Hoarseness is common after anterior neck surgery or any surgery that requires an endotracheal tube down the throat to keep the airway open. Most patients find their voices returning to normal several days after the tube is removed.

Hoarseness and difficulty swallowing can also be caused by injury to the recurrent laryngeal nerve during the operation. This is the nerve to the vocal cords. In about 15 percent of the cases hoarseness only lasts about 24 hours. In a smaller number of patients (2.5 percent) permanent hoarseness can occur.