All About Hoarseness

Have you ever experienced unusual changes in your voice? Say, you’ve had a really good time at a karaoke hub and sang for hours on end, only to wake up the next day with a strained voice? Or you’ve come down with the flu after getting caught in the middle of the rain, which took a toll on your voice and made it raspier? Lower? Hoarseness is defined as any abnormal change in one’s voice which may alter its quality, as characterized by raspiness; harshness; breathiness, also called murmurs; and increased or decreased volume and pitch. Voice may also be tremulous and unstable, and the unhappy speaker may find himself in need of frequent breaks in between sentences.

The voice box (also called larynx) above the windpipe contains the vital vocal folds, a pair of smooth muscles that are responsible for the vibration of air by closing and opening. These vibrations are no other than the sound we produce as we speak. If hoarseness is present, then we can deduct that there have been alterations in the state of the vocal folds. It may have swelled or become inflamed, or a disorder might be at hand. It is important to note that hoarseness itself is not the disorder, rather, it is a symptom of the underlying disorder.

What could possibly be the underlying concerns for hoarseness? It could be lifestyle related such as smoking, too much alcohol consumption, or excessive use of voice as demanded by certain occupations—talking too much and too loud, and for prolonged periods of time. Others could be gastroesophageal reflux or stomach acid surging into the esophagus and irritating the vocal folds; colds, flu, and infections; neurological disorders such as stroke or traumatic brain injuries that interrupt nerve impulses from the brain to the voice box, rendering it weak or paralyzed; trauma to the voice box; allergies; and environmental factors such as low humidity and external irritants.

If the voice has a raspy or grating quality to it, it could be attributed to the swelling of vocal folds from irritants, infections, or overuse. A quivering and soft voice could be due to decreased capacity to breathe or take in the air. In mild conditions such as common colds, hoarseness is not a troubling concern and alleviates on its own in a short period of time or after the family doctor or pediatrician has already prescribed appropriate medications. However, if one agonizes over it beyond two weeks by then, consulting a doctor is highly recommended as persistent hoarseness could be a sign of larynx cancer. In more challenging cases, the patient will be referred to an otolaryngologist, an Ear, Nose, and Throat (ENT) doctor, or a speech-language pathologist.

Treatment, therefore, are contingent with whatever causes the hoarseness of the individual. For overuse, one may just be recommended to rest or modulate voice. If it is lifestyle related, such as smoking or excessive drinking, then one should cut off or abstain from such vices. Environmental modifications can be affected, as in humidifying one’s home and enhancing poor acoustics. As for heavier causes such as vocal fold paralysis or weakness, surgery may be implemented or a speech-language pathologist may administer therapeutic activities such as speech exercises, and/or facilitating the muscles of the voice box.