Hoarseness

At UT Southwestern Medical Center, our multidisciplinary team uses the latest technological advancements to expertly diagnose and effectively treat hoarseness and its underlying causes. With years of experience, our physicians quickly get to the root causes to help patients get back to the activities they enjoy.

Comprehensive Care for Hoarseness

Hoarseness describes abnormal changes in the voice that can sound weak, raspy, or strained. Hoarseness commonly results from a problem with the vocal cords that can involve an infection or inflammation. If hoarseness doesn’t go away after two weeks, it might be a symptom of a more serious condition.

UT Southwestern’s Voice Center brings together fellowship-trained laryngologists (ear, nose, and throat doctors with specialized training in disorders of the larynx) and speech-language pathologists to treat hoarseness and relieve its symptoms. Our program uses therapies derived from the latest scientific advances in voice care, and our specialists use conservative treatment and minimally invasive procedures to evaluate, diagnose, and treat hoarseness.

Causes of Hoarseness

Most often, a viral infection in the upper respiratory tract causes short-term hoarseness. Other common causes of prolonged hoarseness include:

• Aging
• Cancer of the airway, larynx, lungs, thyroid, vocal cords, or other areas of the head and neck
• Chronic cough or throat clearing
• Gastroesophageal reflux disease (GERD)
• Inhalation of irritating substances
• Laryngitis (swollen, inflamed vocal cords), usually caused by a cold or other respiratory infection
• Other medical conditions, such as Parkinson’s disease, rheumatoid arthritis, stroke, or thyroid conditions
• Overuse or abuse of the voice, such as excessive shouting
• Misuse of the voice, seen with excessive or imbalanced muscle tension patterns
• Smoking
• Spasmodic dysphonia
• Vocal cord tremor
• Vocal cord nodules, polyps, and cysts
• Vocal cord cancer
• Vocal cord paralysis

Symptoms of Hoarseness

With hoarseness, the voice can sound:

• Breathy
• High or low in pitch
• Scratchy
• Shaky
• Whisper-like (low in volume)

Other symptoms that can occur along with hoarseness include:

• Coughing
• Difficulty breathing
• Difficulty or pain when swallowing or talking
• Dry, scratchy, or sore throat
• A feeling of a lump in the throat

Diagnosing Hoarseness

At UT Southwestern’s Voice Center, our experienced voice and ear, nose, and throat specialists conduct a thorough evaluation, which includes a:

• Physical exam, with an inspection of the vocal cords and upper airway
• Review of personal medical history
• Discussion of symptoms and vocal demands, such as occupation and hobbies

To examine the vocal cords and larynx, we often use one or more instruments, such as a:

• Flexible laryngoscope: A narrow, flexible tube with a light and camera, inserted through the nose
• Rigid laryngoscope: A narrow, rigid viewing tube inserted through the mouth
• Videostroboscope: A camera with a flashing light that provides a slow-motion view of the vocal cords as they vibrate

We sometimes order additional tests, such as:

• Blood tests: Lab tests to check for signs of infection or disease that might be related to hoarseness
• Computed tomography (CT) scan: Specialized X-ray technology that takes cross-sectional images to produce 3D images of the neck to look for abnormalities
• Sound (acoustic) analysis: Computer analysis that identifies abnormalities in the sounds produced by the vocal cords

Treatment for Hoarseness

If a medical condition is the cause, treating the condition often resolves the hoarseness. Our team treats a wide variety of possible underlying conditions, such as the following (along with treatments we provide):

• Allergies – allergy testing and medications, either prescription or over-the-counter
• Bacterial or fungal infections – antibiotics or antifungals
• GERD/LPR (gastroesophageal/laryngopharyngeal reflux) – weight loss, dietary changes, and medications to reduce stomach acid
• Laryngeal cancer – surgery, radiation therapy, chemotherapy, and other cancer treatments
• Odynophonia or pain with voice use that can accompany hoarseness – voice therapy and in-office injections
• Spasmodic dysphonia – Botulinum toxin (Botox) injections, voice therapy, or surgery
• Voice tremor – Botox injections and voice therapy
• Viral respiratory infections – rest, fluids, and NSAIDs
• Voice misuse, abuse, or overuse – voice therapy with a speech-language pathologist
• Vocal cord nodules, polyps, or cysts – elimination of irritants, voice rest, voice therapy, or surgery to remove the growths
• Vocal cord paralysis – voice therapy, in-office injections, or surgery

At UT Southwestern, our Voice Center features specialized speech-language pathologists who can provide patients with vocal exercises to optimize voice production and tips to avoid hoarseness by changing the way they use their voices. Learn more about our professional voice care.

Self-Care for Hoarseness

Patients can do some things themselves to relieve hoarseness, such as:

• Resting the voice by avoiding talking as much as possible for a few days
• Drinking plenty of fluids to help keep the airways moist and the mucous thin
• Using a humidifier to add moisture to the air
• Avoiding actions that strain the vocal cords such as whispering or shouting
• Taking medicines to reduce stomach acid for hoarseness due to GERD
• Avoiding the chronic use of decongestants, which can dry out the vocal cords over time
• Reducing or stopping smoking and vaping