Hoarseness (Hoarse Voice)

Hoarseness (hoarse voice) is a characteristic alteration of the voice which loses its normal timbre and becomes rough, weak, or “deep”. It is usually accompanied by dryness and irritation in the throat and in most cases is caused by inflammation of the vocal cords, known as laryngitis..

Hoarseness – Common Causes

Η The most common cause of hoarseness is a viral infection of the upper respiratory system.
Άλλοι συνήθεις παράγοντες που μπορεί είτε να προκαλέσουν είτε να επιδεινώσουν το βράχνιασμα είναι:

• Gastroesophageal reflux disease (GERD)
• Smoking
• Increased consumption of caffeine and alcoholic beverages
• Excessive vocalization (screaming, shouting)
• Excessive use of the vocal cords (long hours of talking, singing, crying, etc.)
• Allergic rhinitis
• Inhalation of toxic substances
• Chronic and/or acute cough

In addition, hoarseness can be due to any of the following causes:

• Polyps on the vocal cords
• Vocal cord nodules
• Diseases of the thyroid gland
• Cancer of the larynx or lung
• Injuries or damage to the larynx caused by various conditions such as the insertion of a breathing tube (intubation)
• Puberty in boys (transitional period)
• Thoracic aortic aneurysm
• Neuromuscular diseases that may affect the function of the vocal cords

Hoarseness – When to visit the doctor

In case the hoarseness lasts more than 10 days in adults or more than 7 days in children, a visit to the doctor is necessary. The same applies if hoarseness is accompanied by salivation in children or by difficulty in swallowing or breathing. Also, complete inability to speak (aphonia) may suggest a serious underlying condition.

In the office, ENT will take the patient’s medical history and look for symptoms that will help them determine the underlying cause of the hoarseness.

When taking the history, the patient will be asked about the quality of their voice, the duration of their symptoms as well as possible factors that aggravate the condition such as loud phonation, prolonged talking and smoking.

Your doctor will then perform  a laryngoscopy.. It is the most modern method of diagnosis which is done with a special tool called laryngoscope. This is connected through a special camera with a high-definition screen. This way, doctor and patient can monitor the inside of the larynx in a magnified image, which enables an immediate and accurate diagnosis.

Depending on the findings of the examination, the doctor may request an additional examination such as a CT scan of the larynx, a throat swab culture or a blood test.

Treatment Options

Η The choice of treatment depends primarily on the cause of the hoarseness.

The conservative approach includes the following:

• Voice rest or complete speechlessness for a few days
• Good hydration
• Less consumption of caffeine and alcohol
• Inhalation of water vapour
• Reduce or quit smoking
• Avoidance of substances that can cause allergies

Hoarseness: Surgical Treatment with Microlaryngoscopy

Quite often and depending on the underlying cause (e.g., a polyp of the vocal cords) hoarseness can be treated surgically. The indicated operation is called microlaryngoscopy and is one of the operations on the larynx and vocal cords. It is performed under general anesthesia using a laryngoscope which is inserted through the mouth without any external incision.
It is a safe and relatively short procedure that is easily tolerated. A few hours after the operation, the patient can return to their home, following the medical instructions that will be given to them.

Postoperative pain is absent or minimal and is managed with mild analgesics. Voice rest for a few days is recommended and then there is a gradual return to normal speech.