Insights

The voice after the tube: hoarseness explained

In 3,093 adults, about half were hoarse the same day. By day 7, almost none were.

Airway & voice · 2 min read

A prospective study of 3,093 adults who needed tracheal intubation tracked hoarseness over time: 49% on the day of surgery, 29% on day 1, 11% on day 3 and 0.8% on day 7.

Older age and longer duration of intubation predicted longer hoarseness; sex, weight, how difficult the view of the larynx was, and the anesthetic agents used were not significant factors. Three patients (0.097%) had a dislocated arytenoid cartilage, one of the small cartilages that move the vocal cords.

Meaning: hoarseness after a breathing tube is common and usually short-lived, and rare injuries do occur. A separate randomized trial in thoracic surgery found a benzydamine spray reduced sore throat at 1 and 6 hours after a double-lumen tube, an example of how prevention is being studied.

Curious how the larynx works? Read the deep dive.

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References

  1. Yamanaka H, Hayashi Y, Watanabe Y, et al. Prolonged hoarseness and arytenoid cartilage dislocation after tracheal intubation. Br J Anaesth. 2009;452-455. PMID 19556269
  2. Chang JE, Min SW, Kim CS, et al. Effect of prophylactic benzydamine hydrochloride on postoperative sore throat and hoarseness after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled trial. Can J Anaesth. 2015;1097-1103. PMID 26149601