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 from 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 (such as 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 an 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 (such as 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, et al. Management and therapy in functional aphonia. Otolaryngol Pol. 2006;60:191-197.

Sancho JJ. Pascual-Damieta M, et al. 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.

Revision Information

  • Reviewer: Rimas Lukas, MD
  • Review Date: 11/2012 -
  • Update Date: 11/26/2012 -