Hoarse Voice

Problems with the voice are common and can range from a minor inconvenience to major problems with work and communication. The voice is produced in the larynx and is very sensitive to a wide range of conditions.

What are the causes?

There are a wide range, and include:

  • Problems with movements of the vocal cords including strain, weakness and paralysis.
  • Problems with the lining of the vocal cords including polyps, cysts, nodules and granulomas.
  • Thinning of the vocal cords and a weak voice.
  • Reflux (laryngopharyngeal or “silent reflux”).
  • Laryngeal cancer – voice change which persists for more than a few weeks warrants review by an ENT surgeon to rule this out.

How is this assessed?

The history of the problem and associated symptoms is important as well as your demands on the voice, particularly in singers, teachers, public speakers and others who have high vocal demands. The quality of the voice is assessed, and examination of the voice box is performed using a small flexible endoscope passed through the nose.

What are the treatment options?

If the voice change is mild and not affecting your life, and there is no sign of a serious problem when we examine the voice box, no treatment may be necessary.

For some conditions the best treatment is voice therapy with a speech pathologist, and even in conditions which need surgery, speech pathology is often recommended.

For thinning of the vocal folds and vocal weakness, exercises can help but an injection into the vocal cords (“voice lift”) can also work well – this can be performed under local or general anaesthetic.

For other conditions, examination and / or surgery of the voice box in the operating theatre under a general anaesthetic may be needed.

If reflux is suspected we usually recommend treatment as this can cause voice problems on its own, combine with other issues, and cause problems with healing after surgery.