Voice Disorders & Hoarseness

Hoarseness also commonly referred to as dysphonia is defined as a change in the quality of your voice that effects both adult and pediatric patients.  Hoarseness can be described based on the characteristics of the voice which include raspy, breathy, strained, or a combination of these characteristics.  Patients with hoarseness may experience vocal fatigue, reduction in the volume of their voice, reduced pitch range, variability in the quality of their voice, discomfort when using their voice, and feeling the need to strain when trying to use their voice. Hoarseness can occur suddenly, or it can be a gradual change that progressively worsens with time. 

• Frequent throat clearing
• Feeling of a lump in the throat
• Cough
• Throat pain
• Difficulty swallowing

• Acid reflux
• Asthma
• Allergies
• Neurologic conditions
• Prior trauma to the vocal cords; for example being intubated during previous surgery

Surgeries patients may undergo for other conditions including thyroid surgery, carotid artery surgery, or heart surgery, can potentially injure the nerves which control movement of the vocal cords. Patients may also develop laryngitis (an infection of the vocal cords) that can be viral, bacterial, or fungal. Certain social habits may also contribute to changes in vocal quality including smoking, alcohol use, or prolonged exposure to chemicals and irritants. Certain medications such as oral steroids and steroid inhalers that are used to treat asthma may also be contribute to hoarseness.

• Vocal cord nodules which are small calluses on the vocal cords
• Cysts or polyps of the vocal cords
• Cancerous growths of the vocal cords

There may also be functional changes which affect how patients produce their voice. Functional changes refer to the amount of tension used when producing your voice. Many patients with hoarseness have what is referred to as muscle tension dysphonia, where there is too much tension or strain when using their voice. Often patients have a combination of structural and functional changes.

Any patient who develops a sudden change in their voice or hoarseness that persists for more than two weeks should be evaluated by an Ear Nose and Throat physician to determine the cause of their symptoms and provide treatment recommendations.

At Queen City Ear Nose and Throat we perform a detailed evaluation with diagnostic testing consisting of flexible endoscopy where a fiberoptic camera can be used to examine the vocal cords and advanced videostroboscopy. This testing allows a magnified detailed assessment of the vocal cords and is the only test that allows your doctor to assess the vibratory function of the vocal cords.

There are a variety of different treatments for hoarseness which may include medications, voice therapy which is a form of physical therapy to improve the quality of the voice, and when indicated minimally invasive microscopic vocal cord surgery to remove structural abnormalities of the vocal cords and biopsies to evaluate for precancerous or cancerous growths of the vocal cords.