With rest, appropriate medical management of the primary illness, and adequate hydration, this should resolve on its own in two or three weeks. However, if you have hoarseness for more than three weeks, you should see a doctor.
Vocal fold lesions such as nodules, polyps, and cysts are all benign growths that develop on the vocal folds. They can be caused by straining to talk or sing, talking too much, or coughing or clearing the throat too much. Some vocal folds lesions can be treated with therapy. However, for some people therapy is not enough. In those cases, surgery is required.
Other voice conditions include vocal cord dysfunction and vocal fold weakness.
Normally, vocal folds open for breathing and close for talking. Vocal cord dysfunction, or VCD, is a condition in which the vocal folds attempt to close while breathing and upset normal breathing patterns. This can be triggered by reflux, strong odors, physical activity, inhaled medications, or anxiety. Symptoms include wheezing, gasping, the sensation of the throat closing, and difficulty breathing. While these symptoms are not typically associated with hoarseness, VCD is considered a voice disorder because this difficulty breathing originates with the larynx/vocal folds, not the lungs.
Vocal fold weakness is when the primary muscle of the vocal folds, or the muscles that open and close the vocal folds, are weak. Vocal fold paralysis, a variation of this, is when one or both of the vocal folds are completely immobile. This can be caused by disease, trauma, or as the result of a previous surgery. This may result in a weak, soft, or breathy-sounding voice, difficulty projecting the voice, shortness of breath with voice use, and vocal fatigue. Weakness for either of these reasons often prevents the vocal folds from closing all the way during phonation (voice use/sound production), possibly resulting in a weak, soft, breathy voice. If weakness or paralysis is present following a surgery – such as thyroid, anterior cervical disk fusions, and some heart surgeries – the weakness/paralysis may be temporary or permanent. In more severe cases, particularly with vocal fold paralysis, it might also cause an increase in strangling or choking on liquids.
There are almost no voice problems that cannot be improved in some way. As with many other medical issues, early detection of a voice disorder is key. No one just has a naturally raspy voice. If your voice is raspy, something is going on with it. Practice good vocal hygiene and good vocal pacing to maintain optimum vocal health. Have any negative vocal changes evaluated by an ENT if they don’t resolve themselves in 2-3 weeks. It is much easier to improve a mild and relatively new voice problem than one that has persisted for an extended period of time.
Don’t get used to hoarseness. Have your voice checked today.
This blog is for informational purposes only. For specific medical questions, please consult your physician. To make an appointment with a CEENTA ENT doctor or Voice & Swallowing specialist, use our online scheduling platform or myCEENTAchart.
You’re doing everything right to keep your voice healthy. You don’t overuse it. You keep any acid reflux under control. You do exercises to keep it strong. Despite all that, you still have hoarseness. What’s causing the problem? As it turns out, it might be allergies.
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