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.

Loss of Voice

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

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 astroke.
  • 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.
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