Hoarseness is a change in the quality of the voice that can affect a person's quality of life. The change itself can be a voice that becomes hoarse, weak, or difficult to expel. This condition indicates a problem with the vocal cords.
Sound is produced by vibrations of the vocal cords, which are two V-shaped branches of muscle tissue located in the larynx. The larynx is an air passage between the base of the tongue and the trachea.
When speaking, the vocal cords come together and airflow from the lungs blows causing the vocal cords to vibrate. These vibrations produce sound waves that pass through the throat, mouth, and nose, then come out as sound.
The quality of sound or voice is determined by the size and shape of the vocal cords, as well as the condition of the cavity through which sound waves pass. The difference in sound also depends on the magnitude of the tension in the vocal cords. The higher the tension in the vocal cords, the higher the sound produced. Vice versa.
Hoarseness is not a disease, but a symptom of another condition. Although not an emergency, hoarseness can be a sign of a serious condition, especially if it has been going on for a long time.
Causes of Hoarseness
Hoarseness occurs when the vocal cords become irritated. Some conditions that can interfere with the vocal cords include:
1. Laryngitis
Laryngitis or inflammation of the larynx can be caused by several things, namely:
- Viral, bacterial, or fungal infections
- Allergies that cause coughing, sneezing, or postnasal drip thereby triggering irritation and swelling of the vocal cords
- Gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux, which causes stomach acid to rise and irritate the throat, larynx, and vocal cords
- Excessive use of vocal cords
2. Abnormal tissue growth on the vocal cords
Benign growths of abnormal tissue on the vocal cords, such as nodules, polyps, and cysts, can cause hoarseness. This tissue growth generally occurs when the vocal cords contract excessively, for example due to:
- Talk or sing out loud
- Talking for a long time
- Speak in a tone that is too high or too low
- Whisper
- Cough
In addition, abnormal tissue growth can also be laryngeal cancer, or papillomas that occur due to infection with the HPV virus.
3. Injuries to the vocal cords
Injury to the vocal cords can cause hoarseness. This condition can be caused by an external injury to the vocal cords, the use of a breathing tube for surgery, or the use of a breathing apparatus (ventilator).
4. Weak vocal cords
With age, the vocal cords can become thinner and weaker. However, weak vocal cords can also result from nerve injury at birth. A person with weak vocal cords usually has a voice that is small and breathy.
5. Bleeding on the vocal cords
This condition can occur when a person makes a sound too loud or continuously, so that the blood vessels in the vocal cords can burst.
6. Diseases or neurological disorders
Nerve diseases or disorders, such as Parkinson's disease and stroke, can weaken the vocal cord muscles. In addition, a rare neurological disease called spasmodic dysphonia can also cause the vocal cord muscles to tighten so that the voice becomes hoarse.
Risk factors for hoarseness
Hoarseness can happen to anyone. However, someone who has the following conditions is more at risk of developing hoarseness:
- Age 8–14 (children) or over 65 years (elderly)
- Have a smoking habit
- Consuming foods and drinks that contain caffeine and alcohol
- Having a job that often screams or uses vocal chords excessively, such as a singer or teacher
- Experiencing exposure to toxic substances
Hoarseness Symptoms
A symptom of hoarseness is a change in the pitch or quality of the voice, which can sound weaker, quiver, or hoarse. Someone who has a hoarse voice will also find it difficult to make a sound.
Other symptoms that can accompany hoarseness depend on the underlying cause. For example, in someone who is infected with the virus, hoarseness can occur along with a sore throat, coughing, and sneezing.
When to go to the doctor
Consult a doctor if you or your child has a hoarse voice, especially if it doesn't improve after more than 10 days. However, do not delay seeing a doctor if hoarseness is accompanied by the following symptoms:
- Difficulty breathing or swallowing
- Pain when talking
- Coughing up blood
- Lump on neck
- The sound is completely gone
Hoarse Voice Diagnosis
To diagnose hoarseness, the doctor will ask questions about the symptoms and complaints, medical history, and lifestyle of the patient. Next, the doctor will perform a physical examination to see any abnormalities or inflammation in the throat.
In addition, the doctor can also perform additional tests to determine the cause of hoarseness. Some of the checks that can be done are:
- Laryngoscopy, to see more clearly the condition of the larynx and vocal cords
- Throat swab culture (swab test), to detect the presence of bacteria or viruses in the throat
- Blood tests, to detect signs of infection or disease causing hoarseness
- Scan with neck X-ray or CT scan, to see the condition of the inside of the neck and detect abnormalities in the area
- Biopsy, to confirm if the results of laryngoscopy examination found suspicious tissue growth
Hoarse Voice Treatment
Hoarseness that occurs suddenly or is caused by overuse of the vocal cords usually improves with self-care at home. Following are the steps that can be applied:
- Drink lots of water, try as much as 2 liters per day
- Rest the vocal cords for a few days by talking less and not shouting, but also not whispering
- Avoid consumption of caffeinated or alcoholic beverages
- Do not smoke and avoid exposure to cigarette smoke
- Avoiding factors that trigger allergies or irritation of the vocal cords, for example by wearing a mask
- Using a humidifier to keep the airway open, making it easier to breathe
- Eating lozenges
- Hot shower
If within 1 week the hoarseness does not improve or even worsens, it is advisable to consult a doctor. The doctor will provide treatment whose method depends on the cause. Generally, hoarseness will resolve if the underlying condition is successfully treated.
Some of the treatments that can be done based on the cause are:
1. Laryngitis
Treatment of hoarseness due to laryngitis caused by bacterial infection is the administration of antibiotics. Meanwhile, in laryngitis caused by allergies, the doctor will give antihistamines.
If laryngitis is caused by irritation from stomach acid, your doctor will focus on treatment to reduce stomach acid. The treatment is carried out simultaneously with changes in the patient's diet. If needed, the doctor can also give corticosteroids to relieve inflammation of the vocal cords.
2. Abnormal tissue growth on the vocal cords
In hoarseness caused by abnormal tissue growth in the vocal cords, the doctor will perform vocal cord surgery to stop the growth of the tissue.
If the tissue growth is cancerous or has the potential to become cancerous, the doctor may prescribe radiation therapy or chemotherapy. After surgery, the patient is also advised to undergo voice therapy, in order to find out how to speak safely for his vocal cords.
3. Bleeding and wounds on the vocal cords
Hoarseness from injury or bleeding into the vocal cords can be treated by resting the vocal cords and avoiding medications that can trigger bleeding, such as blood thinners. Patients will also be directed to follow sound therapy so that the wound on the vocal cords can be completely healed.
4. Weak or tense vocal cords
Hoarseness due to weak vocal cords, either due to neurological disease or congenital, can be corrected with voice therapy. However, if therapy doesn't help, doctors can perform surgery to strengthen the vocal cords.
If the hoarseness is caused by tense vocal cords, the doctor may administer Botox injections to relax the vocal cord muscles. The doctor will also advise the patient to continue to undergo sound therapy.
Hoarseness Complications
Hoarseness can become permanent if the cause is not treated properly. If the damage to the vocal cords is severe, permanent voice loss is also possible.
This of course will also have an impact on the patient's quality of life. As a result, sufferers may experience the following problems:
- Worry
- Depression
- Social Disturbance
- Loss of a job
Hoarseness Prevention
Hoarseness can be prevented by doing the things below:
- Avoiding cigarettes and exposure to secondhand smoke
- Avoid excessive consumption of alcoholic and caffeinated beverages
- Drink enough water
- Maintain personal and environmental hygiene, such as washing hands before and after eating, or after handling objects
- Don't make too much noise
- Use water humidifier (humidifier) especially in rooms that use air conditioning
- Resting the vocal cords when you have to speak loudly or for a long time