If you’re recovering from a cold or flu, or have just spent your day speaking or singing a lot, it’s not uncommon to notice a change in the quality of your voice. It could be hoarse, rough or have a raspy quality that is not normal. Typically, this change in voice is due to inflammation and irritation in the throat and voice box. It can last up to two weeks and will get better if you rest your voice. However, neglecting to have your persistent hoarse voice looked at is not ideal, as it could be a symptom of larynx cancer. See a throat doctor if you notice these other changes in your voice.
Apart from hoarseness, vocal cord paralysis can cause symptoms such as a sudden breathy quality to the voice, noisy breathing, loss of vocal pitch, and the inability to speak loudly. Other signs can include choking or coughing while eating or drinking, the frequent need to take breaths while speaking, loss of your gag reflex, and ineffective coughing or constant throat clearing. This condition can be due to several things, such as trauma, certain surgeries, a stroke, tumours, viral infections, and neurological conditions. Treatment involves a combination of surgery and speech therapy.
Small lumps, nodules and polyps can grow on vocal cords and affect the voice. Many of these are non-cancerous. These growths are common in those who use their voice intensively (such as singers or teachers). Using the voice intensively causes the tissues in the vocal cords to thicken. When the thickened tissue localises, it produces a nodule or polyp.
A polyp is a soft, smooth lump containing blood vessels, while a nodule is similar but firmer. Cysts can also form. These are sacs of fluid on the vocal cords. These growths can be treated by surgical or non-surgical means. In some cases, vocal training and speech therapy can help to decrease the irritation caused by the growths. Larger growths may necessitate surgical removal.
If your voice hoarseness continues for more than two to four weeks If there is a change in your voice quality for more than two to four weeks after you have recovered from a cold or sore throat, or if it does not return to its normal characteristics even after lots of rest, seek specialist help from an ear, nose and throat specialist. This is important because a change in voice is one of the first and most important symptoms of throat cancer. If detected early, throat cancer can be more effectively treated. There is a 90% chance of a cure if throat cancer is detected at an early stage, and treatment involves a combination of surgery, radiation therapy and/or chemotherapy.
If your voice hoarseness is accompanied by other symptoms Other signs to look out for include a sore throat that does not go away, chronic cough, pain, trouble with swallowing, or unexplained earache. You may also have a lump in the throat that does not go away. Throat cancer is especially common in those who smoke. This group of people should be more vigilant about changes in their voice; more importantly, they should quit the habit.
If your voice becomes weak or ‘hard to find’ If you struggle to project your voice or speak at a normal volume, you may have a problem with your voice box. Some common problems include vocal cord paralysis or the growth of small lumps, nodules and polyps on the voice box.
Senior Consultant Thyroid-Head & Neck Surgeon
MBBS (Singapore), FRCS (Edinburgh), FRCS (Glasgow), FAMS (ORL)
Prof Goh is a Senior Consultant ENT specialist in Singapore with over 20 years’ experience, both locally and abroad in the UK and Canada under the Health Manpower Development Programme Award and the Singapore General Hospital (SGH) Scholarship.
A respected figure in his field, Prof Goh was the Head of the ENT Department at SGH and a founding member of the Asian Society of Head & Neck Oncology. Passionate about training up future ENT doctors, he teaches at the Duke-NUS Medical School and serves as Chairman on the Residency Advisory Committee at the Ministry of Health. A recipient of numerous service awards, Prof Goh’s dedication to his patients and the advancement of his field cannot be overstated.