The voice is one of the most useful instruments of the human being, being what allows us to use our main means of communication: the spoken language.
Besides being something that is present in our daily life, there are many people whose work depends on the voice, as is the case of singers, teachers, teleoperators, tour guides… And so , when the voice is impaired, it is inevitable that we realize and suffer a lot of discomfort.
Aphonia and dysphonia are two terms commonly used as synonyms, used to describe when our voice fails. They are really two different concepts, with their peculiarities, and that is why we will discover them below. the main differences between aphonia and dysphonia.
Main differences between aphonia and dysphonia
The voice is a very present element in our lives, both daily and professional. Human language has evolved and become more sophisticated thanks to the fact that our species has a very complex appetizing apparatus., capable of emitting hundreds of different phonemes, which is why the main means of communication that we use to convey our ideas, emotions, thoughts and opinions is the oral form of language.
If we were to give a list of all the professions where voice is fundamental, this one wouldn’t stop. One way or another, in all professions, and in virtually all situations that may arise, we need to speak, use oral language, and therefore having a good voice is essential, and much more if we consider their importance in professions such as singer, teleoperator, actor, teacher, tour guide or radio host.
Unfortunately, it’s not uncommon for our voice to fail us at some point. Terms such as “aphonia”, “dysphonia” or “hoarseness” are common in general vocabulary. words that everyone knows and that give them a meaning, often identical. However, these three words are not synonymous, but although they refer to alterations in the voice, they refer to varying degrees of inability to make sounds.
1. Differences in the severity of the problem
Let’s start with dysphonia. This word is composed of the prefix “dis” and the word “phonia”, both of Greek origin and which translate as “bad sound”. This refers to a qualitative and quantitative disorder of phonation, of organic or functional origin linked to the larynx, in which the normal timbre of the voice is lost but the ability to emit sounds is not lost. In dysphonia, our voice is impaired, but we can continue to speak.
However, aphonia (from “to” and “fonia”, “speechless”) refers to the state in which the voice is completely absent. This means that, the many times we say we are aphonic, we don’t use the term correctly, because to be aphonic, in its most literal sense, is not being able to emit sound. What we would really be in this situation is dysphonic, or having a hoarse voice.
Aphonia and dysphonia can be understood as two terms belonging to a continuum, being aphonia the most extreme situation of dysphonia, in which not only the voice would be affected but it would have been lost directly, this being the most conspicuous difference. Apart from that, there are other differences in the form of common symptoms of one condition or another, which we will see below.
Symptoms of dysphonia
The quantitative and qualitative alteration of phonation involves a series of characteristics or vocal signs that differ depending on the type of dysphonia., according to organic or functional origin. Signs of these alterations in phonation can occur singly or in combination with each other, and it is common for the symptoms, in the form of patient complaints, to coincide with the following signs:
- Monotonous voice
- Trembling voice
- Aphonia episodes
- Changes in voice intensity
- Loss of treble
- Shortness of breath when speaking
In addition, the patient usually indicates that he has non-phonetic symptoms:
- I clear my throat to clear my throat
- Strange body sensation when swallowing
- Mild or moderate sore throat when talking
Symptoms of aphonia
In the case of aphonia, the two main symptoms are the most extreme hoarseness and the absolute inability to speak.. The same symptoms do not occur as in dysphonia, such as trembling voice or loss of treble, because it does not have a direct voice. As for the non-phonatory symptoms, they are similar to those of dysphonia, namely:
- Sore throat
- Spasm in the vocal cords
- Difficulty swallowing solids and liquids
How is voice loss given?
The progression from dysphonia to aphonia is gradual. Aphonia can be seen as the last stage, the final stage in a process of alteration and damage to the voice in which no precaution has been taken to avoid loss of voice, whether temporarily or definitively. The main reasons why you may experience decreased voice are:
- Inflammation of the larynx and swelling of the vocal cords.
- Reflux of stomach acids: These acids end up irritating the vocal cords.
- Viral infections such as the common cold can irritate and inflame the vocal cords.
- Bleeding of the vocal cords.
As can be seen, the main phenomenon involved in aphonia and dysphonia is inflammation of the vocal cords, two bands of flexible muscle tissue found at the entrance to the trachea. The vocal cords are like any other muscle, which means they need to be warmed up and cared for so they don’t get injured. When overworked, they can be damaged, and if they are not treated properly or if their injury is not repaired, the problem will eventually get worse.
Inflammation of the vocal cords makes the forehead unable to vibrate, while the back is a space that does not close properly, causing air to escape without producing sound. The combination of these two problems makes it impossible to articulate intelligible sounds, regardless of the strain of the vocal cords.
Treatment and prevention
Dysphonia and aphonia these are two degrees of the same problem: inflammation of the vocal cords. For this reason, the solution is the same for both conditions, disinflammation of the cords, let them rest first and, if necessary, move on to pharmacology. It is crucial not to strain the voice, as this can create a vicious cycle in the inflamed cords, swelling and damaging you further. And, to avoid both of these issues, you should avoid using too loud a tone of voice or shouting too often.
Contrary to popular belief, you must not speak in a low voice when you are dysphonic and aphonic. In fact, otolaryngologists say that whispering is the complete opposite of what to do, because with this action what is done is to tighten the vocal cords even more, aggravating the dysphonia and going straight to the aphonia. What we need to do is try to speak normally, with the voice coming out of us or, directly, avoid saying anything, because the best treatment is total rest.
Adopting a healthy lifestyle is an ally in avoiding these two problems. Foods containing vitamin A, such as dairy products, carrots, broccoli or spinach, help to regenerate and repair tissues; while foods containing vitamin E, such as nuts and avocado stimulate the defenses, and keeping the throat well hydrated is essential. And, of course, you should avoid tobacco and alcoholic beverages anyway.
Can something more serious happen?
Cases of dysphonia usually resolve within a few days, but if not, a doctor should be consulted to assess the severity of the case. Most likely, this professional will prescribe pain relievers to reduce neck discomfort, as well as rest..
But sometimes what lies behind aphonia and dysphonia can be much more serious, a medical condition that requires urgent pharmacological and surgical intervention and is caused by something as dangerous as a tumor. It can also be due to certain congenital malformations, such as alterations of the laryngeal membranes, angiomas, laryngeal papillomas …
In adulthood, dysphonia can be caused by neurological disorders of the larynx, such as spastic dysphonia, which is characterized by voice spasms that hamper regular vocal flow, Parkinson’s disease, or myasthenia gravis. It can also be caused by endocrinology, such as myxedema from hypothyroidism or changes in menopause.
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- Andrews, ML (2006). Voice treatment manual: From pediatrics to geriatrics. Clifton Park, New York: Apprenticeship of Thompson Delmar.
- Cantor Cutiva, LC, Vogel, I., & Burdorf, A. (2013). Voice disorders in teachers and their associations with work-related factors: a systematic review. Journal of Communication Disorders, 46, 143-155.