Hoarse Voice Lasting More Than 2 Weeks: Warning Signs You Should Not Ignore
A hoarse voice refers to a change in voice quality – sounding rough, raspy, weak, or breathy. It is common after flu or shouting, but hoarseness lasting more than 2 weeks should never be ignored.
As an ENT specialist, I often see patients who assume voice changes are “normal” or due to ageing. In reality, persistent hoarseness may indicate vocal cord problems, reflux, or more serious throat conditions that require proper evaluation.
What Does Hoarse Voice Feel Like?
Patients commonly describe:
- Rough or raspy voice
- Voice tiring easily
- Difficulty projecting voice
- Voice breaking when speaking
- Needing to clear throat often
- Pain or discomfort when talking
Common Causes of Hoarse Voice
1. Voice Overuse & Abuse
Teachers, singers, call-centre staff are high risk.
2. Laryngitis (Voice Box Inflammation)
Often after flu or infection.
3. Acid Reflux (Silent Reflux)
Stomach acid irritates vocal cords.
4. Vocal Cord Nodules or Polyps
Benign growths due to strain.
5. Smoking & Vaping
Chemical irritation damages vocal cords.
6. Throat Cancer (Rare but Serious)
Red flags:
- Persistent hoarseness
- Neck lump
- Pain when swallowing
- Weight loss
🚨 When Should You Worry?
Seek urgent ENT review if:
- Hoarseness lasts >2 weeks
- Voice loss is progressive
- Pain when swallowing
- Blood in saliva
- Neck lump
- History of smoking
How an ENT Specialist Evaluates Hoarse Voice
Assessment includes:
- Detailed history
- Mouth & neck exam
- Flexible laryngoscopy to view vocal cords
- Voice assessment
- Imaging or biopsy if needed
Treatment Options
✅ Cause-Based Treatment
- Voice rest
- Reflux treatment
- Infection management
✅ Voice Therapy
- Speech therapy
- Proper voice technique
✅ Surgical Treatment (Selected Cases)
- Polyp removal
- Biopsy of suspicious lesions
Frequently Asked Questions
Q: Is hoarseness always serious?
No, but persistent hoarseness needs checking.
Q: Can reflux cause hoarse voice without heartburn?
Yes, very commonly.
Q: Should singers worry about hoarseness?
Yes. Early treatment prevents permanent damage.
When Should You See an ENT Specialist in Kuala Lumpur?
Consult ENT if:
- Voice change affects work
- Symptoms persist
- You have warning signs
Early diagnosis protects your voice.
👨⚕️ ENT Specialist’s Perspective
Persistent hoarseness is a symptom, not a diagnosis. Direct visualisation of vocal cords is essential to exclude cancer and to identify treatable causes early, preventing permanent voice damage.
Reviewed by Dr Ameen, ENT Specialist, Kuala Lumpur
Dr. Ameen, ENT Specialist in Kuala Lumpur 