Voice is produced by the delicate vibrating vocal cords in the organ of the larynx (voice box. Any changes affecting the structure and function of the vocal cords or its surrounding structures will affect voice production says our Voice Specialist Doctor, Dr Y T Pang.
Abnormal voice changes is referred to as hoarseness. Hoarseness is merely a symptom and does not indicate the underlying cause. The voice is considered hoarse when it is weak, breathy or raspy in quality. Any small changes in the vocal cords or its function can produce this change. To produce a singing or speaking voice, the vocal cord must come together is a specific pattern and create vibrations of the air forming special waves form.
Causes of Hoarseness
Any condition that produces swelling, lump or growth on the vocal cords will change the vibration characteristics of the vocal cords affecting the quality, strength and pitch of the voice says Dr Y T Pang, our Voice Specialist Doctor.
The most common causes of hoarseness are infection of the larynx (laryngitis) or upper respiratory tract infections like the flu and Misuse of Voice in excessive voice use or shouting.
Other causes include
- Vocal Cord Polyps, Cysts and Nodules
- Excessive Coughing
- Vocal Cord Hemorrhage
- Vocal Cord Atrophy – seen mainly in the elderly
- Stomach Acid Reflux
- Neurological conditions like Strokes
- Cancer or Precancerous Lesions of the Larynx (Voice Box)
- Trauma to the Voice Box
- Thyroid Cancer or Lung Cancer
Importantly, ANY HOARSENESS THAT DOES NOT RESOLVE IN 2 WEEKS SHOULD BE EVALUATED BY A Voice Specialist Doctor.
What to expect when you see an ENT Doctor
The ENT Doctor will take thorough history. This will include your occupation, daily activities and habits, voice use, smoking and drinking habits, associated medical conditions and medications.
A nasendoscopy will be performed. This is a tiny video camera that is inserted through the nose and from the the vocal cord can be visualized. This is usually performed in the clinic under topical anesthetic and is well tolerated by children and adults. Most lesion or abnormality on the vocal cords and larynx can be determined this way. In certain situations, Video stroboscopy can be used to better ascertain the function of the vocal cords.