The 4 Underlying Causes of a Hoarse Voice
17
October

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , /


When a person develops a hoarse voice, it
is a bit of a mystery to understand why given you can’t actually see your voicebox. What we are going to share are the secrets
to what may cause a normal sounding voice to go kaput… Before revealing the 4 underlying causes of
the hoarse voice, one first needs to understand what’s going on when the voice is operating
normally. Here we see a perfectly normal voicebox. The key component to look at are the vocal
cords. They are pearly white and straight. When they come together and vibrate, the movement
is symmetric and the vocal cord vibration is even and cyclical. Now… when a person’s voice sounds hoarse,
there are 4 basic things that could be going on leading to a less than clear voice. Keep in mind that the hoarse voice could be
caused by one or more of these abnormalities. Also, these are BASIC principles and there
are bound to be exceptions. If the voice sounds deeper than normal, it
means the vocal cords are swollen. Think of a violin string… the thicker the
string, the deeper the pitch. The thinner the string being played, the higher
the pitch. Vocal cords behave the same exact way. Here is a video showing vocal cords that are
VERY thick, red, and swollen due to inflammation. Note that the vocal quality itself is clear…
it just sounds deeper than normal. The key to a strong sounding voice is good
airflow along with vocal cords that come tightly together. If there is a gap between the vocal cords,
excess air comes out causing a much weaker and breathy sounding voice, even if the overall
quality is clear. Here are two examples of when the vocal cord
does not come together tightly. The first video demonstrates bowed vocal cords
(the vocal cords are too thinned out). The second shows a paralyzed vocal cord where
one vocal cord is not moving. Now if your voice does not sound clear, but
only in the upper range… typically known as pitch breaks or onset delays, this would
indicate some type of small bump on the vocal cord. A pitch break is when the voice suddenly disappears
at certain pitches. Onset delay is when there is a slight pause
from moment of intended vocalization until sound actually commences. Such small bumps typically include vocal cord
nodules, polyps, and cysts, but can more rarely even be a small cancerous growth. These bumps are most noticeable when singing
very quietly in the high range. Here is a video showing what a small bump
on the vocal cord looks like and how it affects the sound. The key thing to observe is that as long as
the vocal cord vibration movement is larger than the bump itself, the voice sounds clear. But the moment the bump is the same size or
larger than the vibratory movement, the vibration gets disrupted and a raspy sound comes out. The corollary to this principle is that as the
bump on the vocal cord becomes larger, the voice becomes affected not only in the high
range but also into the middle range. This typically occurs when a person continues
to aggressively use their voice irritating the bump causing it to get bigger. When resting the voice such as when sleeping
thru the night, the voice sounds better in the morning because the bump has gotten smaller
from lack of irritation from voice use. Such all encompassing raspiness or complete
loss of the voice occur typically due to an infection involving the entire vocal cord
preventing smooth and even vibration at any pitch level. However, there could also be other anatomic
abnormalities that can lead to the same abnormal sound. Here are a few examples of pathology affecting
the entire vocal cord causing a raspy sound at all pitch ranges or even voice loss. There is a condition called muscle tension
dysphonia which can mimic all of the problems mentioned above. It is the same principle utilized when a person
tries to “fake” a hoarse voice by manipulating the tightness of the voicebox muscles. Here is a video showing muscle tension dysphonia. Note that the vocal cords themselves appear
completely normal. However, when talking, see how the muscles
cause the vocal cords to literally become covered up. The analogy would be if someone deliberately
touches a vibrating violin string while it is being played. In either scenario, the resulting sound is
raspiness! If the voice sounds deeper than normal, the
vocal cords are swollen. If the voice sounds weak and breathy, the
vocal cords are not coming together tightly. If the voice sounds raspy only in the upper
range, there may be a small bump on the vocal cord. If the voice sounds raspy in all pitch ranges
or is completely lost, something has affected the entire vocal cord. Keep in mind that the hoarse voice could be
caused by one or more of these problems! And don’t forget muscle tension dysphonia
which can mimic many of the above problems.


100 thoughts on “The 4 Underlying Causes of a Hoarse Voice

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  2. Mine goes out in mid range. My over all voice is now low. I’ve had vocal therapy and it helped for awhile but again it’s bad. Drink a lot of water they said!

  3. Last year, I used to have a a very big vocal range (Bb1-C8 or 6.1 octaves and a semitone). I can sing like Mariah Carey's, Whitney Houston's, and Celine Dion's songs. But now I have a deteriorated voice, I can't get through my low notes and I can only hit a supported B2. I can't access my upper notes but if I attempt, It's so hard and I'm very frustrated, it ends up super flat and very very raspy and very strained. I can't hit my old notes easily. My voice still sounds the same like last year but when I sing, my tone sucks and I strain F4's and upwards but can't hit a Bb4 but used to be easily hitting a G#5 on a neutral larynx and it's super resonant and I hit a Bb5 many times in heady mix. My voice is really resonant mostly at my beltings. Also, I used to have a whisper register like my songbird supreme Mariah Carey, but now I can sometimes hit those whispery vocals but now I always crack as hell. I also do intentional breaks like Mariah Carey. Btw, when I try to mix, I can feel that my throat seems like denying the upward on my soft palette to mix and ends up going to just my modal voice. Also my whistles is inconsistently accessible and I always fucking crack and crack on every register, even at low notes. I'm very frustrates I can't sing like before and I can't sing my idol's songa. God. T_T My upper range (now that I can hit is only F4-C5 but rarely now goes to Ab4-D5) is super super raspy

  4. If the vocal cords are not coming together, is there a way to fix this, or do we have to get it treated professionally?

  5. For a month now I am noticing that when I try to scream while singing or just talk louder I feel something tickling on the side if my throat. My voice is fine though. I don't know is this suppose to be a symptom or something….
    Maybe I sing incorrectly and I screw up my voice.
    If someone can help it would be good .👌🤞

  6. So I'm currently sick right now and I have hoarse and I've been coughing a lot and singing because I take chorus and I sing everyday especially since we have a concert in 4 days so we sing a lot. I was wondering if I should be worried about cancer or anything. Yes after singing it get worse but after a hour my voice gets a bit better but it's still weird. I need answers if I should be worrying about anything please message me back.

  7. My voice sounded really Dee yesterday and now it hurtst on try to talk and no voice comes out of my mouth like literally nothing

  8. Hi I just came across your video… I live in Africa… So I just recovered from a cold and apparently during this period I was practicing and I was able to extend my range to an A5… Well obviously really happy that I could sing any song I wanted I was really singing and all and about two days ago I tried singing and boom… Nothing, couldn't sing my highs only my lows… I don't know what to do and there's no specialists around here I can go to… Do I just wait and stop singing for awhile… Like rest.. Please help me I need my voice back… I'm nothing without it… 😥😥 Thanks… What do I do… I also noticed I switched into falsetto at around and E5… I'm a guy.

  9. Guys help me i have a clear tone voice like there is no raspy in my voice but when i do vocalizing sometimes my voice sound like 4:08 especially when i try to hit note in "ah" headvoice. did i hurt my vocal cords when do vocalizing? Help me😣😭😭😭😭

  10. You have some beautiful vocal cords! Regarding the first one. But wtf is that slime on it? It makes it look nasty..😬

  11. My voice sounds normal sometimes when I wake up from sleeping but usually later that's when it gets bad and I can barely talk. It's been like this for too long I hate it

  12. You didn’t mention that general surgery where they put a tube down your throat can cause scarring. I was on a ventilator for months and I have scars leading to a permanent rasp. Also smoke inhalation can wreck your voice.

  13. Having something like this to imagine, i will never look at moaning the same again, doesnt matter how hot it is…..

  14. What about nerve damage that impedes control of the vocal cords? I thought that was a common cause of vocal problems that tends to causes vocal cord weakness later in the day or when you get tired.

  15. I had a surgery and they placed tube down my throat. After the surgery I can barely talk. I’m doing honey and lemon juice

  16. Great video. I’m currently experiencing number 3. Off to the ENT tomorrow. Caused by lots of singing gigs. Will be interesting to see what’s going on. Cheers.

  17. Help y'all 2k players know how the rage can be and I lost my voice. Can anyone tell me if it's only for a limited time. I went away before but I'm just asking

  18. i think i may have a cyst but my voice has been hoarse ever since 6th grade after i had strep throat now i’m in 10th anyone know what’s wrong with my voice?

  19. Thank you for the video! Now I understand better what singing teachers may mean when the warn you of losing your voice

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