Hoarseness

Sound is produced by the vibration of the free edges of the vocal cords (vocal cords) as compressed air exits the trachea. Hoarseness is a very common symptom. Changes in sound can take different forms:

• Muffled voice
• Forked sound
• Rough sound
• Choppy sound
• Wheeze
• Decreased or increased voice
• Explosive sound
• Difficulty speaking
• Tired voice
• No sound at all

For an adequate and normal sound:

• Proper closure of the vocal cords
• Sufficient outdoor air
• Vibration of the vocal cords
• No deformity of the vocal cords
• The elongation and tension of the vocal cords must be controlled by the patient.

Hoarseness can be seen in infections that usually occur in the upper respiratory tract. However, if there is hoarseness lasting more than 2 weeks without upper respiratory tract infection, the reason for this should be investigated.

The most common causes of hoarseness are:

• Organic disorders
  • Congenital malformations
    • Sulcus vocal (There is difficulty in making a sound or the voice gets tired quickly)
    • Laryngeal web (Symptom usually occurs before 1 year of age. There is weakness, crackling and hoarseness in the crying voice. Sometimes there may be no sound at all)
  • Larynx infections
    • Acute laryngitis (Muffled and painful voice when talking)
    • Acute epiglottitis (muffled voice like having hot food in the mouth)
    • Acute laryngotracheobronchitis (CRUP) (Dry cough and voice change)
    • Nonspecific chronic laryngitis (cough and voice change as a result of irritation)
    • Specific chronic laryngitis (Tuberculosis, syphilis, sarcoidosis, leprosy may cause hoarseness by affecting the larynx)
  • Larynx neoplasms
    • Dysplasias
      • Leukoplakia
    • Malignant tumors
  • Vocal cord paralysis (There is neurological damage. Symptoms vary according to the affected neuron)
  • Mucosal and saccular diseases
    • Vocal nodule (Singer’s nodule)
    • vocal polyp
    • Contact ulcer (Painful and forced sound)
    • Intubation granuloma (usually occurs after surgery)
    • Reinke’s edema (Edema occurs in the reinke chamber of the vocal cord. It is usually seen in women who smoke in their 50s.)
    • Papilloma (Recurrent)
    • Laryngocele (Laryngeal hernia)
    • Saccular cysts (there may be a deepening of the voice)
  • Trauma
    • Mechanical traumas
    • Voice disorders resulting from surgical intervention
    • Iatrogenic traumas (after surgical removal of nodules or polyps)
  • Other reasons
    • Endocrine diseases
      • Hypothyroidism
      • Hyperthyroidism
      • Acromegaly
      • Menstrual period
    • Neurological disorders
      • Parkinson’s
      • Muscular dystrophy
      • Myasthenia gravis
      • Pseudobulbar palsy
      • Huntington korea
      • Multiple sclerosis
      • Amyotrophic lateral sclerosis
    • Presbylarynx (Usually, over 50 years of age, there may be weakening and straining in the voice because of thinning and bending of the vocal cords)
    • Gastrointestinal system diseases
      • Reflux
    • Respiratory system diseases (usually occurs as side effects of inhaled steroids used in the treatment of lung diseases)
      • Asthma
      • Chromine obstructive pulmonary diseases
      • Lung tumor
    • Medicines
      • Antihistamines
        • Diphenhydramine (makes dry)
        • Loratadine (dryness)
      • Decongestants
        • Pseudoephedrine (makes dark secretion)
      • Diuretics
        • Furosemide (dryness)
      • Alpha-adrenergic drugs
        • Terazosin (makes dark secretion)
      • Antitussives (dryness)
      • Vitamin C (makes dry)
      • Chemotherapy drugs
        • Vincristine (transient paralysis of vocal cords)
      • Parkinson’s drugs
        • L-Dopa (makes it dry)
      • Phenothiazine, chlorpromazine (they cause dryness)
      • Aspirin (makes vocal bleeding)
      • NSAIDs (they cause vocal bleeding)
      • Androgens, danazol (temporarily reduced timbre)
      • Antacids (they cause dryness)
    • Shimic irritants (cigarettes and other chemicals)
  • Functional disorders
    • Hyperfunctional dysphonia (It occurs due to fatigue of the vocal cords with excessive use of voice. It can also cause nodules in the vocal cords.)
    • Hypofunctional dysphonia (Voice component is caused by weakness of the muscles. General weakness of the body can also be seen here)
    • Psychogenic dysphonia (hoarseness may occur for psychological reasons without any organic disorder in the body)
    • Psychogenic aphasia (converse aphonia) (These patients voluntarily speak in a whisper for emotional reasons.)

Since the treatment of hoarseness will vary according to the treatment of the underlying cause, it must be evaluated in the health facility. In addition, voice therapy and voice hygiene are an important part of the treatment.