Hoarse voice

Today, I am hoarse.  I whispered to my family yesterday and now I can talk to my patients.  I was given the advice that I “should start on something” to bring my voice back.  Hmmmmm. . . there are guidelines for the diagnosis and management of hoarseness.

I’ll break it down for you.  A full history and physical by your physician will reveal many hints.

Look for a cause of hoarseness.

  • Medications may cause hoarseness due to cough, dry mucous membranes or chemical laryngitis.
  • Underlying conditions like reflux can cause gastric acid to inflame the vocal cords. If reflux is symptomatic,  reflux medication may help.

When should medication be given for hoarseness?  The answer is rarely.   Steroids should not commonly be prescribed unless a specific diagnosis like recurrent croup is present.  Antibiotics should not routinely be prescribed either as the condition is usually not from a bacterial infection.

There isn’t much to DO about a hoarse voice.

  • Laryngoscopy  (a look-see with a scope down the throat)should be done if hoarseness does not resolve within 3 months or if a serious underlying cause is suspected and before voice/speech therapy is initiated.
  • Surgery should only be done on suspected laryngeal cancers or if other measures for soft tissues lesions do not help.
  • Botulinum toxin  (yes, botox!) is injected for those with spasmodic dysphonia.

Some red flags of hoarseness which may suggest a serious underlying cause of hoarseness are coughing up blood, neck mass, history of tobacco or alcohol use, symptoms occurring after trauma, unexplained weight loss, or worsening symptoms.

Preventive measures are staying hydrated, avoidance of irritants (like smoke and chemicals), voice training and amplification when needed.

Hope this helps.

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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