Loss of voice is a disorder that affects the speech system. Also called aphonia, it is characterized by an inability to make sound. This dysfunction usually affects the larynx, which is located between the pharynx and the trachea, but also the vocal cords, which enable phonation and the epiglottis, an organ of the voice.
"Aphonia should not be confused with dysphonia. Dysphonia manifests as a dissonant, disturbed, hoarse, deep, or high-pitched voice. This is not the usual voice. This disorder can occur chronically, that is, it settles over time. Chronic tobacco poisoning, for example, changes the voice. Smokers often have a lower voice than normal " , specifies Faïza Bossy, general practitioner.
What are the causes of aphonia?
Several factors can be responsible for a loss of voice. Doctor Faïza Bossy tells us about the different origins of aphonia.
Loss of voice may be due to a fractured pharynx. These are special traumas. During a physical assault, a person can take a blow or a strong pressure on the throat. These violent gestures can therefore lead to aphonia.
In the car, children may have the seat belt incorrectly positioned. The latter can therefore tighten them at the neck. In the event of a high kinetic traffic accident, the belt can exert pressure or strangulation on the neck area. Neck trauma can also be related to shock. In younger people, the bones, especially the hyoid bone, and cartilage are still immature. They are therefore more easily broken.
"The pharynx can also be punctured during difficult intubation in an emergency setting. The patient may have a throat that is not easily intubable. These are traumas that can occur, but they are rare.", explains the general practitioner.
- Psychiatric causes
Strong shock such as accident or death can cause aphonia. The patient then wallows in silence and no longer emits any sound. This is called psychogenic aphonia. During the clinical examination, the health professional does not observe any damage to the voice system.
A stroke can affect the nerves that support speech and swallowing. In stroke patients who are voiceless, one part of the brain is always affected: the brainstem.
"Aphonia can be due to a bacterial or viral infection, but once it is treated, the voice returns. When a person has fever and a disappearance of voices, we must be more vigilant ", underlines Doctor Faïza Bossy.
Epiglottitis, an inflammation of the epiglottis, is a brutal infectious disease that affects children. In a large majority of cases, this disease is viral. It is contraindicated to lay down a child who has a fever and can no longer speak, as he or she may suffocate.
Voice loss: what are the treatments to treat aphonia?
Treatment for aphonia depends on the cause. For trauma, the health professional consolidates the fracture or fissure of the pharynx. An ENT then provides post-traumatic follow-up with the patient.
"People with stroke are supported by neurologists. They will also be able to undergo rehabilitation with speech therapists or phoniatrists in order to learn to speak again. Patients often have a metallic or robotic voice when they regain the use of speech. Their words can also be chewed ", completes Faïza Bossy.
The general practitioner recommends the prescription of anti-inflammatory drugs such as corticosteroids to fight against inflammation of the speech system and vocal cords. Antibiotics can be prescribed, but only for a pathology of bacterial origin, as these drugs have no effect on viruses. Regarding psychiatric causes, patients usually undergo psychiatric therapy.
In the event of loss of voice, Dr. Faïza Bossy recommends following several hygiene rules:
- quitting tobacco consumption: smoking changes the voice.
- do not consume alcohol: alcoholic drinks promote gastric reflux which can irritate the larynx.
- avoid certain foods: we ban in particular acidic foods, but also fatty food products at the end of the day. These lead to gastric reflux.
- regularly ventilate rooms at work and at home: dry air dries up the mucous membranes and vocal cords. Moisten your rooms especially for children and maintain good hydration.
- breathe through the nose on the outside: the inhaled air that passes through the nose is filtered and warmed, which reduces the risk of inflammation.
It is also important to take vocal rest during voice loss. According to Faïza Bossy, speech therapists often alternate between rehabilitation where they make the vocal cords work well and rest periods.
The general practitioner also advises against whispering. "It is not an extra effort that tires you out. The cold air that comes in through your mouth makes the situation even worse. We therefore avoid whispering, but it is recommended to take vocal rests ", she explains.
Thanks to Faïza Bossy, general practitioner
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