Loss of voice

Loss of voice in medical terminology is called aphonia. The condition is the inability of a person to reproduce sounds, to speak, in a word, his normal sonority, loudness, depth of voice disappears, but the ability to whisper remains. That is, we are not talking about the impossibility of reproducing words and sentences due, for example, to the underdevelopment of the speech apparatus or brain damage, when a person is not able to learn to speak at all during his life. Aphonia is a problem that occurs when a person used to speak normally, but due to certain reasons lost this opportunity.

The structure of the speech apparatus, its ability to function

How does sound formation occur in humans, and why can we pronounce individual words, sentences, texts? Speech sounds and their combinations are produced as a result of muscle contraction of the peripheral speech apparatus. When a person takes a breath, the created air flow enters the larynx, creating nerve impulses, which, in turn, act on the vocal cords. Sound extraction occurs due to the vibration of the vocal cords, that is, they are the main speech instrument in humans, but far from the only one.

The entire vocal apparatus consists of a central and executive departments. The first is the brain: the cerebral cortex, subcortical structures, trunk nuclei, nerves, pathways. The peripheral or executive department is a system of speech organs consisting of bones, cartilage, muscles, ligaments and peripheral nerves that contribute to the work of these organs in the process of creating and extracting sounds.

The peripheral speech apparatus is divided into the respiratory section (lungs, trachea, bronchi, diaphragm and intercostal muscles), the vocal section (ligaments), and articulatory (it is also called sound-producing: soft palate, lips, tongue, lower jaw, teeth, nasal cavity, pharynx larynx, hard palate).

Each of these organs is involved in a well-coordinated mechanism for extracting sounds, giving them a certain sound. So, for example, the strength, timbre and pitch of the voice depend on the movement of the air flow on the cords, on its strength and direction. Articulatory organs are responsible for the nature of the pronounced sounds, the fullness of vowels, the hardness and clarity of consonants.

Causes of voice loss: why pathology is formed

The normal state of a person is the ability to extract sounds, speak words and sentences loudly, clearly. However, in some cases, adults and children may develop aphonia – the absence of a sonorous, normal voice, while the ability to whisper is preserved.

The most common causes of voice disappearance are colds, acute tracheitis, acute respiratory infections, tonsillitis and any processes associated with inflammation and swelling of the pharynx, larynx or vocal cords. In addition, the voice may be “lost” in the following cases:

• congenital malformations of the larynx;
• ligament injuries (in musicians, teachers, lecturers);
• exposure to ligaments of very high or low temperatures;
• foreign bodies entering the respiratory tract or vocal apparatus;
• toxic effects, for example, due to polluted air, a spasm of the larynx may occur;
• psychological trauma: on a nervous basis, from fear;
• paralysis or paresis of the larynx and vocal folds;
• tumor formation in the organs of the speech apparatus;
• inflammation of the lungs, with a severe form of bronzitis, chronic laryngitis;
• prolonged and frequent screaming and screeching (that is, incorrect “use” of the vocal apparatus).

In addition, there is a high probability of voice loss after operations associated with exposure to the organs of the vocal apparatus, with tracheal intubation, as well as in the presence of some lung lesions.

Varieties of aphonia known to medicine

The main classification of the disease involves dividing it into four types:

• true, guttural aphonia;
• paralytic;
• hysterical, or functional;
• spastic.

True loss of voice is formed against the background of diseases and functional pathologies of the larynx, which make it impossible for the normal functioning of the vocal cords, their full correct closure and vibration – tumors, scars. Improvement in a person in this case can only occur if the root cause is eliminated.

The paralytic form of the disease occurs due to dysfunction of the lower laryngeal nerve, which is responsible for the control, functioning and performance of most of the internal muscles of the larynx. Paresis or paralysis of the nerve can occur as a result of mechanical damage, trauma, surgery on the thyroid gland, due to compression of the aorta by a formed aneurysm, and also due to the presence of tumors in the lungs, mediastinal organs, thyroid gland, trachea, esophagus. A possible cause of nerve paralysis is its toxic damage, not associated with its physical infringement or damage.

Functional aphonia is the result of the formation of an acute state of neurosis in a person, while there are no objective pathological changes in the larynx. When trying to cough up or with an irritating mechanical effect on the larynx, the patient develops a sonorous cough.

Spasmodic loss of voice is associated with spasm of the internal muscles of the larynx. As a result, the glottis narrows, the person cannot control the vocal cords. There may be several reasons, for example, mental trauma or irritation of the mucous membrane with caustic chemicals and vapors.

In addition, aphonia is complete or partial. Complete loss of voice is observed with pharyngitis with complications, with laryngitis, in people who for a long time haphazardly sing “on the cords”, without support. At the same time, a person cannot extract any sound from his ligaments at all, he only has the opportunity to whisper.

With a cold, tracheitis, and sore throat, a partial loss of voice is possible, when instead of a normal, deep and full sound, a person speaks with hoarseness and hoarseness, lower and deafer than usual, but at the same time, the ability to extract sound from the ligaments, although distorted, is present.

If voice loss has occurred, for example, due to mechanical damage to the ligaments that cannot be repaired, it is considered irreversible. Basically, aphonia is temporary if, under certain conditions, the voice can return to the person.

Loss of voice due to laryngitis

Laryngitis is a disease that is more common in children, and means an inflammatory process of the mucous membrane of the larynx. Laryngitis can occur for the following reasons:

• infectious lesion;
• overheating or hypothermia;
• tension in the muscles of the larynx.

Adults can also develop such a lesion, however, due to the fact that the lumen of the larynx in an adult is somewhat larger than in a child, it proceeds in milder forms.

Laryngitis can be:

• catarrhal (the simplest form with typically infectious symptoms – high fever, dry cough, hoarseness in the voice);
• stenosing (a form that is accompanied by a significant narrowing of the lumen of the larynx);
• hypertrophic (in this case, a person has a strong hoarseness in his voice, and there is a high probability of complete aphonia);
• atrophic (occurs in adults due to thinning of the mucous membrane of the larynx);
• hemorrhagic (develops in parallel with toxic flu or blood diseases, accompanied by a dry or wet cough with blood);
• diphtheria (in this case, the disease passes from the tonsils to the larynx, a white bacterial coating forms on the mucous membranes);
• purulent (rare, develops from catarrhal laryngitis, characterized by a sharp increase in all symptoms).

Laryngitis is always accompanied by hoarseness or complete loss of voice. In addition, the patient feels a sore throat, swallowing and breathing is difficult, there is hyperemia and redness of the pharyngeal mucosa, a “barking” cough, dryness and irritation in the mouth and throat, spastic contraction of the muscles of the larynx. The condition passes against the background of an increase in body temperature to 38-38,5 degrees.

In newborn babies, it is more difficult to determine laryngitis than in older children, since babies cannot complain about their well-being. If the baby has become unusually capricious, restless and lethargic, he has wheezing during a cry, breathing is difficult and is accompanied by noise and whistling, if the child coughs and has a runny nose with copious discharge from the nose, these signs may indicate laryngitis. The disease can also occur without a temperature, so it is not worth relying on this symptom reliably.

The disease and the loss of voice inherent in it should not cause panic – if you turn to the doctor in time, follow all his recommendations and prescriptions for treatment, the inflammation will soon stop and the voice will be restored.

Nervous voice loss: how and why it happens

Can a person be left without a voice due to nervous experiences, stress or neurosis? Aphonia, as well as some other phonetic pathologies, may be of a psychosomatic nature.

Approximately 20% of people with anxiety-depressive spectrum disorders have an impairment or loss of voice. Most often, aphonia is associated with hysterical neurosis and a general anxiety-depressive state. Women, especially during pregnancy, are more prone to loss of voice due to nervousness than men, since their psyche is somewhat less stable.

Hysterical states can lead a person to functional aphonia, when a normal, loud, sonorous voice is absent, but speech in a whisper is preserved. Violation or loss of voice in this case occurs suddenly, against the background of good physical health. A person complains of a sensation of a lump in the throat, sticking of sputum, which seem to interfere with speaking. Pathology can suddenly go away on its own, but if the voice has disappeared for no apparent physiological reasons, it is better to visit a doctor.

Lung diseases and aphonia: how are they related?

Bronchitis is an inflammatory disease that affects the bronchi, while they form and secrete mucus and even pus on the mucous membrane. Bronchitis mainly develops as a complication of untreated infectious diseases (influenza, SARS), after a cold suffered “on the legs”, and also as a result of allergic reactions. In the absence of proper treatment, it can be complicated by pneumonia or go into bronchial asthma.

The clinical picture of the course is very characteristic – first of all, the patient begins to suffer from coughing. It may be dry or wet, and may contain pus-filled sputum. In addition, a person’s body temperature rises, he feels a general malaise, increased fatigue and weakness, his throat hurts. Chronic forms proceed similarly, but more often without an increase in body temperature.

Often the cough has a “barking” character, intensifies in a dream. If the cough is very strong, and there is an overstrain of the vocal cords, the patient may experience aphonia. Also, loss of voice is possible if bronchitis has developed as a complication of pharyngitis, laryngitis.

There is no direct connection between the processes in the bronchi and aphonia, but a violation of the respiratory processes and a cough due to inflammation of the bronchi can temporarily deprive a person of his voice.

Lung cancer occupies one of the first places among all types of cancer in terms of frequency of occurrence. Primary lung oncology is more common in men, tends to develop against the background of chronic lung diseases – bronchiectasis, chronic bronchitis, and also due to occupational lung diseases associated with the constant inhalation of irritating and dangerous particles (dust, various chemicals). Smoking is one of the determining factors for the development of the disease.

The development of lung cancer occurs gradually, so it is difficult to determine the exact moment of its onset. The tumor is usually located inside the bronchus, gradually closing its lumen, which is why atelectasis is formed. A neoplasm can give metastases, penetrate into other areas, for example, into the pleura and lungs. At the same time, a person feels pain in the chest of a dull nature, he is tormented by bouts of coughing, first dry, then wet with blood. Cough gradually acquires a whistling, “barking” sound. Over time, fever, chills may join. On examination, the doctor notices an expansion of the saphenous veins in the chest area, an increase in lymph nodes, and a slight swelling of the subcutaneous tissue in the neck. The lung affected by the disease somewhat lags behind the healthy one in the rate of inhalation.

Can the voice be lost? Aphonia does accompany the development of lung cancer in some cases, but it cannot be attributed to permanent and reliable signs of pathology. Loss of voice is present in a patient if the tumor grows into the mediastinum, and provokes compression of the nerve trunks, large vessels and esophagus. Along with aphonia, there is a swallowing disorder, a clear edema of the lower half of the face.

Diagnosis, recommendations and treatment of the problem of aphonia

Identification of aphonia itself does not cause any difficulties for both the patient and his attending physician. Diagnostic measures are usually aimed at determining the cause of voice loss. The doctor interviews the patient, clarifies all the accompanying symptoms, conducts an examination. If the problem is solely due to physical causes, they are easy to identify and prescribe treatment. If necessary, after establishing the diagnosis of aphonia, the therapist can refer the patient to a neurologist, otolaryngologist, psychiatrist, speech therapist, the oncologist.

Recommendations for loss of voice include a ban on smoking, including not being near smokers and breathing smoke, as passive smoking also irritates the larynx. It is forbidden to take alcohol, vasoconstrictor drugs, aspirin. Until the voice is restored, you should avoid places and rooms with low air temperature, with dry or excessively humid air, with a high content of dust. Foods containing acids, such as tomatoes, citrus fruits, chocolate, must be temporarily removed from the diet. The exception is lemon juice with honey as a medicine. You also need to exclude very cold and very hot drinks.

In what cases is it necessary to consult a doctor? You should not postpone a visit to the doctor if the child suddenly lost his voice, as children often develop acute stenosis of the larynx due to infectious processes. Small children, unfortunately, are at risk of inhalation of a small foreign body, therefore, if foreign objects are suspected in the respiratory tract, the child is taken to a medical facility as soon as possible.

In addition, it is imperative to seek medical help if the loss of voice is accompanied by some dangerous symptoms, for example, difficulty in breathing, high body temperature, if aphonia that suddenly arises for no apparent reason does not go away within a week.

The treatment regimen depends on the cause of the problem. In rare cases, if the patient’s condition is threatening, he is hospitalized, appropriate therapy is prescribed to treat the pathology that provoked the loss of voice. True aphonia requires excision of scars, removal of the tumor, that is, surgical intervention.

The paralytic type is not always treatable, but if the root cause of the appearance is eliminated (removal of the aortic aneurysm, tumor, or successful anti-influenza, anti-inflammatory therapy), the patient improves.

Spastic and functional loss of voice implies the appointment of general strengthening drug therapy for the nervous system, psychotherapeutic classes, breathing exercises, and phonopedic exercises.

With functional hoarseness of voice, the patient is assigned to rest the vocal cords (you can’t talk, whisper, make any sounds with cords), in addition, you need to give up alcohol and smoking.

If the cause is acute laryngitis, the treatment will be complex. To combat the infectious factor of laryngitis, antibiotic therapy and other antimicrobial drugs are prescribed. Anti-inflammatory drugs, as well as some folk remedies, help reduce swelling and inflammation. Be sure to apply local methods of treatment – sprays and rinses with antiseptic drugs, for example, Miramistin or decoctions of medicinal herbs. The patient is shown soothing inhalations. At home, they can be done using a nebulizer, or in a simple, well-known way, over a saucepan with hot (not boiling) contents – water and active ingredients, for example, anise oil or chlorophyllipt tincture.

Antiseptic lozenges, for example, Lizobakt, Strepsils, help reduce pain and sore throat.

Some people prefer treatment with homeopathic remedies, taking drugs like Homeovox, someone turns to traditional medicine recipes.

Ginger root is considered a powerful antimicrobial and immunostimulating agent. Its root is rubbed on a grater, pour a third glass of water, add one spoonful of honey. All ingredients are mixed in an enamel pan, and put on fire. When the mixture boils, it is cooled, filtered and taken 1 tablespoon before bedtime. It can also be added to milk or weak tea.

Potato juice is used for gargling – for this, raw peeled potatoes are rubbed on a grater, and the resulting liquid is drained and filtered. Rinse is carried out 3-4 times a day, after meals.

Raisin remedy with onion juice is prepared in this way: 2 tablespoons of raisins are poured into a glass of water and brought to a boil. After the broth has cooled, add 1 cup of freshly squeezed onion juice to it and take 2 tablespoons twice a day.

Useful for the patient are gargling with sea salt and soda, with calendula tincture, with fir oil. You can carry out the procedure every 2-3 hours throughout the day. After rinsing for half an hour, you can not eat or drink.

There is an opinion that voice loss can be cured by drinking alcoholic beverages – cognac, beer. In fact, ethyl alcohol affects the ligaments in a destructive way, even if we are talking about a healthy person. And for a sick person, the treatment of voice loss with cognac or other intoxicating products is prohibited.

Loss of voice can accompany both colds and other pathologies with a less obvious connection, for example, nervous disorders, lung cancer. At the same time, the speech apparatus of a person can be completely in normal, working condition, but the person will still not be able to talk. If there is a functional disorder, diseases of the ligaments or larynx, nerve paralysis, it is quite natural that these factors affect a person’s ability to speak normally and extract full-fledged sounds from his vocal apparatus. Fortunately, in most cases, aphonia is not irreversible and final. Adequate therapeutic measures to eliminate the cause of the disease allow you to return the person’s voice over time.