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  • 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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