Hoarseness – Voice Change

Your voice is the sound that is made when air passes from the lungs to the voice box or larynx.

Abnormal changes in the voice are called hoarseness. When your voice is hoarse it can sound raspy, strained or breathy and it can show changes in the volume or pitch. You may have pain or discomfort during speaking and have trouble controlling the pitch, loudness or quality of your voice.

Causes of Hoarseness

Acute Laryngitis:

The most common cause of hoarseness is acute laryngitis. This occurs due to swelling of the vocal cords from the common cold, viral infection, upper respiratory tract infection or from voice strain or abuse.

Vocal Cord Paralysis or Paresis:

Vocal cord paralysis or paresis occur when one or both of the vocal cords do not open or close properly. This causes voice problems and can cause difficulties with breathing and swallowing as well.

Vocal Cord Nodules or Polyps:

Nodules and polyps are non-cancerous growths on one or both of the vocal cords. They can also cause hoarseness and voice change.


Smoking is a cause of hoarseness. As smoking is the major cause of throat cancer, smokers who become hoarse should seek medical advice straight away.

Neurological Disorders or Diseases:

Hoarseness can also be present in patients who have Parkinson’s disease or who have had a stroke. Hoarseness may also be a symptom of a rare neurological disorder called spasmodic dysphonia. This usually only affects the voice but may also affect breathing.

Other Causes:

These can be allergies, gastro oesophageal reflux, trauma to the voice box or larynx and thyroid problems. Overuse of the voice and shouting and screaming can lead to hoarseness and voice problems.



Patients who have voice problems or hoarseness may have a raspy, strained or breathy voice.  You can have difficulty in swallowing or breathing and there may be coughing and a feeling of a lump in your throat.

Diagnosis of Hoarseness

Dr Katzen will take a thorough medical history and perform a physical examination of your vocal cords. This is usually done with a fibre optic scope that allows a clear view of the vocal cords. In some cases, special tests designed to evaluate your voice may be recommended.

Treatment of Hoarseness

Voice problems are often treated by resting your voice. In some cases, medicines, surgery or voice therapy may be recommended. The goal is to regain your normal voice.