Loss of Voice - When to see the ENT?

Posted: Thursday, November 16, 2017

When to see the ENT about Loss of Voice / Hoarseness?

By: Elizabeth M. Hueman, MD

Do you ever wonder what may be causing your hoarse voice?

Hoarseness is a change in the quality of your voice resulting in loss of voice, raspy voice, or a low or high pitched voice.  When you speak or sing, your vocal cords which are muscles in your larynx (voice box) come together and touch creating your voice.  There are many different reasons why you may lose your voice.   It can be sudden in onset such as from viral laryngitis which tends to resolve quickly.  However, hoarseness can often last much longer from chronic irritation of the cords. 

In simple terms, if something is preventing your vocal cords from contacting each other normally then you will have a hoarse voice.  Examples of this include mucous coating your cords from a viral or bacterial illness or allergies/acid reflux, a polyp or benign or malignant tumor or a scar.   Overuse injury (screaming, yelling) and trauma to your neck can result in swelling of the vocal cords and hoarse voice.  Risk factors for vocal cord cancer include tobacco and alcohol use as well as uncontrolled acid reflux. 

Movement of your vocal cords is controlled by the recurrent laryngeal nerve which is a branch off the vagus nerve, or cranial nerve X.  If you suffer from a neurologic condition or a traumatic injury to the nerve this can result in weakness or even paralysis of the nerve that controls vocal cord movement.  The recurrent laryngeal nerve is important for swallowing, breathing, and speaking. 

Your otolaryngologist, ENT doctor, can help determine the cause of your hoarse voice easily in the office with an exam called a flexible laryngoscopy.  This is an in office exam which directly visualizes your vocal cords to look for any abnormalities or lesions on the vocal cords.

Vocal hygiene is extremely important in keeping your cords functioning at optimum level.  This includes adequate hydration, anti-reflux precautions, and refraining from screaming/yelling.

If you have been hoarse longer than ten days, call us at 919-595-2000 to schedule a vocal cord evaluation.

Dr. Hueman sees patients in our North Durham office, located at 4102 N. Roxboro Street, Durham, NC 27704, and our Cary office, located at 1010 TryonVillage Drive, Suite 701, Cary, NC 27518. Call 919-595-2000 to schedule an appointment today.