Voice problems are common. Most are related to poor vocal hygeine (excessive use of voice, shouting, chronic throat clearing etc.). Some patients may have vocal nodules, polyps or cysts which may need voice therapy or ultimately surgery. Hoarseness lasting longer than 3 weeks in an adult requires a laryngoscopy to outrule a more serious cause of hoarseness. Cancer of the larynx is usually present in an older patient with a history of smoking.