Hoarseness describes a voice change from your normal voice to a raspy, breathy, cracking or rough sounding voice. There are many causes of hoarseness. Probably the most common cause is acute laryngitis as part of an upper respiratory infection. Improper voice use is another common cause. Something as simple as shouting at your child’s baseball game or trying to have a conversation at a noisy party could irritate your vocal cords enough to cause hoarseness. Vocal cord nodules and polyps are non-cancerous growths that can form on vocal cords from vocal abuse. Vocal cord nodules are tiny bumps like calluses that may form on vocal cords. They are sometimes called screamer’s nodes, teacher’s nodes or singer’s nodes. These names indicate the type of individual most likely to develop nodules due to voice abuse. Vocal cord polyps are more fleshy and usually larger growths. They also form from voice abuse. Smoking may cause vocal polyps as well. Acid reflux, if it goes high enough in the esophagus to reach the back of the voice box is another common cause of hoarseness. The reflux irritates the back of the voice box causing swelling that may interfere with normal vocal cord movement. Cancer of the larynx (voice box) is a less common but far more serious cause. Throat cancer is usually found in drinkers and smokers. Cancer of the larynx, if caught early is very curable. Since hoarseness occurs early on in the disease it’s very important to have it evaluated quickly. Determining the cause of hoarseness involves looking at the voice box with an endoscope, which is a small telescope, or mirror in the office. This is a very simple and quick procedure done by ear, nose and throat doctors. If hoarseness persists for more than a week or two, medical evaluation is needed. Treatment will depend on the diagnosis. Voice rest, speech therapy, certain medications and surgical removal are treatment options for benign disease. If cancer is suspected, a biopsy, usually under anesthesia,would be a likely next step.