Hoarseness is a harsh, rough, raspy quality to the voice. Hoarseness is generally caused by irritation of, or injury to, the vocal cords. This trauma to the vocal cords leads to a change in the pitch of the voice. The voice box, or larynx, is the portion of the respiratory (breathing) tract containing the vocal cords that produce sound. It is located between the pharynx and the trachea. The larynx, also called the voice box, is a 2-inch-long, tube-shaped organ in the neck.
We use the larynx when we breathe, talk, or swallow. Its outer wall of cartilage forms the area of the front of the neck referred to as the "Adams apple." The vocal cords are two bands of muscle that form a "V" inside the larynx.
Hoarseness can be caused by a number of conditions. The most common cause of hoarseness is inflammation of the vocal cords from virus infection related to the common cold or upper respiratory infection. Hoarseness can also be caused by bacterial infection, overuse of the voice (such as from yelling and voice abuse or singing), trauma to the vocal cords or larynx, inhalation of irritants (smoking, etc.), chronic sinusitis, allergy, reflux of acid from the stomach (GERD), tuberculosis, syphilis, stroke and neurologic disorders (Parkinson's disease), rheumatoid arthritis, thyroid problems (hypothyroidism), and cancer of (or that has spread to) the larynx.
Cough suppressants are sometimes used to prevent recurrent irritation of the vocal cords from coughing. Hoarseness that persists for longer than two weeks should be evaluated by doctor.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
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