Persistent hoarseness or sore throat over two weeks could indicate serious vocal cord issues and require medical attention Premium

Voice disorders in India, from hoarseness to laryngeal cancer, require early diagnosis, treatment, and vocal care for optimal outcomes.

Voice disorders span a broad spectrum, ranging from mild hoarseness to more serious conditions involving structural or neurological causes. Conditions such as vocal cord inflammation (laryngitis), where the voice box becomes inflamed and causes hoarseness or loss of voice, to laryngeal cancer (vocal cord cancer), are significant health concerns in India, contributing to a substantial burden of head and neck cancers.

In India, laryngeal cancer incidence data from population-based cancer registries and national surveys estimates 2.76 cases per 1,00,000.  According to these studies, including those conducted by the National Cancer Registry Programme of India and  report by the International Journal of Head and Neck Surgery, laryngeal cancer accounts for 3-6% of all cancers in men, with age-adjusted incidence rates ranging from 1.26 to 8.18 per 100,000 population. The 5-year survival rate for laryngeal cancer in India is approximately 28%. 

Suhel Hasan, senior consultant, head of department of ENT, Mazumdar Shaw Medical Centre, Narayana Health, Bengaluru highlights the most common voice cord issues. Voice abuse -- common among teachers, singers, public speakers, and call center workers -- often leads to conditions like teacher’s nodules or screamer’s nodules. Both prolonged speaking and short bursts of shouting can injure the vocal cords.

According to Raghavi Vishnu Prasanna, consultant laryngologist, Shri VAS Clinic, SIMS Hospital, Vadapalani, any hoarseness or change in voice persisting for more than two weeks should never be ignored. “A hoarse voice could be due to causes like voice abuse or more serious conditions such as vocal cord nodules, polyps, infections, neurological conditions, or even cancer,” she notes. Dr. Hasan emphasises that chronic coughing, throat clearing, and infections can also strain the vocal cords.

Diagnosis begins with a detailed history, followed by direct visualisation of the vocal cords. With advances in technology, ENT specialists now use rigid or flexible endoscopy to examine the larynx.

The gold standard remains laryngeal endoscopy -- a procedure that uses an endoscope (a thin, flexible tube with a camera) to visualise the larynx (voice box) and vocal cords or stroboscopy -- a specific type of laryngoscopy that uses a flashing light (stroboscope) synchronised with the vocal fold vibration to create a slow-motion effect, allowing for detailed analysis of vocal fold movement during phonation, leading to a real-time or slow-motion assessment of vocal cord movement and mucosal wave patterns.

“Earlier, mirror laryngoscopy-- where laryngeal mirror or laryngoscopy mirror, a small, curved mirror was used to visualise the larynx and pharynx during an indirect laryngoscopy. This procedure used to be a common examination performed by doctors to assess the back of the throat and vocal cords, now modern tools provide significantly better clarity and precision”, he says