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[PubMed: 23235668] 232

PubMed Central , Human Molecular Genetics , vol

Other symptoms can include: Vocal fatigue Unreliable voice Delayed voice initiation Low, gravelly voice Low pitch Voice breaks in first passages of sentences Airy or breathy voice Inability to sing in high, soft voice Increased effort to speak or sing Hoarse and rough voice quality Frequent throat clearing Extra force needed for voice Voice hard to find When a vocal cord lesion is present, symptoms may increase or decrease in degree, but will persist and in general do not go away on their own