Voice disorders

Which are the most common vocal cord medical conditions and which are the most common factors that can cause hoarseness?

     Vocal cord disorders can cause problems with the voice and speech, most commonly presenting as hoarseness or a raspy voice.
Hoarseness refers to a change in the normal quality of the voice, which may become rough, breathy or unusually low-pitched. It can be caused by a variety of conditions.


What are the most common causes of hoarseness:

• Vocal fatigue or vocal injury: Excessive voice use or a sudden, very loud vocalization can injure the vocal cords. This may cause increased blood flow and swelling, reducing their elasticity and their ability to close properly. Management may include voice rest, adequate hydration and, where appropriate, relaxation exercises for the laryngeal muscles. If symptoms persist, an endoscopic examination is necessary to rule out underlying pathological conditions.
• Respiratory tract infections (colds): These may cause acute inflammation of the vocal cords (vocal cord inflammation or corditis) or of the larynx (laryngitis).
• Chronic laryngitis: This may result from exposure to irritants such as smoking, alcohol and very hot foods. Medical evaluation is important, as some persistent laryngeal changes may represent precancerous lesions.
• Iatrogenic causes following surgery: Operations such as thyroidectomy may occasionally result in injury to the laryngeal nerve, which controls vocal cord movement. Depending on the extent of the injury, this may cause persistent or permanent hoarseness.
• Vocal cord nodules or cysts: These may develop as a result of vocal misuse or overuse.
• Vocal cord lesions or impaired laryngeal mobility: Vocal cord fixation or reduced movement may occur in association with laryngeal cancer.
• Age-related changes: As we grow older, the vocal cords may lose elasticity and their ability to support a strong, clear voice.
• HPV-related vocal cord papillomas: These lesions may be associated with human papillomavirus (HPV) infection, including transmission through oral-genital sexual contact.
• Incorrect voice use: Improper vocal technique, including speaking with the false vocal cords, can contribute to voice disorders.
• Vocal cord paralysis following surgery: Thyroidectomy and other surgical procedures may occasionally cause injury to the laryngeal nerve, resulting in impaired vocal cord movement or paralysis.
• Laryngopharyngeal reflux (LPR): Stomach contents may reflux into the throat and reach the larynx, irritating the vocal cords and causing hoarseness.

What should you do if hoarseness suddenly develops?
     If hoarseness occurs alongside a common cold and resolves within a few days, further investigation is not usually necessary.
In these cases, drinking plenty of water, resting the voice and maintaining adequate hydration may help relieve symptoms.

When can hoarseness be a warning sign, and what should you do?
     If hoarseness develops suddenly and persists for more than a week, particularly in smokers, an endoscopic examination of the larynx is important to investigate the cause and rule out potentially serious conditions, including malignancy.
The advanced Olympus flexible video endoscope, featuring high resolution and image magnification (zoom) as well as three levels of image enhancement (Enhance 1, 2 and 3), can assist in identifying subtle changes in the larynx, including early suspicious or precancerous lesions.
The examination is performed easily and comfortably in the ENT clinic, takes only a few minutes and is generally well tolerated.

IMPORTANT: If hoarseness persists for more than 7 days, you should seek evaluation by an ENT specialist. Modern endoscopic examination of the larynx can help identify the underlying cause and rule out potentially serious conditions.