Aphonia is the inability to speak. A person with this disorder cannot vocalize and must use means of communication other than the voice. There are a number of reasons for people to develop aphonia and there are several treatment options. Treatment can involve a speech pathologist; an ear, nose, and throat surgeon; and other medical professionals, such as neurologists.
When people talk, the vocal cords in the throat vibrate to generate the sounds of speech. People with aphonia have vocal cords that do not move into position and vibrate properly. When they try to speak, no sounds come out. This is different from conditions where people have rough or hoarse voices, or have difficulty speaking for neurological or purely psychological reasons.
In a physical examination, a patient with aphonia may be asked to try and speak, as well as to cough. The vocal cords will be visualized and the patient will be interviewed to learn more about the onset of the aphonia. Trauma to the nerves that control the larynx is a common cause and it can also be a result of surgery, physical abuse, or tumors. Sometimes there is a psychological component and some studies have shown that people may develop an inability to speak as a psychological coping mechanism. At other times, the vocal cords are temporarily damaged by smoking, shouting, and other activities, and they will recover if allowed to rest.
Treatments for aphonia can include rest to see if the vocal cords will spontaneously recover, along with treatment of tumors and nodules on vocal cords. If damage was caused by surgery or trauma, the cords may eventually heal, allowing the patient to speak again. Sessions with a speech pathologist can also be helpful. The pathologist can work with the patient to see if it is possible to restore some powers of speech, and to develop the throat and vocal cords.
If the condition cannot be resolved, a patient may be taught sign language or provided with other tools for communication like a notepad. People with speech disorders can become very adept at using other types of communication to go about their daily business and interact with other people. It can be helpful to carry cards explaining the situation so that in a crowded environment or a setting where someone is not paying close attention, the patient can easily provide information about why he is not speaking.