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Voice Disorders and Hoarseness

Abnormal changes in the voice are called “hoarseness.” When hoarse, the voice may sound breathy, raspy, strained, or show changes in volume or pitch. Voice changes are related to disorders in the sound-producing parts (vocal folds) of the voice box (larynx). While breathing, the vocal folds remain apart. When speaking or singing, they come together and, as air leaves the lungs, they vibrate, producing sound. Swelling or lumps on the vocal folds hinder vibration, altering voice quality, volume, and pitch.

Hoarseness can be caused by:

  • Acute Laryngitis or swelling of the vocal folds that occurs during a common cold, upper respiratory tract viral infection, or from voice strain. Serious injury to the vocal folds can result from strenuous voice use during an episode of acute laryngitis.
  • Voice Misuse (speaking loudly in noisy situations or in unamplified public speaking, excessive talking, intentionally speaking in a higher or lower than natural pitch).
  • Benign Vocal Cord Lesions. Prolonged hoarseness can occur when you use your voice too much, or too loudly for extended periods of time. These habits can lead to nodules, polyps, and cysts. Vocal nodules (singers’ nodes) are callus-like growths of the vocal folds. Vocal fold polyps and cysts also occur in those who misuse their voice, but can also occur in those who do not.
  • Vocal Hemorrhage. If you experience a sudden loss of voice following a yell or other strenuous vocal use, you may have developed a vocal fold hemorrhage. Vocal fold hemorrhage occurs when one of the blood vessels on the surface of the vocal folds ruptures and the soft tissues fill with blood. It is considered a vocal emergency and should be treated with absolute voice rest and examination by an otolaryngologist (ear, nose, and throat doctor).
  • Gastroesophageal Reflux (GERD)
  • Laryngopharyngeal Reflux (LPRD)
  • Smoking
  • Neurological Diseases or Disorders
  • Allergies, thyroid problems, trauma to the voice box, and, occasionally, menstruation
  • Laryngeal Cancer

Prevention tips:

  • If you smoke, quit.
  • Avoid agents that dehydrate the body, such as alcohol and caffeine.
  • Avoid secondhand smoke.
  • Stay hydrated—drink plenty of water.
  • Humidify your home.
  • Watch your diet—avoid spicy foods.
  • Try not to use your voice too long or too loudly.
  • Use a microphone if possible in situations where you need to project your voice.
  • Seek professional voice training.
  • Avoid speaking or singing when your voice is injured or hoarse.

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