There are a number of possible causes of Larry Page’s hoarse, strained voice, some of them (like polyps or a paralyzed vocal cord) are physiological and some (like muscle tension dysphonia) can be caused by overuse or misuse of the voice. Spasmodic dysphonia, an involuntary spasming of the vocal cords, causing speech to become effortful, strained or broken, is a neurological disorder of unknown cause that affects speech in mid-life. See my Idea Box on "Living with a Broken Voice."
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