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by Cresse M

Loss of Voice

(Aphonia; Partial Loss of Voice; Voice, Loss of; Voice; Partial Loss of)

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:

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.

RESOURCES

American Speech-Language-Hearing Association http://www.asha.org/

National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/

CANADIAN RESOURCES

Canadian Association of Speech Language Pathologists http://www.caslpa.ca/

Ontario Association of Speech-Language Pathologists and Audiologists http://www.osla.on.ca/

References

Acute laryngitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated June 24, 2011. Accessed November 26, 2012.

Conversion disorder. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about . Updated September 30, 2012. Accessed November 26, 2012.

Casthely PA, Labagnara J. Hoarseness and vocal cord paralysis following coronary artery bypass surgery. J Cardiothorac Vasc Anesth . 1992;6:263-264.

Fact sheet: common problems that can affect your voice. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/commonvoiceproblems.cfm . Accessed November 26, 2012.

Hoarseness or loss of voice. The Harvard Medical School Family Health Guide website. Available at: http://www.health.harvard.edu/fhg/symptoms/hoarseness/hoarseness1.shtml?Back=Back . Accessed November 26, 2012.

Laryngitis. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 30, 2012. Accessed November 26, 2012.

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.

Vocal nodule. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated August 20, 2012. Accessed November 26, 2012.

Wolfe H. Hysterical aphonia & electroacupuncture. Townsend Letter for Doctors & Patients. 2003;(237):139.

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