The Differences Between Aphonia and Dysphonia
The voice is a human’s main communication tool and is part of each person’s identity. Unfortunately, it can suffer various alterations, including aphonia and dysphonia.
In general, people use both terms arbitrarily to describe the inability to make sounds or communicate verbally. However, these symptoms have other additional characteristics that help them to be differentiated.
Aphonia and dysphonia are related conditions that are medically different in a wide variety of ways. The proper identification of both conditions is essential when establishing any treatment. Generally speaking, dysphonia is known as hoarseness, while aphonia describes the loss of voice.
What are the differences between aphonia and dysphonia?
The term dysphonia describes a qualitative or quantitative phonation disorder characterized by a difficulty in producing sounds when speaking. Similarly, this symptom defines any change or alteration in the elements of the voice perceived by the person and their environment. Changes can occur in pitch, timbre, intensity, and duration.
Studies suggest that dysphonia is a partial loss of the voice that manifests itself in a weak, hoarse, raspy or breathy voice. However, aphonia is considered the most serious and disabling form of the two conditions. It describes the total inability to emit words or sounds, which can evolve from dysphonia or appear suddenly.
Associated symptoms
In most cases, aphonia and dysphonia are benign disorders associated with inadequate coordination of the elements that participate in the production of the voice. Both entities are accompanied by characteristic manifestations that help to identify them. Among the symptoms associated with dysphonia are the following:
- A rough, deep tone of voice
- Hoarseness
- The sensation of mucus in the throat
- Constant throat clearing when speaking
- Feeling short of breath
- Coughing
- Difficulty swallowing
- An annoying sensation in the throat
On the other hand, aphonia is usually related to the typical symptoms of diseases of the upper respiratory tract such as pharyngitis. Some of the most common manifestations are the following:
- Inaudible voice
- Moderate to severe sore throat
- The sensation of constriction in the throat
- The inability to swallow certain food
In both cases, it’s recommended that the person maintains a soft or liquid diet to avoid further laryngeal problems. In addition, drinking cold water and low-temperature environments can make symptoms worse.
How does it occur?
The vocal cords are muscular folds located in the upper part of the trachea and surrounded by the laryngeal mucosa. Aphonia and dysphonia are the result of changes in the structure or functioning of the vocal cords, with some differences in the severity of presentation.
Research suggests that dysphonia can be the result of temporary or permanent organic, functional, psychogenic, or traumatic changes. The usual cause is the excessive use of the voice, with the consequent irritation, inflammation, and malfunction of the speech apparatus.
However, aphonia is usually associated mainly with severe anatomical or neurological disorders that completely block the movement of the vocal cords. In this sense, no sound will be generated as there’s no adequate response of the vocal cords to muscle changes and the flow of expelled air.
Causes
Dysphonia is a common symptom in a wide variety of diseases. Asthma, bronchitis, laryngeal nodules, and laryngeal cancer are some of the most common organic causes of this condition. Similarly, it can be the result of decreased or increased muscle tone of the vocal cords due to poor use of the voice.
Changes in the quality of the voice are also associated with psychological conditions such as fear, anguish and anxiety. In these cases, people often have a shaky tone of voice. Additionally, traumatic causes include traffic accidents, penetrating wounds, burns, and orotracheal intubation.
It can be the result of the evolution of any of the previously mentioned pathologies. However, there are also diseases that can start off with the total loss of the voice. Such is the case with severe acute laryngitis and recurrent laryngeal nerve palsy due to a tumor or surgery.
Two conditions that shouldn’t go unnoticed
Voice disturbances are often warning signs that something is wrong with the upper airway. In this sense, recognizing the differences between dysphonia and aphonia facilitates early medical care and improves the prognosis of patients. When you notice any of these symptoms, don’t hesitate to seek medical attention as soon as possible.
- Gamarra Zavala A, Santillán Ayala Y, Llovet Miniet A. Factores de riesgo asociados a la disfonía en docentes de la Facultad de Ciencias de la Comunicación U.L.E.A.M. Multimed. 2019 Abr ; 23( 2 ): 255-265.
- Elhendi H W, Caravaca G A, Santos P S. Medición de la discapacidad vocal en los pacientes con disfonías funcionales. Rev. Otorrinolaringol. Cir. Cabeza Cuello. 2012 Ago; 72( 2 ): 145-150.
- Ng KO, Lee JF, Mui WC. Aphonia induced by conversion disorder during a Cesarean section. Acta Anaesthesiol Taiwan. 2012 Sep;50(3):138-41.
- Moreno CA, Fonseca S. Aphonia after shoulder surgery: case report. Braz J Anesthesiol. 2016 May-Jun;66(3):321-3.
- Stachler RJ, Francis DO, Schwartz SR, Damask CC, et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018 Mar;158(1_suppl):S1-S42.
- Van Houtte E, Van Lierde K, Claeys S. Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. J Voice. 2011 Mar;25(2):202-7.