Hoarseness: What is it, Symptoms, Diagnosis and Treatment

People’s ability to speak occurs when their vocal cords and larynx work together.

People’s ability to speak occurs when their vocal cords and larynx work together. The larynx is located above the windpipe. The vocal cords, consisting of two muscle bands, are located in the larynx and are connected to the largest laryngeal cartilage known as the Adam’s apple. When you talk, the air coming out of the lungs reaches the mouth with the help of the trachea. Here, as it passes through the windpipe, it vibrates the vocal cords in the larynx. And this is how sound is created.

Some people’s voices are deeper or thinner. Voice pitch is related to the length of the vocal cords. When you relax your vocal cords, your voice may sound deeper due to shorter vocal cords or vice versa. The vocal cords vibrate together symmetrically under normal conditions. In this way, the resulting sound is heard clearly rather than muffled or hissing. However, in some cases, the vocal cords may not close completely or vibrate symmetrically. In this case, hoarseness occurs.

What is Hoarseness?

Hoarseness is when your voice sounds hoarse or like you’re out of breath. It occurs due to differences in volume or tone of your voice. There may be more than one reason why hoarseness occurs. However, most of them are not a serious cause and can disappear in a short time. It is usually caused by a problem with the vocal cords. Misuse and excessive use of the voice and growths such as polyps and nodules are some factors that cause hoarseness. Feeling itchy throat during hoarseness is also a common symptom.

What are the symptoms of hoarseness?

In addition to some obvious symptoms of hoarseness, there are also less known or seen symptoms. The cause of hoarseness may cause different symptoms. Common symptoms of hoarseness may include:

• abnormally weak, breathy, or hoarse voice
• Change in pitch (thinness or thickness) of the voice
• Difficulty using the voice, getting tired easily
• Sore throat
• cough
• swelling in the throat area
• difficulty swallowing

Hoarseness has some symptoms and can also be a symptom of some diseases. One of these is lung cancer. Having any symptoms of cancer does not mean you have cancer. However, if there is hoarseness that has existed for a long time and does not go away, it is useful to be examined by a doctor just in case.

What are the causes of Hoarseness?

Hoarseness is a health problem that can be seen in everyone. It develops regardless of age; You may experience hoarseness at age 60 or at age 15. It is common in people who use their voice professionally or frequently, especially smokers. The causes of hoarseness are:

• Excessive use of voice, such as talking for long periods of time, shouting, or singing for long periods of time
• cold
• Swelling of the vocal cords due to various reasons such as illness or allergies
• Laryngopharyngeal reflux (A condition in which stomach acid caused by gastroesophageal reflux rises up to the throat and damages the vocal cords)
• Vocal cord bleeding (bleeding in the vein on the vocal cord)
• Vocal cord paralysis (inability to move one or both vocal cords)
• Neurological diseases or disorders that affect the laryngeal muscles of the brain
• Polyps, cysts or vocal nodules
• throat cancer
• Recurrent respiratory papillomatosis
• Muscle tension dysphonia (excessive tension in the vocal cords)

How Does Hoarseness Occur?

Hoarseness is a common problem. Generally, one-third of people experience hoarseness at some point in their lives. Hoarseness occurs as a result of a problem in the vocal cords. However, no problem occurs in the vocal cords by itself. Swelling from a nodule, cyst, or polyp can damage the vocal cords. Similarly, speaking outside your own voice range (too high or too low) for a long time can strain the vocal cords, tiring them and preventing them from working synchronously. As a result of hoarseness, you may need to consult a doctor in the following cases:

• If hoarseness is not caused by cold or flu,
• If you have had hoarseness for more than three weeks,
• If you have difficulty swallowing,
• If there is blood when coughing,
• If you have difficulty breathing,
• If there is a feeling of a lump in the neck area,
• If your voice disappears completely within a few days.

How is Hoarseness Diagnosed?

An ear, nose and throat (ENT) specialist or speech pathologist can best evaluate hoarseness. When you go for any examination, your doctor first takes your medical history. During your medical history, you may have some questions about the diseases you have or the medications you use. These questions are usually;

• Duration of the problem
• Does it develop suddenly or slowly?
• Cigarette consumption and duration
• Presence of additional symptoms
• Your history of respiratory infections
• It may include the amount of alcohol consumption.

Then your doctor will want to perform a physical examination. During the physical examination, the following may be done:

• Listening to the voice or back
• Checking for the presence of any lumps in the head or neck area
• Laryngoscopy; examination of the larynx at the back of the throat with a small camera tube inserted through the nostrils
• Rigid laryngoscopy; It is performed under surgical conditions under anesthesia for patients who cannot tolerate flexible laryngoscopy.
• Laryngeal stroboscopy; A binocular with a flash is passed through the throat to examine the appearance of the person’s vocal cords while speaking, and their synchronization is checked.

If your doctor thinks there is a suspicious situation after the examinations, he or she may additionally request computerized tomography (CT) or magnetic resonance imaging (MRI).

Hoarseness Treatment Methods?

Hoarseness treatment options are diverse and vary depending on what causes the hoarseness. No matter what reason you are experiencing hoarseness, the first thing that will help you is not to use your voice too much. In this case, although speaking in a low voice seems like an option for most people, speaking higher or lower than the normal pitch of your voice can similarly tire your voice. Therefore, it may be best for you to try to talk as little as possible for a while. Apart from this, the following can be applied as general hoarseness treatment methods:

• In cases of hoarseness caused by cold or flu infection, solving the disease also improves the voice. Therefore, your doctor will prescribe you the necessary medications.
• Your problem can be solved with antibiotics or corticosteroid medications prescribed for hoarseness caused by laryngitis.
• It is known that in case of GERD, the juice coming into the throat damages the vocal cords. Therefore, controlling GERD with antacids or proton pump inhibitors helps resolve your hoarseness.
• Treatment of neurological hoarseness may be more specific and different.
• You can work with a speech and language therapist for hoarseness caused by nodules, cysts or polyps, or muscle tension dysphonia. Surgical treatment may be applied depending on your condition.
• In case of cancer, radiation therapy, chemotherapy or other appropriate cancer treatments are applied.
• In case of vocal cord paralysis, a simple operation that involves pushing the vocal cord to the center may be required, or a more complex surgical treatment may be required. Your ENT specialist will inform you.

Hoarseness is not a serious problem and usually passes in a short time. Trying to rest your voice as much as possible during this process is the easiest treatment you can apply. In addition, to prevent hoarseness or accelerate the healing process; Quit smoking, drink plenty of water, stay away from liquids that impair body hydration such as alcohol and caffeine, or consume them in a balanced manner, and avoid using your voice too loudly or for too long.