There is huge variation in what is accepted as a ‘normal voice’. Defining its essential characteristics is problematic as there is a continuum between a normal and a disordered voice. A normal voice is essentially unremarkable in quality and permits adequate communication without undue effort or discomfort. ‘Hoarseness’ is a term that describes an abnormal quality of the voice which may be rough, harsh, breathy, weak or strained. A voice problem, or dysphonia, can be defined as any impairment, limitation in activity or restriction in participation (World Health Organisation) as a result of a structural or functional abnormality of the voice mechanism.