Hoarseness, loss of voice: What's it, causes, symptoms, diagnostics, treatment, prevention

Hoarseness; Voice strain; Dysphonia; Loss of voice

Hoarseness: What's it?

Hoarseness is a symptom or condition, associated with a change in voice quality: I'm screeching, hoarse or hoarse. It refers to the change in the sound of a person's voice, usually, to a lower tone, which is caused by a form of irritability or damage to the vocal cords.

Hoarseness can be caused by a virus, GERD (gastroesophageal reflux disease), excessive tension on the vocal cords, smoking, diseases or taking certain types of medications. Although this condition is often temporary and mild, sometimes it can be the result of a disease.

Causes of hoarseness

There are many potential causes of hoarseness. The most common cause of hoarseness is overexertion of the voice.. Examples of this type of hoarseness include screaming, prolonged talking or singing.

The second most common cause of hoarseness is a viral infection.. The most common viruses, causing hoarseness, are the common cold or flu.

Hoarseness can also be caused by acid reflux., when stomach acid leaks into the esophagus, irritating the vocal cords and causing them to swell. This type of hoarseness may be associated with GERD. (gastroesophageal reflux disease).

Generally, hoarseness can be caused by the following reasons:

  • acid reflux ( hastroэzofahealnыy reflux )
  • Allergies
  • Inhalation of irritants
  • Cancer of the throat or larynx
  • Chronic cough
  • Colds or upper respiratory infections
  • Chronic smoking or alcohol consumption, especially together
  • Overuse or strain of the voice (eg, when screaming or singing), which can cause swelling or swelling of the vocal cords.

Less common causes of hoarseness include:

  • Injury or irritation from breathing tube or bronchoscopy
  • Damage to the nerves and muscles around the vocal apparatus (as a result of trauma or surgery)
  • Foreign object in the esophagus or trachea
  • Ingestion of a hazardous chemical liquid
  • Laryngeal changes during puberty
  • Thyroid or lung cancer
  • underactive thyroid gland
  • Immobility of one or both vocal cords

Symptoms of hoarseness

Hoarseness may be transient ( acute ) or long ( chronic ). Rest and time can reduce hoarseness. Hoarseness, that lasts for weeks or months, must be checked by a doctor.

The most common symptom of hoarseness is a hoarse or husky voice.. This usually indicates swelling., irritation or tension of the vocal cords. Additional symptoms include:

  • Dry throat
  • Sore throat
  • Feeling a creak in the voice
  • Narrowing gorle
  • Pain or pressure when talking
  • Difficulty projecting voice
  • Ticking or crackling in the voice
  • Insufficient vocal range.
  • Difficulty swallowing

When to see a doctor

If hoarseness lasts more than three weeks, it is important to see a doctor. Hoarseness, that is accompanied by other signs or symptoms, such as difficulty breathing, sore throat or chest, nosebleed, fever or chills or weight loss, should be evaluated by a physician immediately.

Questions, that your doctor may ask

Your doctor may ask you a few questions, to better understand your condition and make a diagnosis. These may include:

  • When hoarseness appeared?
  • How long does it take?
  • Have you had a cold or other respiratory infection?
  • Do you have acid reflux or GERD?
  • Do you smoke or live in a smoky environment??
  • Are you taking any medication, including birth control pills?
  • What type of work do you do?
  • Do you have other symptoms?

Diagnosis of hoarseness

The most common way to diagnose hoarseness is to do a physical examination and take a personal and family history.. Your doctor may also order imaging tests., such as computed tomography, to check for any physical abnormalities in the throat or neck.

The doctor may also order a biopsy of the vocal cords., to rule out any other throat or neck problems. Besides, your doctor may recommend a test for gastroesophageal reflux, which includes the use of a special dye, leaving contours on the vocal cords, to determine, whether hoarseness is caused by acid reflux or GERD.

Treatment of hoarseness

Treatment for hoarseness depends on the cause of the condition.. If the hoarseness is caused by an infection, your doctor may prescribe antibiotics or antiviral drugs. If hoarseness is caused by allergies, your doctor may prescribe antihistamines or nasal sprays. If hoarseness is related to GERD, your doctor may prescribe medication to treat reflux.

In some cases, hoarseness may require surgery to treat.. This usually happens, if the hoarseness is caused by a tumor or physical obstruction in the throat or vocal cords.

Home treatment for hoarseness

There are several ways to treat hoarseness at home.. It is important to drink plenty of fluids and warm liquids, to soothe the throat and keep it lubricated. Avoid dry, cold or sour foods and drinks, as they can increase hoarseness and irritation. Do not smoke or sit in smoky, dusty or very cold rooms. Try to take breaks in screaming, singing or talking and do not whisper.

Using a humidifier or inhaling the steam can help reduce throat and vocal cord irritation.. Besides, use over-the-counter medicines, such as ibuprofen or aspirin, to reduce inflammation.

Prevention of hoarseness

The best way to prevent hoarseness is to practice good voice hygiene.. This includes avoiding screaming., excessively loud talking or loud singing, because these activities can overload the vocal cords. It is also important to avoid smoking and sitting in smoky, dusty or very cold environments and speak in the most natural voice possible.

Take regular breaks and drink plenty of fluids, to lubricate the vocal cords, and avoid dry, cold and sour foods and drinks. Besides, it is important to stay away from certain medications, such as antihistamines, decongestants, diuretics or birth control pills.

Be sure to schedule regular checkups with your doctor, To make sure, that any diseases are controlled and treated.

Used sources and literature

Akst L. Hoarseness and laryngitis. In: Kellerman RD, Rakel DP, eds. Conn’s Current Therapy 2021. Philadelphia, PA: Elsevier 2021:27-32.

Flint PW. Throat disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 401.

Stachler RJ, Francis DO, Schwartz SR, et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018;158(1_suppl):S1-S42. PMID: 29494321 www.ncbi.nlm.nih.gov/pubmed/29494321.

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