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.

The Larynx

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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:
  • Laryngitis caused by a viral, bacterial, or fungal infection
  • Vocal abuse (yelling or talking excessively)
  • Exposure to airborne irritants, such as smoke or air pollution
  • Acid reflux (eg, heartburn)
  • Thickening of the vocal chords
  • Nodules or polyps on the vocal chords
  • Muscle tension dysphonia
  • Damage to the nerves that affect how the larynx functions
  • Laryngeal or thyroid cancer
  • Removal of larynx due to cancer
  • Breathing problems that affect the ability to speak
  • Neurological disorders (eg, myasthenia gravis, multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis)
• 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.)

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.