Hoarseness signifies an abnormality in the voice box, or larynx. The voice often sounds gravelly or weak and may crack or have an unusually high or low pitch. Hoarseness may occur acutely, lasting a brief period, or chronically. Causes of hoarseness include infections, inflammation, abnormal growths, nerve disorders and voice overuse. Chronic hoarseness may indicate a serious underlying illness. Treatment for hoarseness varies, depending on the underlying cause.
Acute Laryngitis
Acute laryngitis is the most frequent cause of hoarseness, reports the American Academy of Otolaryngology--Head and Neck Surgery. Viral upper respiratory infections and head colds may cause inflammation and swelling of the voice box tissues, leading to hoarseness. Acute laryngitis typically clears within a few days. The Academy warns, however, that straining the voice during a bout of acute laryngitis can cause significant injury to the vocal cords.
Voice Strain
Voice strain occurs with misuse or overuse of the voice. Excessive talking, shouting and singing frequently lead to hoarseness. People who talk as part of their work or recreational activities are at risk for voice strain, including teachers and other instructors, coaches, referees, members of the clergy, lawyers, actors, singers and customer service representatives.
Prolonged shouting, such as cheering at a sporting event, or protracted bouts of crying can also cause acute voice strain, notes Dr. Alan Lipkin in a National Library of Medicine Medline Plus entry. Resting the voice typically relieves hoarseness due to minor voice strain.
Vocal Cord Lesions
Severe, persistent voice strain and other types of voice box irritation may lead to physical abnormalities, or lesions, of the vocal cords. These noncancerous lesions can take the form of vocal cord nodules, polyps or ulcers, notes the National Institute on Deafness and Other Communication Disorders.
Vocal cord nodules are firm, callous-like growths that occur due to excessive friction along the surfaces where the vocal cords meet. Vocal cord polyps arise in the same region, but are softer blister-like lesions. Less commonly, ulcers may form with chronic voice overuse. Distinguishing benign vocal cord lesions from cancer of the voice box, or larynx, is important as both types of growths can cause similar symptoms.
Voice therapy is often helpful for people who develop vocal cord lesions due to overuse. Treatment involves training to strengthen the voice and lessen strain on the vocal cords. Surgery may be needed for vocal cord nodules or polyps.
Nerve Disorders of the Voice Box
Interruption of nervous system control of the voice box can cause hoarseness and other voice changes. The American Academy of Otolaryngology--Head and Neck Surgery explains that a partial disruption of the nerves typically causes weakness, or paresis, of the vocal cords. Complete loss of nerve control leads to paralysis.
Many conditions and disorders can cause voice paralysis or paresis, including traumatic or surgical injuries, tumors, stroke, Parkinson's disease and multiple sclerosis. Treatment depends on the underlying cause of the nerve problem.
References
- American Academy of Otolaryngology--Head and Neck Surgery: Hoarseness
- Medline Plus: Hoarseness
- National Institute on Deafness and Other Communication Disorders: Disorders of Vocal Abuse and Misuse
- National Institute on Deafness and Other Communication Disorders: Vocal Cord Paralysis
- American Academy of Otolaryngology--Head and Neck Surgery: Vocal Cord Paralysis
