hoarseness

Hoarseness is an alteration in voice quality in which the voice sounds rough, breathy, strained, or otherwise abnormal, often with reduced vocal volume. It results from dysfunction or irritation of the vocal folds (vocal cords) or the laryngeal mechanisms that control voice production.

Common causes include acute or chronic laryngitis from viral infections, vocal overuse or misuse (such as shouting or singing for extended periods), smoking or exposure to tobacco smoke, and gastroesophageal reflux that irritates the larynx. Allergies, environmental irritants, vocal fold lesions (nodules, polyps, cysts), and certain medical conditions or medications can also contribute. In rare cases, persistent hoarseness may indicate more serious problems such as laryngeal cancer, especially in those with risk factors like tobacco use or significant weight loss.

Diagnosis typically involves a medical history and physical examination, followed by visualization of the vocal folds with laryngoscopy and, if needed, stroboscopy to assess vocal fold vibration. Additional tests may be used to identify reflux, allergies, infection, or structural abnormalities.

Management focuses on the underlying cause and voice restoration. Voice rest and adequate hydration help acute cases; avoiding irritants (smoking, alcohol, noisy environments) and using humidification can assist recovery. Medical treatment may include antibiotics for bacterial infections or acid suppression for reflux. Speech-language therapy is often beneficial for persistent hoarseness or vocal fold lesions, and surgical intervention may be indicated for nodules, polyps, cysts, or tumors.

Most acute hoarseness resolves within days to weeks; chronic or worsening hoarseness warrants professional evaluation to exclude serious conditions.