There are many reasons for hoarseness, mainly the following: 1. Hoarseness caused by inflammatory diseases, which is the most common clinically, including acute and chronic laryngitis, mainly vocal fold congestion, vocal fold hypertrophy resulting in poor vocal fold closure, so hoarseness occurs. 2. Hoarseness can also occur due to benign tumors on the vocal folds, such as vocal fold polyps, vocal fold cysts, vocal fold hemangiomas, etc. 3. The vocal cords are often affected by malignant tumors, such as vocal cord cancer, which is common in middle-aged and elderly patients with a long history of smoking and drinking, and hoarseness can also occur. 5. Some patients are unable to speak normally due to psychological factors, such as hysterical loss of voice, where there are no organic lesions in the bilateral vocal cords during clinical examination, but due to mental stimulation.