Hoarseness refers to a change in voice quality. It could either be low pitch, weak, fatigued, raspy or
inconsistent, making it difficult to speak and at times breath.
Causes of hoarseness include an acute throat or upper respiratory infection, commonly viral; acute voice
abuse especially in people who use their voice a lot e.g. Singers, teachers, preachers, hawkers; straining
voice in abrupt shouting e.g. when cheering your favourite team. Chronic irritation from toxic fumes,
smoking, alcohol abuse, chronic nasal discharge, laryngopharyngeal reflux (whereby gastric contents
move backwards beyond the upper esophageal sphincter, into the larynx)
It can also be due to various non cancerous causes including vocal cord polyps, cysts, nodules,
edema/swelling, or atrophy due to aging. Cancer of the larynx causes hoarseness, it is especially
common in smokers. Diseases or injury to some nerves in your neck due to trauma, disease or surgery
can also lead to hoarseness.
Other less common causes are thyroid disorders, Parkinson’s disease, myasthenia gravis. In some cases,
no identifiable cause is identified. This is called functional hoarseness.
Measures to reduce hoarseness and improve sound quality include taking plenty of water, using a
microphone to reduce shouting, avoiding and reducing caffeine e.g. in coffee, carbonated drinks,
cessation of smoking, both primary and secondary, avoid talking in loud environments and voice rest
when symptoms start.
You should see an ENT (ear, nose and throat) specialist if you have mild hoarseness lasting more than
four weeks especially if you smoke, severe hoarseness for a few days, difficulty breathing, pain when
speaking or if your job requires use of your voice e.g. Teachers, singers etc.
The ENT specialist will take a history and examine your throat with a special instrument before
recommending treatment depending on the cause of your symptoms.

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