Hoarse voice, vocal change

A change in volume, tone or character of voice is a common symptom both at initial presentation and as a complication later in many conditions. It can have a profound impact on a person, potentially leading to social withdrawal as speaking becomes difficult, tiring, or embarrassing. A full assessment of cause and provoking and alleviating factors is vital as drug treatments should be targeted to specific causes.

Causes

Recurrent laryngeal nerve palsy (e.g. secondary to mediastinal lymphadenopathy)
Lung cancer
Laryngeal cancer
Acid reflux
Postnasal drip
Parkinson’s disease
Stroke
Hypothyroidism
Nerve injury (e.g. during neck resection for head and neck cancers)

Non-drug treatments

Always give adequate time to communicate
Reassure that you can understand
Vocal cord injection can be used to “bulk” the paralysed vocal cord
Speech and language referral