Loading Results
We have updated our Online Services Terms of Use and Privacy Policy. See our Cookies Notice for information concerning our use of cookies and similar technologies. By using this website or clicking “I ACCEPT”, you consent to our Online Services Terms of Use.

When Is Losing Your Voice Cause for Concern?

Share
Facebook
X
Pinterest
LinkedIn
Email
Print
A doctor is examining a male patient's throat

When you lose your voice, chances are a little rest and hydration will bring it back. But if hoarseness lasts for several weeks, it’s time to seek medical attention, says University Hospitals voice therapist Lex Rakowski, SLP.

“There is certain degree of hoarseness that is normal from day to day or an upper respiratory infection,” Rakowski says. “It becomes a concern when that hoarseness lasts for three weeks or more. That’s when we consider it to be a chronic issue.”

What Causes Hoarseness?

There are several potential causes of persistent hoarseness.

Overuse and Abuse. Straining the vocal cords is a common reason people lose their voice. “For example, yelling at sports events or prolonged singing can lead to stiffness of the vocal cords or lesions on the vocal folds,” says UH otolaryngologist N. Scott Howard, MD, Director of the University Hospitals Voice, Airway and Swallowing Center. “Professionals who use their voices extensively, like singers, fitness instructors and call center workers, are particularly at risk.”

Laryngitis. Inflammation of the vocal cords, usually caused by a viral infection or overuse, can lead to chronic hoarseness.

Vocal Cord Hemorrhage. Excessive yelling, singing or chronic coughing can cause blood vessels to rupture, leading to sudden hoarseness and potentially causing polyps or cysts.

Gastroesophageal Reflux Disease (GERD). Stomach acid washing up in the throat can irritate the vocal cords and cause hoarseness.

Nodules, Cysts, Polyps, Papillomas. These are non-cancerous growths on the vocal cords. Singers are prone to develop “singer’s nodules” from overusing their voices. Papillomas are caused by the human papillovirus (HPV), a common sexually transmitted infection.

Cancer of the Larynx. Smoking is the biggest risk for developing laryngeal cancer.

Medications. Certain medications, such as asthma inhalers, can contribute to hoarseness.

Neurological Diseases. Parkinson’s disease, stroke and other conditions can affect the muscles of the larynx. A chronic neurological condition called laryngeal dystonia can cause muscles in the voice box to spasm. This is treated with either Botox injections or surgery. Vocal cord paralysis is another neurological condition that affects the muscles of the voice. This can occur after surgery or an upper respiratory infection and most often results in a breathy quality of the voice.

Age-Related Weakness. Vocal cords may become weaker as we get older, Dr. Howard says.

“It’s just like any other muscle, we can see atrophy in some of the muscle in the throat, which may lead to an increase in effort when using the voice,” he says. “A lot of our patients will describe a sensation of being hoarse but actually have a good voice quality. The hoarseness they feel is an increase in the effort to use their voice relative to what it used to be.”

Treatments for Chronic Hoarseness

To help determine the cause of chronic hoarseness, your doctor will use a small, flexible scope with a camera to look at the voice box through the nose or mouth. “From that evaluation, we get a lot of information about how the vocal cords look, whether there are any lumps, bumps or weakness that may be contributing to the hoarseness,” says Rakowski.

Resting the vocal cords is often key to recovery. That means keeping your voice low and refraining from straining. “We call it the podcast voice,” says Rakowski. “We also have patients focus on hydration. Water is so important for the health of the throat. It helps with mucus, making sure mucus works as a good lubricant for our vocal cords.”

Other strategies for reducing the risk of losing your voice include:

  • Using a humidifier during winter.
  • Good sleep and good diet.
  • Voice (speech) therapy using various techniques and exercises to improve breathing control and vocal cord function.
  • If acid reflux is an issue, over-the-counter and prescription medications and dietary modifications are often recommended.
  • Minor procedures done in the office include injections of medications or fillers into the vocal cords for some conditions. This often improves function.

Minimally invasive surgery may be indicated to remove growths on the vocal cords. “Whether a growth is benign or cancerous, we are often able to perform minimally invasive surgery to preserve voice and swallowing function,” says Dr. Howard.

“We do laser surgery in both the operating room and the office. We can use a small fiber laser and treat the vocal cords with pulses of laser light. This can treat early cancers, papillomas, polyps and leukoplakia, which is a thick plaque that can be a precursor to cancer.”

Most patients do well with these conservative treatments, says Dr. Howard. “Rest, hydration, and vocal technique is also critically important after these procedures.”

Related Links

Our highly trained experts in voice, airway and swallowing disorders employ advanced technology to diagnose and treat any speech disorder, breathing condition or swallowing disorder. Learn more.

Share
Facebook
X
Pinterest
LinkedIn
Email
Print