Hoarseness occurs when a person has difficulty producing sound or experiences any change in the quality of the voice. Hoarseness is also known as voice strain, dysphonia, and loss of voice.

Most cases of hoarseness are associated with inflammation of the larynx.  Vocal cord vibration allows creation of sounds which are then articulated by the lips, tongue, and palate. When something causes the surface of the vocal cords to become thickened or swollen, the vocal cords can no longer vibrate freely and hoarseness will develop.

It is important to seek care from an otolaryngologist if the hoarseness lingers for weeks or months. The symptoms may be caused by a variety of problems. Some causes are minor, while others are more serious.


Common contributors to hoarseness can include:

  • Vocal cord polyps or nodules
  • Vocal cord paralysis
  • Neurologic voice disorders such as spasmodic dysphonia
  • Allergies
  • Coughing caused by allergies or diseases such as bronchitis
  • Excessive use of alcohol or tobacco
  • Laryngitis, which is most commonly viral or bacterial
  • Acid reflux
  • Chronic sinusitis and postnasal drip
  • Yeast infections, especially for those patients using steroid inhalers
  • Cancer


Hoarseness presents as a change in the quality of the voice, often sounding breathy, scratchy, or husky. Hoarseness may come and go, or it can be continuous. It may or may not be accompanied by pain.

It’s important to see an ear, nose and throat specialist when the hoarseness is associated with:

  • Duration of more than three weeks
  • Absence of a cold or flu
  • Coughing up blood
  • A lump in the neck
  • Pain when swallowing or talking
  • Trouble breathing that coincides with the onset of symptoms
  • Trouble swallowing


The key to the therapy of hoarseness is an early examination by an otolaryngologist. Flexible Fiberoptic Laryngoscopy is the most common type of exam used to visualize the areas of the throat and larynx. After the patient is given a local anesthesic, a thin, flexible fiberoptic scope containing a light carrying cable allows the otolaryngologist to take a look at the vocal cords. In addition to the Flexible Fiberoptic Laryngoscopy, the otolaryngologist might order more tests, including a CT scan.

Treatment options may include:

  • Steroids to decrease swelling
  • Use of a humidifier to increase moisture
  • Medication such as guiafenesin, a mucus thinning agent
  • Changes in diet
  • Surgery to remove vocal cord polyps, nodules, or tumors
  • Speech therapy