Common voice and throat problems
- Hoarseness lasting more than three weeks — needs a look. Most causes are benign (reflux, nodules, polyps) but a few are not, and earlier is always better.
- Reflux laryngitis — silent reflux that irritates the voice box without classic heartburn. Surprisingly common.
- Vocal cord nodules — usually from sustained voice misuse in teachers, callers, singers. Often respond to voice therapy alone.
- Vocal cord polyps and cysts — typically need a brief surgical removal followed by voice rest and therapy.
- Difficulty swallowing (dysphagia) — needs evaluation, especially in older adults or smokers.
- Chronic cough or globus (feeling of something in the throat) — often related to reflux or post-nasal drip.
How a voice consultation works
The key tool is video laryngoscopy — a slim flexible scope through the nose gives a clear, recordable view of the voice box in motion. Takes under a minute and is well tolerated. You see what I see on the screen.
For swallowing concerns, a clinic assessment plus, when needed, a barium swallow or FEES (fibreoptic evaluation of swallowing) gives a clear picture of where the holdup is.
Treatment, simplest first
- Voice rest and hydration for short-term hoarseness from overuse.
- Reflux management — lifestyle changes plus a short course of acid-suppression — resolves a surprising number of chronic throat symptoms.
- Voice therapy with a speech-language pathologist for nodules and many functional voice problems.
- Phonomicrosurgery — minimally invasive surgery for polyps, cysts, and benign lesions, preserving voice quality.
- Onward referral to oncology and multidisciplinary care if a concerning lesion is found.
Frequently asked questions
I've been hoarse for a month. Should I worry?
Three or more weeks of hoarseness without an obvious cold should be checked. The vast majority of causes are benign and very treatable, but the small minority that aren't benefit enormously from early diagnosis. A 15-minute scope visit usually settles the question.
Can voice problems be fixed without surgery?
Often yes. Nodules, muscle-tension dysphonia, and reflux-related hoarseness usually respond to voice therapy and medical management. Surgery is reserved for lesions that don't respond to those steps, and even then it's microscopic and voice-sparing.
What is silent reflux?
Reflux that affects the throat and voice box without the classic burning sensation. Symptoms include chronic throat clearing, hoarseness, mild cough, lump-in-throat feeling, and post-nasal drip. Diagnosis is usually clinical plus a look with the scope; treatment combines lifestyle and a course of acid-suppression.
I keep getting food stuck. What's going on?
Persistent food sticking deserves a workup — not always sinister, but always worth checking. Causes range from acid reflux strictures to muscle-coordination problems to (rarely) a growth. Clinic exam plus imaging or endoscopy gives a clear answer.
Do you treat singers and voice professionals?
Yes — voice professionals get a specific evaluation, including video laryngoscopy and discussion of their performance schedule. Treatment plans factor in upcoming gigs, recording deadlines, and the realities of their craft, not just textbook recovery times.