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Introduction

"Hoarseness" is a term often used to describe any change in quality of voice.  Hoarseness that lasts for more than two weeks requires a complete otolaryngologic examination to rule out potentially serious causes such as malignancy. This is particularly a concern in patients with a history of tobacco or alcohol use who are at higher risk for cancer of the head and neck.

Etiology

• Acute laryngitis, which is self-limited and related to acute respiratory illness or acute voice misuse
• Chronic laryngitis, which is related to irritants, reflux, or misuse
• Benign vocal fold lesions
• Malignancy involving the larynx
• Neurologic dysfunction
• Non-organic ("functional") issues
• Systemic conditions and rare causes

Manifestation

Phonation is referred to production of a vocal tone at the level of the vocal folds. The quality of the tone is modified by resonation through the upper airway and sinonasal tract and articulated into speech.

Evaluation

Patients with hoarseness for more than two weeks, in the absence of symptoms of an acute respiratory infection, should have a complete examination of the laryngopharynx, with visualization of the larynx, by an otolaryngologist. This may be performed by indirect laryngoscopy with a mirror in the posterior oropharynx, or with a transnasal or transoral fiberoptic or digital laryngoscope.

Treatment

Treatment of hoarseness may be considered according to underlying etiology.

Prevention

Patient should quit smoking, alcohol drinking and betel chewing. Phonation education may be effective.