Hoarseness is a condition resulting in a rough or harsh sound to the voice.
Hoarseness may be caused by many things. Hoarseness may be acute (of short duration) or chronic (of long duration).
In understanding what is happening in the body, the healthcare provider will want to know the answers to these questions:
Causes of hoarseness vary but may include:
Typical symptoms of hoarseness are a rough voice and a harsh sound to the voice.
In evaluating hoarseness, the healthcare provider usually will take a complete medical history. Any symptoms associated with the hoarseness will also be discussed. The person may be asked if there is a history of other illnesses or conditions, such as cancer, arthritis, or aneurysm. A physical exam will also be done.
The mouth and throat will be examined for redness, swelling, or drainage of pus. The neck will be felt for swollen glands, lymph nodes, thyroid enlargement, or other lumps in the neck. The healthcare provider may ask the person to stick out his or her tongue. If this is extremely difficult, there may be paralysis of one of the cranial nerves.
The eyes may be examined for ulcers or other problems. The neck and chest may be examined for enlarged veins possibly indicating an thoracic aortic aneurysm. Vital signs, including pulse, rate of breathing, temperature, and blood pressure will also be monitored to evaluate for infection.
A laryngoscopy may also be necessary. This test involves putting a special tube with a down a person's throat. This allows the healthcare provider to see the throat and vocal cords to determine if there are problems. Blood tests and sputum cultures also may be ordered to identify infections.
Avoiding smoking and exposure to smoke will decrease risk of hoarseness. Avoiding exposure to others with infections may also reduce the risk of hoarseness. Certain conditions and diseases that cause hoarseness are not preventable. If the person is using the vocal cords frequently, such as with singing, resting the voice between songs may reduce the risk of hoarseness. Seeking treatment for the underlying cause of the hoarseness may decrease the risk of hoarseness.
Long-term effects depend on the cause of the hoarseness. If the hoarseness is caused by an upper respiratory infection or overuse of the voice, hoarseness may improve without any further effects. If the hoarseness is caused by other conditions, long-term effects could result in permanent hoarseness or even death.
The risk of spreading hoarseness to others will depend on the cause. If the hoarseness is the result of an infection, it may be spread to others. If it is caused from trauma, disease to the larynx, or cancer, it is not necessarily contagious.
Treatment for hoarseness will depend on the cause. Upper respiratory infections may be treated with humidifiers, drinking warm fluids, bed rest, and medications. A person may be given antibiotics or anti-inflammatory medications. Medications to treat the underlying cause of the hoarseness may also be recommended. Resting the voice box by avoiding talking may also help the hoarseness. Avoiding smoking and alcohol may decrease hoarseness. In certain situations, surgery may be necessary to remove tumors or to take a sample of a tumor on or near the vocal cords to evaluate it.
Home care, bed rest, warm fluids, and humidifiers do not necessarily cause side effects. Antibiotics may cause stomach upset, allergic reaction, or other side effects. Surgery poses a risk of bleeding, infection, and reaction to the anesthesia.
After treatment, conditions will depend on the cause of the hoarseness. If an upper respiratory infection was the cause of the hoarseness, there may be no need for further treatment. If a chronic disease or cancer is the cause of the hoarseness, treatment could last a lifetime, or the course of treatment may change over time.
Any new or worsening symptoms should be reported to the healthcare provider.
Author:Eileen McLaughlin, RN, BSN
Editor:Wendel, Sandra J., BA
Reviewer:Melissa Sanders, PharmD
Professional Guide to Signs and Symptoms, Springhouse, 1997.