Aphonia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Aphonia is the medical term for the inability to speak. It is considered more severe than dysphonia. A primary cause of aphonia is bilateral disruption of the recurrent laryngeal nerve, which supplies nearly all the muscles in the larynx. Damage to the nerve may be the result of surgery (e.g., thyroidectomy) or a tumor.

Aphonia means “no voice.” In other words, a person with this disorder has “lost” his/her voice.

Functional (or psychogenic) aphonia is often seen in patients with underlying psychological problems. Laryngeal examination will show usually bowed vocal folds that fail to adduct to the midline during phonation. However, the vocal folds will adduct when the patient is asked to cough. Treatment should involve consultation and counseling with a speech pathologist and, if necessary, a psychologist.

In this case, the patient’s history and the observed unilateral immobility rules out functional aphonia.

There are many reasons why this may happen. Injuries seem to be the cause of aphonia rather frequently – minor injuries which affect the second and third dorsal area in such a manner that the lymph patches concerned with coordination become either atrophic or relatively nonfunctioning.

Basically, any injury or condition that prevents the vocal cords, the paired bands of muscle tissue positioned over the trachea, from coming together and vibrating will have the potential to make a person unable to speak. When a person prepares to speak, the vocal folds come together over the trachea and vibrate due to the airflow from the lungs. This mechanism produces the sound of the voice. If the vocal folds cannot meet together to vibrate, sound will not be produced.

Poor eliminations can bring about disturbances and sometimes are the primary cause of aphonia; this build-up of wastes within the bloodstream becomes a toxic force and makes it necessary for the body to achieve its own balance after a lapse of time. When this comes about, the throat and larynx area might be disassociated in function from the rest of the body, and the forces there bring about local inflammation in an effort to achieve balance. Fear also is often a concomitant and a contributor.

Therapy should first be aimed at correcting those conditions which might produce a disturbance in the centers of coordination between the three nervous systems. Then the overtaxed nerve forces of the body as a whole should be relieved, the incoordination which has been a factor in the disease process should be eliminated, and the forces of the body should be coordinated. The diet should be corrected and sufficient stimulus of a medicinal nature should be added to keep the body in a normal force. Some cases that are psychological – where the body is amenable to suggestion – would benefit by suggestive therapy. Attention should be paid to attitudes of mind and to ideals.

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