Those who suffer from aphonia, loss of voice or voicelessness, can usually only speak in a whisper. The loss of voice may accompany a cold, but it can also have other causes. Usually the voice comes back quickly, but sometimes the loss of voice can be permanent.
What is aphonia?
Voice loss (aphonia) is when you can only whisper and your voice is toneless to complete voicelessness. Voice loss (aphonia) is when one can only whisper and the voice is toneless to complete voicelessness. As a rule, the underlying causes are either psychogenic or functional disorders. Aphonia should be distinguished from hoarseness, although the complaints and symptoms are similar. The term voicelessness is rarely used in medicine. Rather, it is a linguistic phonetic term. For example, voiceless sounds of the fricatives, which are [f], [s], [ʃ], [ç], [x], [χ], and [h], and the voiceless series of closure sounds, which are [p], [t], and [k], are examined and described in more detail here.
Causes
Aphonia can be caused by a cold, among other things. A virus then irritates the vocal cords and/or larynx. Hoarseness results, and with it, loss of voice. If the larynx is irritated or even inflamed, voice loss can last longer than with hoarseness. Affected persons can then only whisper for a longer period of time. Bronchitis can also result in voice loss. However, voice loss can also have causes other than a cold. People in professions that require a lot of use of their voice, such as teachers or singers, can lose their voice due to permanent overload, because the vocal cords become irritated. Due to the constant irritation, the mucous membrane on the vocal folds swells and forms small nodules, which are also called singer’s and screamer’s nodules. If one is unlucky, this can develop into Reinke’s edema, in which the entire vocal folds are swollen. The nodules can also develop into benign growths, polyps. A tumor can also make itself felt through loss of voice and hoarseness. In addition to benign nodules, there is also malignant laryngeal cancer or labial ligament carcinoma. Voice loss or hoarseness may also occur temporarily after surgery. Therefore, attention should be paid to the larynx during intubations during surgery. In addition, chemical irritants such as cigarette smoke or air that is too cold or too dry can also irritate the vocal cords and promote voice loss.
Diseases with this symptom
- Common cold
- Throat cancer
- Vocal cord inflammation
- Bronchitis
- Laryngitis
- Laryngeal cancer
- Vocal cord paralysis
- Vocal fold polyp
- Vocal fold nodule
Diagnosis and course
Usually, the loss of voice recedes after a short time if you take it easy. If this is not the case, you should see an ear, nose and throat specialist and have the cause clarified. Most of the time, the causes are harmless, but some, such as nodules on the vocal cords, do need to be treated. The ear, nose and throat doctor has a number of examination procedures at his or her disposal. First, the doctor examines the mouth and throat and palpates the lymph nodes. If he detects an infection, he takes a swab and prepares a culture. A blood test can also provide information. To assess the condition of the larynx, a laryngoscopy is performed, which is not so pleasant, but during which vocal exercises can be performed to determine the mobility of the vocal folds. To rule out a tumor, further examinations such as ultrasound, computer tomography or magnetic resonance imaging can be performed. If long-term voice loss is left untreated, permanent damage can occur. Polyps or nodules must be removed, and there is also a risk of malignant tumor.
Complications
Complications may also occur with aphonia. The complications that may occur are situated according to the symptomatology of aphonia. A severe disorder of tone formation or voicelessness makes it impossible to communicate with other people through speech. In everyday life, this naturally brings some difficulties.Communication with other people is limited in all areas of everyday life. This restriction and the patient’s inability to change this circumstance on his own can lead to some problems or complications of a psychological nature in the patient. However, this is most likely to occur only if the aphonia persists for a long time. Mental illnesses and problems are conceivable both as a cause and as a consequence or concomitant of aphonia. In addition, in the context of a cold or other respiratory illnesses, there may be a temporary impairment of the voice or even a brief complete loss of the voice. In this case, a possible complication is the chronification of this voice loss, i.e., the development of permanent or at least prolonged aphonia. In a broader sense, difficulties in everyday life can be seen as complications of aphonia. Thus, misunderstandings may well occur, and the patient’s needs or wishes may not be perceived because he or she is unable to express himself or herself through his or her voice.
When should you see a doctor?
Aphonia (loss of voice) can have many causes and should lead sufferers to a doctor soon. Sufferers can only whisper, and sometimes there is even complete voicelessness. Aphonia is different from hoarseness, which is usually caused by upper respiratory tract infections. Nevertheless, a cold can also lead to aphonia. Then the vocal cords and larynx are so irritated by viruses that voice production is not possible. Persistent hoarseness can also lead to voice loss if left untreated. A medical examination is necessary to rule out serious organic diseases such as tumors of the vocal cords or larynx. Teachers and lecturers whose jobs require them to speak a lot can suffer from aphonia due to overwork. The less they strain their voice, the faster vocal cord irritation can heal. Benign polyps or tumors on the vocal folds can affect the voice to such an extent that no audible sound is produced. The larynx and vocal cords are also severely irritated after incubation on the occasion of an operation. They need a few days to recover. It also happens that the vocal cords are affected after thyroid surgery. Only a specialist can determine whether there is permanent damage. It is not uncommon for voice loss to have psychological causes. In the case of emotionally induced voice loss, the cause cannot be readily determined. Good anamnesis and long-term psychotherapy can bring help.
Treatment and therapy
For voice loss caused by a cold, inhalations or gargling with salt water often help. When gargling, however, one should be careful not to irritate the voice even more. It is very important to take care of the voice. If bloody or discolored sputum is also present, there may be a bacterial infection that needs to be treated with an antibiotic. Vocal cord nodules or polyps are more likely to be removed by surgery. Surgery must also be performed if laryngeal cancer is diagnosed, followed by further treatment.
Outlook and prognosis
Breathing, posture, and articulation directly affect the voice, as do psychological impairments. If voicelessness occurs as a result of a cold, it should also be gone after the cold has subsided. If it lasts longer than four weeks, a doctor must be consulted. In the case of psychosomatic causes of aphonia, a holistic therapy in which the patient also participates promises the greatest success. Nevertheless, psychosomatic illnesses belong in the hands of trained psychologists. Although the patient himself cannot directly influence his aphonia, he can increase the success of the therapy through stress reduction, relaxation and balancing activities. Underlying neurological diseases such as Parkinson’s disease must always be treated by a specialist. It is not uncommon for aphonia to be caused by environmental stress. If it is clear that the workplace is exposed to pollutants that affect the vocal cords, the employer must take remedial action. If necessary, a change of workplace is necessary. Pathological changes in the hormonal balance can cause functional disorders of the vocal cords. Here, too, a medical examination is important. In mild cases, throat compresses and rinses bring improvement. Again, self-treatment should not last longer than 3-4 weeks. After that, a medical examination is necessary.Tension in the respiratory muscles can also lead to functional voice disorders. Even with effort, the affected person then cannot produce a sound. It often helps to train the voice and practice a better breathing technique.
Prevention
A cold, which is often the cause of voice loss, can be prevented by strengthening one’s immune system. Still, you can’t avoid infections altogether because you come into contact with many people. During surgery, doctors should pay attention to the larynx during intubation so as not to irritate it. An important prevention is regular rest for the voice, because stress or a permanent overload of the voice can lead to voice loss.
This is what you can do yourself
Various home remedies help with aphonia. First, it is recommended to spare the voice and speak little. Basically, all activities that could put additional strain on the vocal cords should be avoided. Various home remedies such as hot milk with honey, soothing oils, lozenges or herbal candies help to stimulate saliva production and relax the throat. Ginger and Icelandic moss, which can be used in the form of tea or bath salts, are also particularly effective. In the event of a loss of voice as a result of a cold, it is advisable to take it easy on the immune system in order to cure the cold quickly. By wearing a scarf or a potato wrap and breathing through the nose, the throat can be additionally protected in low outside temperatures. In addition, drink plenty of fluids, ideally warm tea made from mallow leaves, fern frond herb, ribwort plantain or thyme herb. In addition, food should not be eaten too hot or too spicy. Cold foods and drinks as well as various stimulants are best avoided. In the case of aphonia with hoarseness, care should also be taken to maintain a sufficiently high level of humidity. Regular inhalation with hot water or chamomile tea is also good for the vocal cords and can quickly relieve aphonia. If the aphonia persists for a longer period of time, speech training can help to restore the voice. If the symptoms persist for a longer period of time, a doctor must clarify the causes.
