Miley Cyrus has one of the most unique voices of her time, but it comes at a cost.

Almost 20 years into her career, the Flowers singer has opened up about the medical condition that gives her that unique raspy and also prevents her from touring.

On Apple Music’s the Zane Lowe Show, the 32-year-old shared that she has Reinke’s Edema, a condition which has caused an abnormal tissue growth on her vocal chords.

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”I have this very large polyp on my vocal cord which is giving me a lot of the tone and the texture that has made me who I am,” she explained.

“But it’s extremely difficult to perform with because it’s like running a marathon with ankle weights on.

”So even when I’m talking sometimes, at the end of the day, you know, I’ll call my mum and she’ll go, ‘Oh you sound like you’re talking through a radio’, and that’s how you know when I’m really tired, it creates that like ultimate vocal fry.”

According to the Cleveland Clinic, Reinke’s Edema affects less than one per cent of the general population and is most commonly caused by long-term smoking but can also be caused by excessive use of the vocal cords.

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Cyrus went on to say that “staying up and drinking and smoking and partying after every show” when she was young definitely didn’t help her condition, but in her case it was not the cause.

The singer could have surgery to remove the polyp, however she said it is not something that she has ever considered since her voice is a part of her “unique anatomy”.

”I’m not willing to sever it because the chance of waking up from a surgery and not sounding like myself is a probability,” she explained.

While her condition does impact her ability to tour, something fans have been asking the singer for for years now, she said it’s not entirely off the cards.

“I put a tour together like every other week ’cause I want to do it,” Cyrus told Lowe.

“But it would have to happen in a way that is sustainable for me in all the ways that we talked about and then also with what I got going on, like I don’t lip-sync I sing live, and these songs are big.”

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With all the costs of touring, Cyrus explained that if she weren’t able to do a certain amount of shows, it wouldn’t financially make any sense to tour.

“It’s why a lot of artists don’t tour as much as they maybe want to or used to because to have it make sense, it’s really hard to not design a tour that’s going to hurt you, whether you have [Reinke’s edema] or not,” she said.

”The truth of it is that touring, as much as it’s an experience for the audience, it’s a business for everybody else.”

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