Hoarseness or Changing Voice

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What to Expect at your Health Care Provider's Office

If there is severe difficulty breathing, the first priority is to ensure normal breathing. This may require the placement of a breathing tube. Once the condition is stable, the medical history will be obtained and a physical examination performed.

Medical history questions documenting hoarseness or changed voice in detail may include:

• Quality
  • Is your (or your child's) voice hoarse?
  • Did you lose your voice completely?
  • Is the voice weak?
  • Does it sound breathy, scratchy, or husky?
• Time pattern
  • Does the voice change refuse to go away completely (persistent)?
  • Does the voice change occur repeatedly (recurrent)?
  • Has the condition worsened gradually over time?
  • Is it continuous (does not change intensity over time)?
  • At what age did the voice change begin?
  • How long has this symptom been present?
• Aggravating factors
  • Have you been shouting, singing, or otherwise overusing your voice?
  • Has there been an exposure to irritating fumes?
  • Has there been ingestion of a caustic liquid?
  • Has there been a foreign object aspiration or ingestion?
  • Do you use alcohol?
  • Do you smoke?
  • Do you have a history of allergies?
  • If an infant or child, has there been prolonged crying?
  • Has there been a recent surgery or procedure on the mouth or throat?
• Other
  • What other symptoms are present?
  • Is there a fever?
  • Is there malaise?
  • Is there coughing?
  • Is there weakness?
  • Is there a sore throat?
  • Is there fatigue?
  • Is there postnasal drip?

• Blood tests such as CBC or blood differential
• Throat examination with small mirror
• X-rays of the neck
• Laryngoscopy (visualization of the larynx with a laryngoscope)
• Throat culture

Intervention:
Thickened cords, polyps, and benign nodules can all be treated surgically or with a laser. Cancers are sometimes completely cured by either surgery, radiation, or both. Vocal cords that are accidentally damaged while administering anesthesia or during surgery can often be repaired.

Other conditions may benefit from voice rest and speech therapy. Reflux laryngitis is treated with anti-reflux measures (avoid spicy and fried food, reduce coffee intake) and antacids.

Stopping smoking helps in early recovery from laryngitis and other conditions causing hoarseness.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to hoarseness or changed voice, you may want to note that diagnosis in your personal medical record.