Back to TopConsiderations. Hoarseness is most often caused by a problem with the vocal cords, which are part of your voice box (larynx) in the throat.When the vocal cords become inflamed or infected, they swell. This can cause hoarseness. The most common cause of hoarseness is a cold or sinus infection, which usually goes away on its own within 2 weeks. Another rare, but serious cause of hoarseness that does not go away in a few weeks is cancer of the voice box.