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Hoarseness can be described as abnormal voice changes that make your voice sound raspy and strained and higher or lower or louder or quieter than normal.
These changes are usually the result of disorders of the vocal cords which are the sound-producing parts of the voice box (larynx).
The most common cause of hoarseness is laryngitis (inflammation of the vocal cords) which is usually associated with a viral infection but can also be the result of irritation caused by overuse of your voice e.g. excessive singing, cheering, loud talking.
Other causes of hoarseness include:
  • nodules on the vocal cords – these may develop after using your voice too much or too loudly over a long period of time
  • smoking
  • gastro-oesophageal reflux disease (GERD) – stomach acid comes back up the oesophagus and irritates the vocal cords. This is a common cause of hoarseness in older people
  • Recurrent respiratory papilloma (RRP)
  • allergies
  • polyps on the vocal cords
  • glandular problems
  • tumours.
Diagnostic tests may include viewing the vocal cords with a mirror at the back of your throat or by inserting a small flexible tube with a camera on the end (endoscope) through your mouth. Sometimes tests may be done to analyse the sounds of your voice.
Treatment depends on the cause of the hoarseness and may include resting your voice or changing how it is used, avoiding smoking, medication to slow stomach acid production and sometimes surgical removal of nodules or polyps.  New treatments available include laser therapy, vocal fold augmentation, Botox injections and office removal or treatment of many problems. 
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This page was last updated at 9:45AM on February 10, 2021.