Hoarseness
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Hoarseness is a general term that describes abnormal
changes in voice quality. Common changes can include
a person’s voice becoming rough, harsh or squeaky
or the voice cracking when the person tries to speak
loudly or shout. Sometimes the volume or pitch can
become too extreme (i.e. too high or low). In some
cases, a person may have no voice at all.
Changes in voice quality are usually due to disorders
affecting the vocal cords (also known as vocal folds),
which are tiny bands located in the voice box. Common
disorders that affect vocal cords include nodules,
polyps, granuloma, cysts, pseudocysts, vocal fold
paralysis, vocal fold paresis, muscle tension dysphonia,
puberphonia, cancer of the voice box, vocal fold
papilloma, leukoplakia of the vocal folds, hemorrhage,
laryngitis and fungal infection of the voice box.
Common symptoms include:
- Raspy or hoarse voice quality
- Difficulty projecting
- Strain while speaking
- Shortness of breath while speaking
- Difficulty singing
- Worsening of voice quality at the end of the day or after increased talking
- Pain and / or discomfort in the throat
- A lump-in-the-throat sensation
- No voice or the inability to speak
- Reduced singing range
- Voice fatigue
You should make an appointment to see an ear, nose
and throat doctor or a speech-language pathologist if
you experience the following symptoms:
- Hoarseness lasting longer than two weeks
- Loss or severe change in voice lasting more than a few days
- Difficulty swallowing
- Pain in the throat that is not related to an upper respiratory tract infection
- Lump in the throat
- Coughing up blood
Hoarseness is evaluated by a multidisciplinary team
including an otolaryngologist and a speech-language
pathologist with a specialization in voice. Often this
type of specialized team is found at a “voice clinic.”
After gathering a comprehensive medical history,
the otolaryngologist and/or the speech-language
pathologist will take a look at the vocal cord structure
and movement with either a rigid endoscope that
remains in the mouth or a flexible endoscope that
goes through the nose. Evaluation of vocal cord
movement is done by performing a stroboscopy or
high-speed endoscopy. In addition, other specialized
testing is performed to measure voice acoustics and
aerodynamics (breath support for the voice).
Hoarseness is best managed by a team of professionals who
understand and know how the voice works. The professional
team involved in care and management of voice disorders
includes but is not limited to laryngologists (ear, nose and
throat doctors who specializes in the area of voice), speech-language pathologists, singing coaches, voice teachers,
acting coaches, psychologists, gastroenterologists and
pulmonary specialists.
Depending on the cause, hoarseness can be treated medically,
surgically and with voice therapy. The recovery period varies.
Some voice conditions can be treated in as little as one hour
and some may require long-term ongoing management.
The UK Clinical Voice Center began in 2008 as a result of
years of research in vocal disorders. Until the center was
opened by the UK College of Health Sciences, patients with
voice problems or concerns had to travel out of state to seek
care. Now a multidisciplinary team of dedicated clinicians,
researchers, physicians, professors and specialists can treat
even the most complex voice disorders in a location that is
close to home for many Kentuckians. Eventually, the center
plans to utilize telemedicine to extend the reach of the
center across the state.
The Clinical Voice Center is located in the Kentucky Clinic,
Third Floor, Wing C, Room B317. To make an appointment,
call 859-257-0143.
9-964 3/09
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