Loss of Voice
Definition
Loss of voice (also called aphonia) may take several different forms. You may have a partial loss of your voice and it may sound hoarse. Or, you may have complete loss of your voice and it may sound like a whisper. Loss of voice can come on slowly or quickly depending on the cause.
Aphonia
is different than aphasia, which is a language disorder.
Causes
Aphonia is usually due to problems with the voice box (called the larynx). However, there can be other causes, including:
-
Conditions that affect the vocal cords or airway. This may involve injury, swelling, or disease, such as:
- Psychological conditions (eg, hysterical aphonia)
Risk Factors
Risk factors that increase your chance of developing aphonia include:
- Overusing your voice (eg, speaking until you are hoarse)
-
Behaviors that abuse your vocal chords, such as
smoking
, which also puts you at a higher risk for cancer of the larynx
- Having surgery on or around the larynx
Symptoms
Symptoms may include:
- Inability to speak or inability to speak above a whisper
- Hoarseness
- Spasm of vocal cords
- Throat pain
- Difficulty swallowing (Food or fluids may go into the lungs.)
When Should I Call My Doctor?
Call your doctor if you:
- Have hoarseness that is not getting better after two weeks
- Have complete loss of voice that lasts more than a few days
- Have hard, swollen lymph nodes
- Have difficulty swallowing
- Cough up blood
- Feel a lump in your throat
- Have severe throat pain
- Have unexplained weight loss
When Should I Call for Medical Help Right Away?
Call for medical help right away or go to the emergency room if you:.
-
Suddenly lose your ability to speak—This may be a sign of a
head injury
or a
stroke.
- Are having trouble breathing
If you think you have an emergency, call for medical help right away.
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
The cause of your symptoms may not be obvious. You may be referred to a ear, nose, and throat doctor. This doctor may use an instrument called a laryngoscope to examine your vocal cords. Other tests may also be done to evaluate your voice function.
If your doctor is concerned that there may be a neurological or psychological cause, you may be referred to other specialists.
Treatment
General measures that can help ease laryngitis
include:
- Resting your voice
- Avoiding smoking
- Staying hydrated
- Using a cool mist humidifier
-
Taking nonprescription pain relievers (eg,
acetaminophen
,
ibuprofen
) as needed
Other treatments depend on the specific cause, such as:
- Participating in voice therapy if your loss of voice is due to voice overuse
- Taking medicine to control acid reflux
- Having surgery to remove growths
Prevention
Take the following steps to help reduce your chance of getting aphonia:
-
If you smoke,
quit.
- If you drink, limit your intake.
- Limit your exposure to fumes and toxins.
- Avoid talking a lot or yelling.
- Avoid whispering
- Learn vocal techniques from a voice therapist if you have to speak a lot for your job.
- Get treatment for conditions that may cause loss of voice.
References
Casthely PA, Labagnara J. Hoarseness and vocal cord paralysis following coronary artery bypass surgery.
J Cardiothorac Vasc Anesth. 1992;6:263-264.
Maniecka-Aleksandrowicz B, Domeracka-Kolodziej A, Rozak-Komorowska A, Szeptycka-Adamus A. Management and therapy in functional aphonia.
Otolaryngol Pol.
2006;60:191-197.
Sancho JJ. Pascual-Damieta M, Pereira JA, Carrera MJ, Fontané J, Sitges-Serra A. Risk factors for transient vocal cord palsy after thyroidectomy.
Br J Surg.
2008;95:961-967.
Wolfe H. Hysterical aphonia & electroacupuncture.
Townsend Letter for Doctors & Patients.
2003;(237):139.