Lost your voice? Could be Aphonia

By M H Ahssan

Aphonia is a functional voice disorder literally meaning 'no voice'. Normally, when we speak, the vocal folds come together over the trachea and vibrate due to the airflow from the lungs. Injury or conditions that prevent the vocal cords from coming together and vibrating, result in making a person unable to speak.

Functional Aphonia
Functional (or psychogenic) aphonia is often seen in patients with underlying psychological problems. A laryngeal examination will show usually bowed vocal folds that fail to adduct to the midline during phonation but adducts when the patient is asked to cough.

What are the Causes?
Common cold or allergy. Benign or malignant growth on the vocal folds. Nerve or brain damage, including paralysis of the vocal folds.
Spasms of the vocal folds (Spasmodic dysphonia). Neurological disorders like myasthenia gravis, multiple sclerosis, Parkinson's disease etc.

Vocal abuse, yelling, excessive use of alcohol, caffeine ,exposure to fumes and toxins. Smoking (cancerous growths) and unknown causes.

When do you need to see a specialist?
If aphonia persists beyond the duration of the common cold or flu or if aphonia begins in the absence of an upper respiratory infection, one should consult a doctor.

Treatment of Adjustment Disorder
Adjustment disorder is a reaction to life stress which is abnormal and excessive, a life-threatening or extremely distressing situation that causes a person to feel intense fear, horror or a sense of helplessness leading to post-traumatic stress disorder. Aphonia could be one of the symptoms.

The primary goal of treatment is to relieve symptoms and help the person return to the level of functioning the person had before the stressful event.

Some cases that are psychological would benefit from suggestive therapy by a qualified professional.

Voice Therapy
A voice care team involving an otolaryngologist and speech pathologist is a prerequisite to voice therapy.

It aims at techniques that eliminate vocal behaviours which are potentially harmful.

Alter the manner of voice production, and enhance vocal fold tissue healing, following injury.

Voice therapy is an effective and appropriate method of therapy either in itself or as a compliment.

Therapeutic regimen employed for a particular patient varies depending on:
- Tissue health of the vocal folds,
- Vocal demands of the patient,
- Phonatory behaviour,
- Compliance of the patient.

Once evaluated, a customised voice therapy programme is developed and tailored to address vocal complaints.

Tips to help you
- Take care not to abuse the voice
- Don't shout or yell excessively
- Smoking is injurious to health and the vocal cords. Quit it.
- Give your voice rest if you are a public speaker, teacher or performer
- Visit an ENT doctor if you are voiceless