Hoarseness, voice fatigue, loss of voice or discomfort when speaking can be signs of diseases of the vocal folds and larynx. At Baltic American Clinic, ENT doctors (otorhinolaryngologists) diagnose voice and laryngeal disorders, perform endoscopic examinations and choose treatment according to the cause found.
Consultations with doctors specialising in laryngology and phoniatrics.
The larynx can be examined and the condition of the vocal folds assessed.
Diagnosis of ear, nose and throat conditions for patients of all ages.
Based on the diagnosis, your symptoms and how you need to use your voice.
When should you see a doctor about voice and throat problems?
An ENT consultation is recommended if:
- Your voice is hoarse. Hoarseness does not go away or keeps coming back for no clear reason.
- Your voice tires quickly. When you speak for longer, your voice weakens or becomes husky or strained.
- The quality of your voice has changed. Your voice has become lower, rougher, weaker or unusually muffled.
- You lose your voice. You temporarily lose your voice or speaking becomes difficult.
- You feel discomfort when speaking. You have throat tension, a scratchy feeling or pain when using your voice.
- You constantly need to clear your throat. You feel irritation or as if something is stuck in your throat.
- You have a long-lasting cough. Especially if it is linked to throat irritation or changes in your voice.
- Voice problems interfere with your work. Especially if you talk a lot, sing or your voice is your main working tool.
If hoarseness lasts longer than 3–4 weeks, your larynx needs to be examined even if there is no pain. Seeing a doctor sooner is especially important for smokers and for patients who have other worrying symptoms.
Important. If you develop severe shortness of breath, noisy breathing or rapidly worsening difficulty breathing, you need urgent medical help. In a life-threatening situation, call 112.
Which voice and laryngeal disorders do we diagnose?
Laryngitis
Laryngitis is inflammation of the lining of the larynx, often causing hoarseness, a weaker voice, a cough or throat irritation.
Acute laryngitis is most often caused by a viral infection, while long-lasting symptoms may be maintained by voice overuse, irritants or other conditions.
Vocal fold nodules
Vocal fold nodules are benign changes that most often develop because of long-term voice overuse.
They can cause persistent hoarseness, voice fatigue and difficulty producing certain sounds. They are more common in people whose work involves intensive speaking or singing.
Vocal fold polyps and other benign growths
Vocal fold polyps and other growths can disrupt the normal vibration of the vocal folds.
They can make the voice husky, rough or weak. A doctor’s examination is needed to determine the nature of the growth and, in some cases, further tests.
Vocal fold mobility disorders
When one or both vocal folds do not move enough, the voice may be weak and muffled, speaking may be difficult, or you may choke when swallowing.
These disorders can be related to nerve damage, previous operations or other diseases.
Functional voice disorders
Voice changes can also occur without marked structural changes of the larynx.
In such cases the voice may be used with too much strain or inefficiently, or voice control may be impaired. The doctor assesses voice function and possible causes of the symptoms.
Changes of the laryngeal lining
Changes of the laryngeal lining can be related to chronic irritation, inflammation, reflux or other conditions.
Some changes can be precancerous or malignant, so long-lasting hoarseness should not be ignored. In suspicious cases a biopsy may be needed.
Diagnosis of voice and laryngeal disorders
During the consultation, the doctor asks when the voice changes started, how long they have lasted, about your work, voice load, other conditions and other symptoms.
If needed, the following tests are performed:
Laryngeal endoscopy
An endoscopic examination that allows the doctor to look at the larynx and vocal folds and assess their condition, mobility and any visible changes of the lining.
The examination helps to identify possible causes of hoarseness, a weakened voice or other laryngeal symptoms.
Pharyngeal endoscopy
An examination of the structures and lining of the pharynx. It may be needed when voice changes come with throat discomfort or other pharyngeal symptoms.
Laryngeal biopsy
If a suspicious tissue change is found during the laryngeal examination, the doctor may recommend a biopsy – taking a tissue sample for histological examination.
A biopsy helps to determine the nature of the change more precisely. The histological examination is charged separately according to the price list in force.
Not every patient needs all the tests. The need for them is decided individually.
ENT examinationsHow are voice and laryngeal disorders treated?
Treatment depends on the diagnosis, how long the symptoms have lasted and the condition of the vocal folds.
Treatment of inflammatory laryngeal conditions
If laryngitis or another inflammatory condition is found, the doctor assesses its cause and recommends suitable treatment.
Medicines may be prescribed, and you may be advised to reduce voice load, avoid irritants and treat conditions that keep the symptoms going.
Assessment of voice function and voice use
If the voice disorder is related to long-term voice overuse or incorrect voice use, the doctor discusses the principles of voice care and whether further help is needed.
Investigation of vocal fold and laryngeal growths
If nodules, polyps or other changes are found, the doctor assesses their nature, size and effect on voice function.
If a histological examination is needed, a laryngeal biopsy may be performed. The need for other interventions is decided individually.
Follow-up care
If symptoms persist or recur, a repeat consultation and a follow-up laryngeal examination may be recommended.
How to prepare for the ENT consultation
Usually no special preparation is needed, but it helps to:
- Think about how long the symptoms have lasted. Remember when your voice changed and whether the changes are constant.
- Describe your voice load. Tell us if you talk a lot, sing or work in a noisy environment.
- Bring previous test results. Especially if a laryngeal examination or biopsy has already been done.
- Tell us about the medicines you take. And about smoking, reflux symptoms and previous operations.
- Mention other symptoms. Difficulty swallowing, a cough, lumps in the neck or changes in breathing.
If a biopsy is planned, the doctor will separately explain the preparation requirements and possible risks of the procedure.
When may tests or procedures be postponed?
Whether a laryngeal examination or biopsy is suitable is assessed individually.
Some procedures may be adjusted or postponed in case of a severe acute infection, unstable general health, an increased risk of bleeding or other medical circumstances.
Before a biopsy it is important to tell the doctor about any blood clotting disorders and medicines that affect blood clotting. Do not stop taking them on your own.
Frequently asked questions
Why is my voice hoarse even though my throat does not hurt?
Hoarseness can be caused by vocal fold overuse, nodules, polyps, mobility disorders or other changes of the larynx. A sore throat is not a necessary sign of vocal fold disease.
Can hoarseness be a sign of a serious disease?
Yes. Although hoarseness is often caused by harmless conditions, it can sometimes be related to precancerous or malignant changes of the larynx. That is why hoarseness lasting longer than 3–4 weeks must be investigated.
Can I talk when my voice is hoarse?
If your voice is hoarse because of acute inflammation or overuse, it is advisable to talk less, avoid shouting and long conversations. Whispering can also strain the voice, so it is better to speak quietly in your normal voice if this does not cause discomfort.
Is laryngeal endoscopy painful?
The examination is usually not painful, but it may cause brief discomfort, a feeling of something in the throat or an urge to cough. The doctor explains how the examination works before the procedure.
Are vocal fold nodules always treated with surgery?
No. Treatment depends on the nature of the changes, the symptoms and how you use your voice. In most cases non-surgical treatment is considered first.
Can voice problems be related to reflux?
Yes. Reflux can irritate the larynx and contribute to hoarseness, throat clearing or throat discomfort. However, reflux cannot be diagnosed from these symptoms alone.
Should I see an ENT doctor or a phoniatrician about hoarseness?
You can start with an ENT doctor. If a more detailed assessment of voice function is needed, it makes sense to choose an ENT doctor specialising in laryngology and phoniatrics.
Price of voice and laryngeal disorder treatment
Prices for ENT consultations, laryngeal and pharyngeal endoscopy, laryngeal biopsy and other necessary services are set according to the Baltic American Clinic price list in force.
The consultation, diagnostic tests and procedures are charged separately unless they are included in the price of a specific service. When a biopsy is performed, the histological examination is paid for additionally.
The scope of the tests and treatment needed and the expected costs are discussed during the consultation.