Hoarseness is having difficulty producing sound when trying to speak, or a change in the pitch or quality of the voice. The voice may sound weak, very breathy, scratchy, or husky.

Voice strain; Dysphonia; Loss of voice

Hoarseness is usually caused by a problem in the vocal cords. Most cases of hoarseness are associated with inflammation of the larynx (laryngitis).

Hoarseness that lingers for weeks or months may be caused by a variety of problems. Some causes are minor, while others are serious.

• Allergies
• Coughing (may be caused by allergies or diseases such as bronchitis)
• Excessive use of alcohol or tobacco
• Excessive use of the voice (as in shouting or singing)
• Gastroesophageal reflux
• Inhaling irritating substances
• Laryngitis
• Prolonged or excessive crying (in children)
• Viral illness

Other causes include:

• Aneurysms of the upper aorta
• Bronchoscopy or other tests (temporary)
• Cancer of the voice box (laryngeal cancer)
• Foreign object in the esophagus or trachea
• Heavy smoking and drinking, especially together
• Infectious mononucleosis
• Ingesting a harsh chemical liquid
• Overall weakness caused by other diseases
• Postnasal drip
• Puberty
• Thyroid or lung cancer
• Tonsillitis
• Vocal cord nodules or paralysis (after surgery)

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo; Mosby; 2005.

Rakel P, ed. Conn’s Current Therapy 2007. 59th ed. Philadelphia, Pa: WB Saunders; 2007.