The cause of hoarse voice

14 March 2020

A sore throat and hoarse voice may be common especially after shouting or singing in high tones. However, if this lasts for more than two weeks, and your voice is showing no improvement or if you are making wheezing sounds while breathing, there may possibly be an inflammation, injury or growth at the vocal cords.

The vocal cords are two V-shaped muscles located inside the larynx or voice box that are part of the respiratory system. When we sing or talk too much, these vocal cords will vibrate excessively and potentially cause injury and hoarse voice.

Sunway Medical Centre Consultant Ear, Nose and Throat (ENT), and Head and Neck Surgeon, Dr Rahmat Omar said most hoarse voice is due to benign tumours (non-cancerous) at the voice box and cysts, polyps or nodules on either left or right side of the vocal cords.

He said that these growths prevent the vocal cord from vibrating properly and interfere with the flow of vocal cord mucus when speaking, causing sound quality to be impaired, hoarseness and difficulty in removing the growth.  

“Voice abuse, smoking habits and drinking alcoholic beverages over a long period of time are the main causes of injury, inflammation or growth to the vocal cords. Allergies and Gastroesophageal Reflux Disease (GERD) can also cause inflammation or swelling to the voice box. Meanwhile, problems in the veins around the voice box area are caused by viral infections and are usually temporary,” he added.

Patients with an inflamed voice box or growth will experience a change in their voice, develop a chronic cough and have difficulty in breathing. If these growths go untreated or aren’t removed due to late detection, voice hoarseness will become more noticeable and cause the respiratory tract to be affected.

In fact, if the growth enlarges, patients will have difficulty in breathing when they try to talk and develop a wheezing sound while breathing (stridor).

Growths can be detected through a flexible and lightweight fiberoptic scope inserted into the throat through the nose or a rigid endoscope through the mouth to see the voice box in detail for diagnostic purposes (disease detection). This procedure is usually performed at an ENT clinic and does not require sedation or anaesthesia.

If a growth is detected, a biopsy where a sample from the vocal cord will be taken to test if the cells are cancerous of not. This procedure is performed in the operating theatre under general anaesthesia.

“Treatment depends on the cause of hoarse voice whether it is due to a growth that needs to be removed through surgery or simply by taking certain medicine. If it is caused by frequent shouting or singing, patients need to rest their voice to avoid the condition from worsening such as bleeding or injury,” Dr Rahmat said.

He added that the treatment of GERD or allergies can be used if hoarse voice is caused by it.

Patients with normal growths or non-cancerous growths do not need to go through surgery, instead they need only speech therapy to help them speak better.

Hoarse voice can also be caused by the disruption of the nerves that move the voice box (nerve paralysis can occur either temporarily or permanently depending on the cause), viral infections, complications during thyroid surgery, lung cancer or heart disease such as Ortner’s syndrome. The habit of smoking can also be a cause of hoarse voice.

Source: Berita Harian