Voice Disorders

Voice disorders affect the way the voice sounds — hoarseness, weakness, breathiness, whispery voice, or pain. Most are short-lived from a cold or voice overuse. Persistent hoarseness lasting more than 3 weeks — especially in smokers and tobacco users — needs an urgent ENT review to rule out vocal-cord lesions and cancer.

Common causes

• Acute laryngitis — viral upper respiratory infection; resolves in 1–2 weeks.
• Voice misuse — shouting, prolonged loud speaking, cheering at events, professional demand (teachers, singers, call-centre workers, auctioneers, priests).
• Vocal nodules, polyps, and cysts — from chronic voice strain.
• Reflux laryngitis — acid from the stomach irritating the voice box; often morning hoarseness.
• Smoking and tobacco chewing — a major cause of laryngitis, vocal-cord damage, and laryngeal cancer.
• Thyroid disease, Parkinson's, stroke, myasthenia gravis — voice symptoms can be the first sign.
• Laryngeal cancer — most important to rule out in persistent hoarseness.
• Psychogenic voice loss after severe stress.

Red flags — see an ENT

• Hoarseness lasting more than 3 weeks — especially in smokers/tobacco users.
• Trouble swallowing, pain on swallowing, ear pain, neck lump, weight loss.
• Coughing up blood, stridor (noisy breathing), breathlessness with voice change.
• Voice loss after head/neck surgery — possible vocal-cord paralysis.

Self-care for short-term hoarseness

• Voice rest — whisper is harder on the cords than soft speech. Speak softly, don't whisper.
• Hydration; warm saline gargles; honey-lemon; paracetamol-class for discomfort.
• Stop smoking and tobacco.
• Treat reflux (raise head of bed, avoid late meals, avoid very spicy/oily food).
• Humidify the room in dry weather.

Professional help

• Voice therapy with a speech-language pathologist — evidence-based for nodules, muscle-tension dysphonia, and professional voice users.
• Laryngoscopy — a simple clinic examination to look at the vocal cords.
• Surgery only for selected lesions and followed by voice therapy.
• Professional voice users benefit from regular voice hygiene training — warm-ups, posture, breathing.