sound is produced in the voice box. For this the voice box has 2 tiny bands with a core of thin muscles covered with a slim smooth lining. Vibration of these structures produces sound.
When these structures get injured, hoarseness results.
1. The primary nature of injury is overuse of voice as would occur after
A. talking for long periods of time as is common in teachers.
B. Talking very loudly or shouting even if it is for a short period of time as when one looses one's temper and screams.
This commonly results in vocal nodules or firm clots at points of maximum vibration and sometimes vocal cord bleeds
2. Smoking, tobacco use and excessive alcohol intake are also known to injure the lining and result in cancers and more serious disorders.