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Chronic Hoarseness: What Causes It & How Is It Treated?

June 10, 2021 - Katie McCallum

Dealing with a hoarse voice is frustrating — especially if a few days go by without any improvement. And if it really drags on, you may start to wonder how long is too long for a hoarse voice to linger?

"Most of the time, hoarseness is acute and lasts only a few days. However, it can last longer," explains Dr. Apurva Thekdi, ENT doctor specializing in laryngology at Houston Methodist. "It's considered chronic when it persists for two weeks or more. And chronic hoarseness isn't just inconvenient. It can sometimes be a sign of a more serious underlying health condition."

Hoarseness is the most noticeable symptom of laryngitis, which is when your vocal cords are inflamed or irritated. The swelling that accompanies this inflammation prevents your vocal cords from vibrating properly, causing changes to the sound and volume of your voice.

And from being sick to yelling too much at a concert or sporting event, there are a few obvious explanations for losing your voice.

But what about when your voice is persistently hoarse without a clear reason or any accompanying symptoms?

What causes chronic hoarseness?

"If you have a cold or another type of upper respiratory infection, it's not unusual to experience some amount of hoarseness. This isn't something we worry about too much. However, if your other symptoms clear up and you continue to be hoarse for another two weeks, that's considered chronic and we begin to worry," explains Dr. Thekdi.

The most common causes of chronic hoarseness are:

  • Overusing your voice, which is most common in individuals who use their voices professionally (performing artists, teachers, salespersons and speakers)
  • Persistent bacterial or viral infection
  • Polyps, cysts or nodules on your vocal cords
  • Vocal cord paralysis

Chronically inflamed or irritated vocal cords can lead to strain and injury — so it's important to get chronic hoarseness checked out.

"Additionally, while rare, chronic hoarseness can be a sign of cancer, and this isn't something we want to miss. When caught early, throat cancer is very curable," says Dr. Thekdi.

If you're experiencing chronic hoarseness, an ENT voice specialist (also called a laryngologist) can identify the cause and severity of your vocal cord issue, as well as recommend a targeted course of treatment.

How is chronic hoarseness treated?

Treating chronic hoarseness starts with treating the underlying cause of the laryngitis.

The first line of treatment you can do at home, such as:

  • Resting your voice
  • Taking a steamy shower

"The most effective self-care treatment is typically voice rest — simply not speaking for an entire day, for example," says Dr. Thekdi. "However, if hoarseness persists beyond two weeks of at-home remedies, it's time to see a specialist," says Dr. Thekdi. "Through a 30-second, in-office scope evaluation, we can examine your vocal cords and identify what's causing your issue."

In addition, seeing an ENT voice specialist can help separate your symptoms from those of other common conditions.

"Sometimes chronic hoarseness is attributed to allergies or acid reflux. But in reality, it's rare for either of these conditions to cause persistent hoarseness," adds Dr. Thekdi. "This is something we can easily rule out by visualizing the larynx."

If you are diagnosed with a throat disorder or vocal cord condition, your doctor may recommend voice therapy, a type of physical therapy used to heal and strengthen your vocal cords. For more serious vocal cord issues, surgery may be needed.

"We always begin with the most conservative approach, but, in some cases, such as with polyps or tumors on the vocal cords, we opt for surgery right away," says Dr. Thekdi. "We can also use surgery to treat other types of vocal cord issues that don't respond to voice therapy."

Most important, Dr. Thekdi says don't wait to see an ENT voice specialist if you're experiencing chronic hoarseness.

"If you've tried resting your voice and haven't seen any improvement after two weeks, you need to be evaluated so the issue can be defined and treated. Left untreated, serious complications or permanent damage to your vocal cords can occur. Lastly, it's also very important to rule out cancer," adds Dr. Thekdi.

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