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Hoarseness is a general term that describes abnormal voice changes. The changes in sound are usually due to disorders related to the vocal cords that are the sound producing parts of the voice box. While breathing, the vocal cords remain apart. When speaking or singing, they come together, and as air leaves the lungs, they vibrate, producing sound. Swelling or lumps on the vocal cords prevent them from coming together properly and changes the way the cords vibrate, which makes a change in the voice, altering quality, volume, and pitch.
There are many causes of hoarseness. Fortunately, most are not serious and tend to go away in a short period of time. The most common cause is acute laryngitis, which usually occurs due to swelling from a common cold, upper respiratory tract viral infection, or irritation caused by excessive voice use.
Many unusual causes for hoarseness include nodules, reflux disease, smoking, allergies, thyroid problems, neurological disorders, trauma to the voice box, and occasionally, the normal menstrual cycle.
When hoarseness lasts longer than two weeks or has no obvious cause it should be evaluated by an otolaryngologist--head and neck surgeon (ear, nose and throat doctor).
An otolaryngologist will obtain a thorough history of the hoarseness and your general health. Your doctor will usually look at the vocal cords with either a mirror or a very small, lighted flexible tube (fiberoptic scope). Videotaping the examination or using stroboscopy (slow motion assessment) may also help with the analysis.
The treatment of hoarseness depends on the cause. Most hoarseness can be treated by simply resting the voice or modifying how it is used. The otolaryngologist may recommend surgery if a lesion, such as a polyp, is identified. Avoidance of smoking or exposure to secondhand smoke (passive smoking) is recommended to all patients. Drinking fluids and possibly using medications to thin the mucus are also helpful.
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