Lost your voice? Here’s what your body is saying

5 reasons why you lose your ability to speak, the remedies, and when to see a doctor

Have you ever lost your voice? Do you know what happens to your vocal cords?

Our vocal cords are located within the Adam’s apple (thyroid cartilage) in the middle of our neck. Production of sound happens when air from the lungs passes through the vocal cords, causing them to vibrate. These vibrations are invisible to the naked eye (they occur about 100 to 250 times per second). The sound produced from these vibrations is amplified through our resonance chambers (nose and the mouth).

Other than giving us the ability to speak, why is it important to protect the vocal cords?

When we use our voice excessively or in an abusive manner, our vocal cords can become swollen and inflamed, occasionally causing bleeding. The result is hoarseness, pain in the throat, a change in the pitch at which we talk, inability to sing high notes, or even loss of voice.

Sinus infections and nasal allergies may also block our resonance chambers (nose and the mouth) and affect our ability to project our voice. Vocal cords can become injured by excessive use and abuse. Common problems include vocal nodules, polyps, cysts, laryngitis (inflammation) and vocal haemorrhage (bleeding).

We asked Senior Consultant ENT Surgeon, Dr Paul Mok, from My ENT Specialist Clinic at Mount Elizabeth Novena Specialist Centre (a member of the MHC Asia Group network) who has more than 20 years of experience treating voice problems.

According to Dr Mok, certain groups of people tend to be more susceptible to vocal disorders. Teachers, show hosts, sports coaches, singers and other professions that require high usage of the voice, and people who work in noisy environments that require lots of shouting are at greater risk.

He shares five things that can cause you to lose your voice and how you can get it back.

1. Voice Misuse and Abuse

All of us have experienced some degree of voice loss, typically after we shout, cheer, and sing excessively at events such as parties or camps. In most cases, the body can easily heal minor injuries in the vocal cords, but recurrent vocal trauma can lead to vocal nodules (calluses on the vocal cord), vocal polyps, vocal cysts and vocal swelling.

Sometimes, blood vessels in the vocal cord can burst suddenly and cause bleeding (vocal haemorrhage). This usually causes a sudden loss of voice and is a vocal emergency that should be treated immediately.

What should you do?

Rest and minimise talking. Do not whisper. Use a pen and paper to communicate if necessary.

If you do not recover after one week, make an appointment to see an ENT doctor. Your doctor will perform a videostroboscopy on you with a flexible nasendoscope to make an accurate diagnosis. A videostroboscopy is a special equipment to evaluate movement of vocal cords. It gives the specialist important information on your vocal cord function to make an accurate diagnosis. The procedure takes five minutes in clinic and does not hurt.

Starting on the appropriate treatment early will help you recover faster. If you lose your voice suddenly and suspect a vocal haemorrhage, avoid talking completely and make an appointment to see an ENT surgeon immediately.

Although not life-threatening, continued use of your voice can cause your vocal cords to become stiff and swollen. It may take longer to heal.

2. Upper Respiratory Tract Infection (common cold)

When we catch a cold, we often experience a blocked nose, or nasal congestion. In certain cases, we may develop thick yellow-green phlegm and start coughing. A blocked nose affects our ability to project our voice, causing extra strain when talking.

Clearing our throat of the phlegm that drips into our throats makes our vocal cords more inflamed.

What should you do?

If you come down with a cold and start experiencing the symptoms listed above, get medical treatment early. If your cough and hoarseness of voice persist for more than two weeks, you may want to visit an Ear, Nose and Throat (ENT) doctor.

Typically, loss of voice (acute laryngitis) may take three to five days to heal so give yourself time to make a full recovery. If your job involves a lot of talking, going back to work too early when your voice is still hoarse could result in long-term damage to your voice.

3. Acid reflux

Loss of voice may also occur due to acid reflux. Acid reflux happens when acid from the stomach comes up into the throat and injure the mucosal lining. This may be perceived as a lump in the throat, throat phlegm, cough and hoarseness.

Typically, these symptoms occur within half an hour of eating or lying down soon after a meal. Acid reflux sufferers often have a history of gastric pain and frequent burping. Certain foods are associated with the increased frequency of acid reflux, such as fried, oily food, dairy products, caffeinated beverages and alcohol as well as acidic foods like oranges, lemons and grapes.

What should you do?

Avoid reflux-causing foods and lying down in bed within three hours of eating. Medication can also help to prevent reflux. If symptoms persist, make an appointment to see an ENT doctor.

4. Persistent blocked nose or runny nose due to allergies

Loss of voice can also happen due to frequent throat clearing and coughing as a result of allergies. Patients with nasal allergies often experience nasal congestion, sneezing or a “runny” nose. The mucus in the nose frequently back-drips into the throat and causes discomfort.

What should you do?

If your nose is frequently congested, first visit your family doctor for treatment. If symptoms persist, or if your voice is affected, it may be beneficial to visit an ENT surgeon who will perform a skin prick test to confirm your allergies. Sorting out your nasal allergies will help relieve any voice-associated problems too.

5. Vocal cord cancer

Lastly, a serious cause of voice loss is vocal cord cancer. Vocal cord cancer usually presents itself as persistent and progressive hoarseness. Other signs to look out for includes noisy breathing, shortness of breath and difficulty swallowing. If the symptoms are ignored, breathing may become progressively more difficult.

The risk of developing cancer is 30 times greater in patients who consume alcohol and smoke regularly.

What should you do?

To minimise the risk of cancer, avoid smoking and drinking alcohol regularly. If you have hoarseness that does not recover in two weeks, you should make an appointment to see an ENT surgeon.


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