Hoarseness is characterized by any abnormal change in the voice. Your voice could change in volume or pitch and may sound breathy, raspy or strained. Typically, a change to your voice is related to a disorder of the vocal folds, located in the larynx (voice box). Vocal folds open while breathing and come together when speaking. Air leaving the lungs while the folds are closing causes a vibration; this is sound. Swelling or growths on the vocal folds can lead to changes in your voice.
Hoarseness can be caused by a number of different changes to the vocal fold. Acute laryngitis is the most common cause of hoarseness, and is the result of swelling of the vocal folds. Usually, acute laryngitis occurs during a cold or upper respiratory tract viral infection. Voice misuse, such as excessive use or speaking loudly in a noisy environment can cause swelling of the vocal folds as well as the development of benign vocal cord lesions. These lesions are callus-like growths on the vocal folds called nodules, polyps or cysts. Other causes such as allergies, thyroid problems and even cancer can also lead to hoarseness.
Hoarseness will usually go away on its own. If it lasts longer than a week and you are not currently suffering from a cold or the flu you should contact your doctor. In addition, you should see a doctor if you cough up blood, have difficulty swallowing or experience pain when speaking.
After reviewing your medical history, your doctor will perform a complete physical exam in order to diagnose the cause of your hoarseness. A laryngoscopy enables your doctor to examine the back of your throat, the larynx and the vocal folds. This can be done as an indirect laryngoscopy or a direct fiber-optic laryngoscopy. Indirect involves a series of mirrors and lights to see into the back of your throat. The direct fiber-optic exam involves a small lighted flexible tube inserted through the nose to get a closer look at the vocal folds. In some cases, tests used to evaluate the irregularities in the voice may be performed.
The most common treatment for hoarseness is rest; this involves using your voice in moderation or not using it at all. The amount of time this is recommended for depends on the severity and the cause of the hoarseness. Not smoking, avoiding second-hand smoke and drinking plenty of fluids is also recommended. If your hoarseness is caused by a lesion on the vocal folds, surgery may be required.