Hoarse Voice Lasting More Than 2 Weeks: A Head & Neck Warning Sign
A hoarse voice refers to an abnormal change in voice quality, including roughness, breathiness, weakness, or reduced projection. While hoarseness is commonly caused by voice strain or infection, persistent hoarseness lasting more than two weeks should always be taken seriously—especially in adults.
From an ENT and Head & Neck specialist’s perspective, prolonged hoarseness may be an early sign of laryngeal (voice box) cancer or other serious throat conditions. Early assessment is crucial for voice preservation and survival.
What Does Hoarseness Feel or Sound Like?
Patients often describe:
- Rough or raspy voice
- Weak voice that tires easily
- Breathiness or air leakage when speaking
- Reduced voice volume
- Voice breaks or instability
- Difficulty projecting voice
Hoarseness may be painless, which often delays medical review.
Common ENT-Related Causes of Hoarseness
1. Voice Box (Laryngeal) Cancer
Often presents with persistent hoarseness without pain.
2. Vocal Cord Nodules or Polyps
Common in voice overuse, but usually improve with rest.
3. Laryngopharyngeal Reflux
Acid irritation causes chronic voice changes.
4. Chronic Smoking or Vaping
Directly damages vocal cord lining.
5. Vocal Cord Paralysis
Causes weak, breathy voice.
6. Post-Infective Inflammation
Usually resolves within two weeks.
🚨 Red Flags You Must Not Ignore
Seek urgent ENT assessment if hoarseness:
- Persists longer than 2 weeks
- Is progressively worsening
- Occurs without recent infection
- Is associated with neck swelling
- Comes with dysphagia or ear pain
- Occurs in smokers or heavy alcohol users
Persistent hoarseness in adults is cancer until proven otherwise.
How an ENT Specialist Evaluates Hoarseness
ENT assessment is direct and precise:
- Detailed voice history
- Neck and oral examination
- Flexible nasolaryngoscopy to visualise vocal cords
- Assessment of vocal cord movement
- Imaging or biopsy if suspicious lesions are seen
This allows early diagnosis and voice-saving treatment.
Treatment Depends on the Cause
✅ Benign Voice Conditions
- Voice rest and hygiene
- Reflux treatment
- Speech therapy
✅ Malignancy
- Early cancer referral
- Radiotherapy or surgery
- Early treatment preserves voice and swallowing
When Should You See an ENT Specialist in Kuala Lumpur?
Consult an ENT specialist if:
- Hoarseness lasts more than two weeks
- Voice change affects work or daily life
- You have cancer risk factors
Early ENT review can be life-saving and voice-preserving.
👨⚕️ ENT Specialist’s Perspective
Hoarseness is not just a voice issue—it is a laryngeal symptom. From a head and neck oncology standpoint, persistent hoarseness must always be investigated to exclude cancer early, when treatment outcomes are best.
Reviewed by Dr Ameen, ENT Specialist, Kuala Lumpur
Dr. Ameen, ENT Specialist in Kuala Lumpur 