Is your voice hoarse? Has it become hoarse? (Hoarseness/Dysphonia) - Let's talk about this!

Do you sometimes feel like your voice has changed when you wake up in the morning, or after a hard day of talking? It's like it's been caught in a cold, or it's become hoarse, making it difficult to speak. Sometimes your voice can become weak, or it can become very heavy and harsh. This is what we usually call 'hoarseness' or, in medical terms, a change in the voice (Dysphonia) . In fact, this is a condition that can affect about one in three people at some point in their lives. So there's nothing to worry about, but it's important to be aware of it.

What exactly is hoarseness?

Simply put, hoarseness is when the normal quality of your voice changes, becoming raspy, rough, strained, or breathy. This can include an increase or decrease in the loudness of your voice, or a change in the pitch (high or low pitch) of your voice. Imagine if your normal voice suddenly sounded like someone was squeezing it, or if it came out suddenly and suddenly, that's what this condition is.

This is especially common in smokers, as well as in those who use their voices professionally, such as teachers, singers, actors, sales representatives, and call center workers.

What are the symptoms of hoarseness?

If you have a hoarse voice, you may experience symptoms like these:

• It feels like you have difficulty getting the words out when you speak.
• The voice sounds hoarse, rough, or windy .
• Having to speak more softly than usual.
• The pitch of the voice is different from usual . The voice may be very low or very heavy.

When should we be concerned about hoarseness?

Most of the time, hoarseness occurs when we overuse our voice. In such cases, it usually resolves on its own within a few days. However, if your voice has been hoarse for more than three weeks , or if you have any of these dangerous symptoms, you should definitely see a doctor.

Situations when it is mandatory to seek medical advice:

* If your throat hurts when you talk or swallow something.

* If you feel like you are having trouble breathing or swallowing .

* If you cough up blood .

* If you feel a lump in your neck .

* If several days have passed since the complete loss of voice .

If you have these symptoms, don't assume that it's normal. It's best to see a doctor as soon as possible to find the cause.

Why does our voice become so hoarse? What are the reasons?

To understand why this happens to us, let's first learn a little about how our voice is formed. We can speak because of two parts: our vocal cords and our larynx. The larynx is located above our trachea/windpipe. The trachea is a long tube that connects the larynx to the lungs.

Your vocal cords are two flexible bands of tissue inside your larynx. Think of them like strings on a guitar. When we speak, air from our lungs passes over these vocal cords, causing them to vibrate, creating sound waves. So, anything that affects these vocal cords or your larynx can cause your voice to become hoarse.

Here are some of the main reasons:

• Laryngitis: This is the most common cause of hoarseness. It occurs when the vocal cords become swollen due to things like allergies, upper respiratory infections, or sinus infections. Just like a cold or flu can cause a change in your voice.
• Overuse or misusing your voice: For example, your voice may become hoarse after you give a long speech or shout loudly during a sports match. It can also be caused by continuously speaking at a higher or lower pitch than your normal voice. This is common among people like teachers and singers.
• Aging: As we age, our vocal cords become thinner and weaker, which can also cause changes in our voice.
• GERD (Gastroesophageal Reflux Disease): This is what we often call heartburn or stomach pain. GERD is when stomach acid comes up into the throat. Sometimes, this acid can damage the vocal cords. This is called Laryngopharyngeal Reflux (LPR).
• Vocal cord hemorrhage: This occurs when a blood vessel in the vocal cord bursts. This causes blood to fill the muscle fibers. This can cause sudden loss of voice.
• Vocal nodules, cysts and polyps: These are noncancerous growths that form on the vocal cords. Just as we get calluses when we work with our hands, vocal cords can also develop these conditions when we use our voice incorrectly.
• Vocal cord paralysis: This is a condition in which one or both vocal cords do not open or close properly. This can be caused by things like nerve damage or side effects from surgery.
• Recurrent Respiratory Papillomatosis (RRP): This condition causes benign warts to form on and around the vocal cords.
• Spasmodic Dysphonia: This is a long-term neurological speech disorder that causes changes in the quality of the voice.
• Muscle Tension Dysphonia: This can occur when there is excessive stress on the vocal cords and surrounding muscles. It can also be caused by an injury to the neck, shoulders, or chest area.
• Nervous system diseases and disorders: If you have a condition like a stroke or Parkinson's disease, the disease can affect the part of your brain that controls the muscles in your voice box. This can also cause a change in your voice.
• Cancer: Cancers such as laryngeal cancer, lung cancer, and throat cancer can also cause hoarseness. This is something that many people are afraid of. But remember, not every time your voice becomes hoarse, it is due to cancer.

How to recognize hoarseness?

Depending on your symptoms, your general practitioner may refer you to an ear, nose and throat specialist (Otolaryngologist/ENT specialist). He or she will ask you about your medical history and any medications you are taking. They may also ask questions such as:

• How long has this voice difference been there?
• Did these symptoms start suddenly, or did they gradually increase?
• Have you recently had an upper respiratory infection (like a cold)?
• Are there other symptoms (e.g. fever, body aches, difficulty swallowing)?
• Do you smoke? If so, how long have you been smoking?
• Do you drink alcohol?

What are the diagnostic tests?

The doctor will listen to your voice and check your head and neck for any lumps or bumps. In addition, they may also do tests such as:

• Laryngoscopy: This involves inserting a thin, flexible tube (an endoscope) through the nose or mouth to examine the larynx and vocal cords. The tube has a camera attached to the end, allowing the doctor to view it on a screen.
• Videostroboscopy: This is similar to laryngoscopy, but it uses a special light and camera that can see the vibration of the vocal cords in great detail, almost in slow motion.
• CT scan (Computed Tomography - CT scan): A special X-ray test that takes cross-sectional images of the inside of the body.
• MRI (Magnetic Resonance Imaging - MRI): A test that uses magnetic fields and radio waves to produce detailed images of the inside of the body.
• Biopsy: If there is something suspicious in the vocal cords or the surrounding area, a small piece of tissue is taken and examined under a microscope. This is done if there is a suspicion of something like cancer.

What are the treatments for hoarseness?

Treatment depends on the cause of your hoarseness.

• The most basic treatment is usually to rest the voice . That means minimizing talking and shouting as much as possible.
• If the laryngitis is caused by an infection, such as an infection (such as laryngitis) , the doctor will prescribe the necessary medications (e.g. antibiotics, painkillers). If it is caused by an allergy, medication will be given for that.
• If GERD is the cause, lifestyle changes (diet control, changing sleeping position) and acid-controlling medications will be prescribed.
• If you have nodules, polyps, or cysts on your vocal cords , they can sometimes be treated with voice therapy . However, in some cases, surgery may be necessary.
• If a serious condition such as cancer causes hoarseness, treatment such as radiation therapy, chemotherapy, or surgery may be required under the supervision of an oncologist.
• If it is due to diseases related to the nervous system , voice training can be provided while the underlying disease is being treated.

Can you prevent hoarseness?

Sometimes, hoarseness can be caused by medical conditions that we can't prevent. However, taking care of your voice, especially if you use your voice for long periods of time every day (e.g., a teacher, singer, or public speaker), can help reduce the risk of this condition. Here are some tips:

• Avoid smoking completely. (If you need help with this, you can consult your doctor.) Stay away from secondhand smoke.
• Limit alcohol and beverages containing caffeine (tea, coffee). These can dehydrate the body and affect the vocal cords.
• Drink plenty of water. Drinking at least 8 glasses of water a day helps keep your vocal cords moist.
• If the indoor air is dry, use a humidifier.
• Avoid spicy, oily foods, especially if you have GERD.
• Avoid activities that strain the voice (e.g., talking for long periods of time, talking loudly, shouting).
• When your voice is tired (e.g. when giving a lecture) , use a device such as a microphone/megaphone.
• Consult a voice coach about correct speaking postures and techniques .

What happens if there is a hoarseness in the voice?

Usually, your voice will return to normal after you give it a rest or treat the underlying cause. However, it is very rare for hoarseness to be a sign of cancer or a serious neurological condition. So don't panic, but be aware of the symptoms.

How do I take care of myself?

If you have a hoarse voice, following your doctor's instructions is the best way to quickly heal your voice.

• Give your voice a rest. Avoid talking as much as possible. Whispering is also bad for your vocal cords, so avoid that too.
• Drink warm liquids (salt water gargles, ginger-cilantro gargles, etc.) to help soothe your throat.
• Stay away from smoking and smoky environments.
• Take the medications prescribed by the doctor as prescribed and on time.

When should I see a doctor again?

If your voice is still hoarse despite treatment, or if you feel your symptoms are getting worse, be sure to see your doctor again.

What questions should I ask my doctor?

Hoarseness is a common problem. If you have this condition, you can ask your doctor questions like:

• Why is my voice so hoarse?
• Is this caused by a serious illness?
• What treatments do you recommend?
• How should I take care of myself? What can I do?

Finally, remember (Take-Home Message)

Silence is golden, but it's not so good when your voice is hoarse and you have difficulty speaking, when your voice changes, or when you lose your voice altogether. If your voice has been hoarse for more than three weeks, or if you have difficulty swallowing or breathing, if you cough up blood, if you have a lump in your throat, or if you can't use your voice for several days, you should definitely see a doctor. He or she will find out the cause of your hoarseness and help you regain your normal voice. Don't panic, take the right steps at the right time!

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