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Hoarseness

Introduction

What is vocal cord?

Is the structure in the larynx that will close and vibrate during vocalisation/phonation (produce voice/swallowing) and open during breathing. Voice box or vocal cord is located in your throat. It has 3 functions that is for :

  1. Airway (breathing)
  2. Prevent aspiration (protect the lungs)
  3. Vocalization (produce voice)

(A) Vocal cord

(B)During breathing

(C) During vocalization and swallowing

Definition

Hoarseness is abnormal voice changes. The voice may be weak, scratchy, raspy, strained, or there may be changes in volume or pitch.

Causes

Most of the causes are not serious (benign) but may be caused by serious cancerous lesions (malignancy).

Benign causes includes :

Infective cause :

Vocal cord polyp

  1. Acute laryngitis usually associated with the common cold and viral infection.
  2. Irritation due to excessive voice use (screaming at sports event or concert).
  3. Prolonged voice usage as in teacher, singers or those using voice excessively. This causes a condition called polyp or nodule.
  4. Irritative substances such as smoking, corrosive inhalational or swallowed substance.
  5. Gastric reflux. Feeling of gastric acid regurgitate back to the throat. Usual in patient gastritis and elderly patients.

Signs & symptoms

  • Hoarseness
  • Difficulty in breathing / noisy breathing
  • Throat discomfort
  • Cough
  • Aspiration
  • Neck swelling
  • Dysphagia (difficulty in swallowing)
  • Odynophagia (painful swallowing)

Complications

  • Difficulty to communicate
  • Difficulty in breathing
  • Sometimes malignancy can mimics benign lesion

Treatment

  • Treat underlying cause
  • Voice rest
  • Avoid precipitating factors such as smoking, alcohol, voice abuse
  • Treat gastro oesophageal reflux
  • Sometimes laryngeal lesion has to be removed surgically
  • Malignancy needs assessment and proper management by ENT surgoen

Prevention

  • Avoid smoking, alcohol and voice abuse
  • Food modification in reflux disease

Rehabilitation

Speech therapist

Last reviewed : 26 April 2012
Writer : Dr. Hjh Saraiza Abu Bakar
Reviewer : Dato’ Dr. Narizan Ariffin