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.
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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 from gastroesophageal reflux disease (GERD)
- 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
- Breathing problems that affect the ability to speak
- Neurological disorders such as myasthenia gravis, multiple sclerosis, Parkinson disease, and amyotrophic lateral sclerosis
- Psychological conditions such as hysterical aphonia
Factors that may 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 may include:
- Inability to speak or inability to speak above a whisper
- 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 any of the following:
- Hoarseness that is not getting better after 2 weeks
- Complete loss of voice that lasts more than a few days
- Hard, swollen lymph nodes
- Difficulty swallowing
- Coughing up blood
- A lump in your throat
- Severe throat pain
- Unexplained weight loss
When Should I Call for Medical Help Right Away?
Call for emergency medical services 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 emergency medical services right away.
You will be asked 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.
You can take the following steps to help ease laryngitis:
- Rest your voice.
- Avoid smoking.
- Stay hydrated.
- Use a cool mist humidifier.
- Take over-the-counter pain relievers, such as acetaminophen and ibuprofen.
Other treatments depend on the specific cause, such as:
- Participating in voice therapy if your loss of voice is due to voice overuse
- Taking medication to control acid reflux
- Having surgery to remove growths
To help reduce your chance of aphonia:
- If you smoke, talk to your doctor about ways to 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.
American Speech-Language-Hearing Association http://www.asha.org
National Institute on Deafness and Other Communication Disorders (NIDCD) https://www.nidcd.nih.gov
Ontario Association of Speech-Language Pathologists and Audiologists http://www.osla.on.ca
Speech-Language & Audiology Canada http://www.sac-oac.ca
Casthely PA, Labagnara J. Hoarseness and vocal cord paralysis following coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 1992;6(2):263-264.
Common problems that can affect your voice. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/common-problems-can-affect-your-voice. Accessed August 14, 2017.
Laryngitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/topics/dmp~AN~T115115/Laryngitis . Updated October 18, 2016. Accessed August 14, 2017.
Maniecka-Aleksandrowicz B, Domeracka-Kolodziej A, et al. Management and therapy in functional aphonia. Otolaryngol Pol. 2006;60(2):191-197.
Sancho JJ. Pascual-Damieta M, et al. Risk factors for transient vocal cord palsy after thyroidectomy. Br J Surg. 2008;95(8):961-967.
Vocal cord disorders. The Harvard Medical School Family Health Guide website. Available at: https://www.health.harvard.edu/diseases-and-conditions/vocal-cord-disorders. Accessed August 14, 2017.
- Reviewer: David L. Horn, MD, FACP
- Review Date: 09/2018
- Update Date: 07/14/2020