Hoarse voice

A hoarse voice, also known as dysphonia or hoarseness,^[1] is when the voice involuntarily sounds breathy, raspy, or strained, or is softer in volume or lower in pitch.^{[2][3][clarification needed]} A hoarse voice can be associated with a feeling of unease or scratchiness in the throat.^[2] Hoarseness is often a symptom of problems in the vocal folds of the larynx.^[2] It may be caused by laryngitis, which in turn may be caused by an upper respiratory infection, a cold, or allergies.^[2] Cheering at sporting events, speaking loudly in noisy situations, talking for too long without resting one's voice, singing loudly, or speaking with a voice that is too high or too low can also cause temporary hoarseness.^[2] A number of other causes for losing one's voice exist, and treatment is generally by resting the voice and treating the underlying cause.^[2] If the cause is misuse or overuse of the voice, drinking plenty of water may alleviate the problems.^[2]

It appears to occur more commonly in females and the elderly.^[4] Furthermore, certain occupational groups, such as teachers and singers, are at an increased risk.^[5][6]

Long-term hoarseness, or hoarseness that persists over three weeks, especially when not associated with a cold or flu should be assessed by a medical doctor.^[2] It is also recommended to see a doctor if hoarseness is associated with coughing up blood, difficulties swallowing, a lump in the neck, pain when speaking or swallowing, difficulty breathing, or complete loss of voice for more than a few days.^[2] For voice to be classified as "dysphonic", abnormalities must be present in one or more vocal parameters: pitch, loudness, quality, or variability.^[7] Perceptually, dysphonia can be characterised by hoarse, breathy, harsh, or rough vocal qualities, but some kind of phonation remains.^[7]

Dysphonia can be categorized into two broad main types: organic and functional, and classification is based on the underlying pathology. While the causes of dysphonia can be divided into five basic categories, all of them result in an interruption of the ability of the vocal folds to vibrate normally during exhalation, which affects the voice. The assessment and diagnosis of dysphonia is done by a multidisciplinary team, and involves the use of a variety of subjective and objective measures, which look at both the quality of the voice as well as the physical state of the larynx.^{[citation needed]} Multiple treatments have been developed to address organic and functional causes of dysphonia. Dysphonia can be targeted through direct therapy, indirect therapy, medical treatments, and surgery. Functional dysphonias may be treated through direct and indirect voice therapies, whereas surgeries are recommended for chronic, organic dysphonias.^[8]