What is loss of voice?

Loss of voice or hoarseness is the inability to use the vocal cords (larynx) effectively for speech. Medical terms for this symptom are dysphonia (change in voice) and aphonia (loss of voice). When speaking, air moves through folds in the larynx responsible for producing sound vibrations. If swelling or obstruction occurs within the vocal cords, the vibration is altered, thereby causing changes in or loss of voice. It’s remarkable how tiny changes in the vocal cord anatomy can result in profound changes in voice – good or bad. The most common cause of loss of voice is inflammation of the larynx.

Inflammation of the larynx results from infection or voice strain. Misuse of the voice can cause the vocal folds to swell and become unable to vibrate as needed for speech; it is one of the most common causes of voice problems. When infection occurs within the larynx due to bacterial or viral organisms, inflammation leads to swelling of the vocal folds. Loss of voice may also occur with any infection of the upper respiratory tract or with serious allergic reactions, such as anaphylaxis.

In addition to inflammation, many different types of nervous system conditions and diseases can cause loss of voice. Aphonia may occur from conditions that impair the vocal cords, such as cerebrovascular accident (stroke), myasthenia gravis (neuromuscular disease), and cerebral palsy. Loss of voice related to nervous system conditions is caused by an interruption in signals (neural impulses) between the larynx and the brain. Without these impulses the vocal folds do not open and close, thereby preventing speech from occurring.

Loss of voice can also arise from conditions that obstruct the normal function of the vocal cords. Tumors, nodules or benign growths, bony growths, or goiters occurring within the region of the larynx may all cause loss of voice. Malignancies of the oropharynx, larynx, and thyroid gland may obstruct the normal function of the vocal cords due to their close proximity to the larynx.

Loss of voice is rarely associated with a medical emergency. Seek immediate medical care (call 911) if your loss of voice is associated with loss of vision or numbness or weakness on one side of the body.

Seek prompt medical care if your loss of voice is persistent or causes you concern.

What other symptoms might occur with loss of voice?

Loss of voice may accompany other symptoms, which will vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the voice may also involve other body systems.

Inflammatory symptoms that may occur along with loss of voice

Loss of voice may accompany other symptoms related to inflammation including:

Congestion
Cough
Earache
Flu-like symptoms
Sore throat
Swelling

Other symptoms that may occur along with loss of voice

Loss of voice may accompany symptoms related to other body systems. Such symptoms include:

Difficulty swallowing
Loss of vision or changes in vision
Numbness on one side of the body
Rash
Swelling or lump in throat
Tight feeling in throat
Weakness on one side of the body

Serious symptoms that might indicate a life-threatening condition

In some cases, loss of voice may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

Abnormal pupil size or nonreactivity to light
Difficulty breathing or rapid breathing
Difficulty swallowing
Loss of vision or changes in vision
Numbness on one side of the body
Swelling of the throat, tongue, lips or mouth
Weakness on one side of the body

What causes loss of voice?

Loss of voice is the inability of the vocal cords to function properly. The most common causes are due to inflammation and infection and a result of swelling of the vocal folds, which prevents proper vibration needed to speak. Other causes include nervous system disorders and obstruction within the vocal cord region. Obstructions can be benign or malignant occurring within different locations, such as the thyroid gland, parathyroid glands, throat, and larynx.

Inflammatory causes of loss of voice

Loss of voice may be caused by inflammation or infections including:

Other causes of loss of voice

Loss of voice can also be caused by several other conditions including:

Benign or malignant tumors
Goiter
Inhaled toxins or noxious fumes
Myasthenia gravis (autoimmune neuromuscular disorder that causes muscle weakness)
Nodes on vocal cords (singer’s nodes)
Tobacco use

Serious or life-threatening causes of loss of voice

In some cases, loss of voice may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

Anaphylaxis (life-threatening allergic reaction)
Malignant tumors
Stroke
Transient ischemic attack (temporary stroke-like symptoms that may be a warning sign of an impending stroke)

Questions for diagnosing the cause of loss of voice

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your loss of voice including:

How long have you lost your voice?
Do you smoke?
Do you have any other symptoms?
What medications are you taking?

What are the potential complications of loss of voice?

Because loss of voice can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including: