Hoarse voice that lasts for weeks should be evaluated
Q: For the past few weeks, I have had a hoarse voice, even though I don’t have a cold. Is this something I should be concerned about?
A: It’s not uncommon to experience hoarseness once in a while, especially with a cold or even after cheering loudly at a sporting event. But when a hoarse voice doesn’t go away after three to four weeks, it’s a good idea to see your health care provider.
Your voice is created when air fromyour lungs flows up through the vocal cords in your voice box, or larynx. The vocal cords are made up of layers of delicate tissue. As air passes through the vocal cords, they vibrate, producing sound. When the sound travels through your vocal tract, throat, mouth and nose, you shape this sound into speech.
Laryngitis is when the vocal cords are swollen and inflamed, a common cause of hoarseness. Most cases of laryngitis clear up in a few days to twoweeks. Most often, laryngitis is associated with a viral respiratory infection, such as a cold, or extended periods of talking or singing. In the case of respiratory infections, self-care tips thatmay help include drinking plenty of liquids, using throat lozenges or hard candy, and resting your voice for a few days. This is considered phonotrauma and can cause long-term and even permanent damage if the situation is repeated.
When hoarseness lasts more than threeweeks, or if you have other symptoms such as a lump in your neck, pain when speaking or difficulty swallowing, it’s time to see your
health care provider. A visual inspection of your vocal cords may be performed with a mirror or using a small camera attached to a thin, flexible tube. The quality of your voice also may be evaluated. For example, your voice may sound breathy or weak, or have a tremor quality that may offer clues to the source of the medical problem. In some cases, tests used to measure voice irregularities, airflowand other characteristics can help reach a diagnosis.
When laryngitis lasts longer than a fewweeks, it’s considered chronic. This may be due to ongoing infection, smoking, allergies, other irritants, persistent vocal strain or reflux. Certain medications also can affect your voice. Hoarseness due to chronic laryngitis typically improves by eliminating the underlying cause. If medications seem to be the culprit, ask your health care provider forways to minimize this side effect.
Hoarseness also can be caused by noncancerous growths along the vocal folds. These include small vocal cord swellings (polyps), calluslike patches (nodules) or small encapsulated lesions (cysts). Lesions often heal by
eliminating irritants, and with voice therapy. Surgery may be needed to remove persistent lesions.
Aging is another factor that can affect your voice. Vocal cords can naturally lose some tone and fullness as you age. Voice therapy is a common treatment, but if these changes greatly impair your ability to communicate, your health care providermay recommend a surgical procedure in which an injection is used to add bulk and fullness to your vocal cords.
Other causes of hoarseness include vocal cord spasm; complications of other conditions that affect areas of the brain that control muscles in the throat or larynx, including Parkinson’s disease and multiple sclerosis; and cancer.
I recommend that you be evaluated by your health care provider, who will likely send you to see an ear nose and throat doctor.
— Diana Orbelo, Ph.D., Otolaryngology, Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota