Chronic Hoarseness

All kids strain their voices every now and then: cheering for the home team at a ballgame; belting out a favorite song in the shower; calling out to friends on the playground.

Most of the time, such actions don't do any real harm to the vocal cords, the delicate bands of tissue in the larynx, or voice box. But chronic misuse of the vocal cords — caused by such things as repetitive screaming, yelling, or using the voice in an unnatural way — can lead to hoarseness. When this happens, the voice crackles and sounds rough, raspy, or breathy.

Sounding hoarse for a few hours or the day after a big game is probably nothing to worry about, and usually resolves on its own. However, chronic hoarseness that lasts for days, weeks, or even months needs to be checked out by a doctor. Speech therapy may be required to get the vocal cords back into perfect pitch.

How Vocal Cords Work
When we inhale, oxygen travels through the nose or mouth and down the throat (pharynx), passing through the voice box and windpipe (trachea), to get to the airway passages in the lungs. This route is reversed when exhaling carbon dioxide from the lungs, or talking.

To speak, air is pushed out of the lungs. In the larynx, the vocal cords — a "V"-shaped band of muscle — prepare for making sound by tightening up and moving closer together. As air passes through the vocal cords, they vibrate. This vibration, combined with the movement of the tongue, lips, and teeth, is what makes the sound of the voice.

Chronic misuse of the voice can cause excess wear and tear on the vocal cords. They may stretch too far or rub together, causing small irritations that, if not allowed to heal, turn into small calluses, or vocal cord nodules.