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

Nucleus factsheet image

Copyright © Nucleus Medical Media, Inc.

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 (such as 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 (such as myasthenia gravis, multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis)
  • Psychological conditions (such as hysterical aphonia)
  • 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.