From the Guidelines
A hoarse voice, also known as dysphonia, is typically caused by inflammation or irritation of the vocal cords, and can be attributed to various factors, including viral infections, vocal strain, allergies, acid reflux, smoking, and inhaling irritants, as well as underlying diseases such as head and neck cancer, neurologic disorders, and gastrointestinal conditions 1.
Common Causes of Hoarseness
The most common causes of hoarseness include:
- Viral infections, such as the common cold or flu
- Vocal strain from overuse or yelling
- Allergies
- Acid reflux
- Smoking and inhaling irritants
- Dehydration, which can dry out the vocal cords
Less Common Causes of Hoarseness
Less common causes of hoarseness may include:
- Growths on the vocal cords
- Thyroid problems
- Neurological conditions, such as vocal fold paralysis or spasmodic dysphonia
- Rarely, cancer, such as head and neck cancer or lung cancer
Importance of Early Evaluation
It is essential to note that dysphonia can be a symptom of underlying diseases, and early evaluation is crucial to determine the underlying cause and appropriate treatment, especially in patients with head and neck cancer, as delay in diagnosis can result in higher staging, need for more aggressive treatment, and reduced survival rates 1.
Recommendations for Temporary Hoarseness
For temporary hoarseness, it is recommended to:
- Rest your voice
- Drink plenty of fluids
- Use a humidifier
- Avoid smoking and alcohol
- Try throat lozenges for comfort
When to Seek Medical Attention
If hoarseness persists beyond two weeks, worsens, or is accompanied by difficulty swallowing, breathing problems, or pain, it is essential to seek medical attention promptly, and an ENT specialist may need to examine your vocal cords with a laryngoscope to determine the exact cause and appropriate treatment, which might include medications, voice therapy, or in some cases, surgery 1.
From the Research
Causes of Horse Voice
- Voice abuse is a commonly cited important aetiological factor for vocal cord granulomas, which can cause horse voice 2
- Gastro-oesophageal reflux is also a commonly cited important aetiological factor for vocal cord granulomas, which can cause horse voice 2
- Herpes simplex viral infection of the vocal cords can cause chronic hoarseness and leukoplakic lesions on direct laryngoscopy, leading to horse voice 3
- Squamous epithelial changes of the larynx, such as squamous metaplasia, squamous hyperplasia, and keratosis, can cause horse voice 4
- Benign laryngeal lesions, such as vocal cord granulomas and squamous epithelial changes, can be caused by phonotraumatic forces on the vocal folds, leading to horse voice 5
Related Conditions
- Vocal cord granulomas are benign inflammatory lesions of the vocal cords that can cause horse voice 2
- Chronic laryngitis can be caused by infections or tumors, such as Kaposi's sarcoma and non-Hodgkin's lymphoma, and can lead to horse voice 3
- Squamous epithelial changes of the larynx can be premalignant or non-premalignant, and can cause horse voice 4
- Benign laryngeal lesions can be treated with a combination of voice therapy and phonomicrosurgical techniques to minimize inadvertent additional trauma 5