Hoarseness: Hoarseness is a term referring to abnormal voice changes. Hoarseness may be manifested as a voice that sounds breathy, strained, rough, raspy, or a voice that has higher or lower pitch. There are many causes of hoarseness, including viral laryngitis, vocal cord nodules, laryngeal papillomas, gastroesophageal reflux-related laryngitis, and environmental irritants (such as tobacco smoking). An accumulation of fluid in the vocal cords associated with hoarseness has been termed Reinke's edema. Reinke's edema may occur as a result of cigarette smoking or voice abuse (prolonged or extended talking or shouting). Rarely, hoarseness results from serious conditions such as cancers of the head and neck region.