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.