The 2 differences between aphonia and dysphonia (explained)

Let's see how to differentiate between aphonia and dysphonia and what are their similarities that can confuse us.

The voice is one of the most useful instruments of the human being, being that which allows us to use our main means of communication: oral language.

In addition to being something that is present in our daily lives, there are many people whose work depends on the voice, as is the case of singers, teachers, telemarketers, tour guides ... And therefore, when the voice is altered is inevitable that we realize and suffer much discomfort.

Aphonia and dysphonia are two terms colloquially used as synonyms, used to describe when our voice fails us. They are really two different concepts, with their peculiarities and, therefore, we are going to discover 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 in everyday and professional life. Human language has been evolving and becoming more sophisticated thanks to the fact that our species has a very complex mouth-voice apparatus, capable of emitting hundreds of phonemes.This is why the main means of communication we use to convey our ideas, emotions, thoughts and opinions is the oral form of language.

If we had to give a list of all the professions where the voice is fundamental, it would be endless. In one way or another, in all professions, and in practically any situation that can occur to us, we need to speak, to resort to oral language and, therefore, having a voice in good condition is essential, and even more so if we consider its importance in professions such as singer, teleoperator, actor, teacher, tour guide or radio presenter.

Unfortunately, it is not uncommon for our voice to fail us at times. Terms such as "aphonia", "dysphonia" or "hoarseness" are common in the general vocabulary, words that everyone knows and ascribes to them a meaning, often the same meaning.. However, these three words are not synonymous, but rather, although they refer to voice alterations, they refer to different degrees of inability to emit 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 translated as "bad sound". It refers to a qualitative and quantitative disorder of phonation, either due to organic or functional causes related to the larynx, in which the normal timbre is lost.In dysphonia, the normal timbre of the voice is lost but the capacity to emit sounds is not lost. In dysphonia our voice is altered, but we can still speak.

On the other hand, aphonia (from "a" and "phonia", "voiceless") refers to the condition in which the voice is completely absent.. This means that, the many times we say that we are aphonic, we are not really using the term correctly, since being aphonic, in its most literal sense, is not being able to emit any sound. What we would really be in that situation is dysphonic, or having a hoarse voice.

2. Symptomatology

Aphonia and dysphonia can be understood as two terms belonging to a continuum.aphonia being the most extreme situation of dysphonia, in which not only the voice would be affected, but it would be directly lost, being this the most striking difference. Apart from this, there are other differences in the form of common symptoms of one or the other condition, which we will see below.

Symptoms of dysphonia

The quantitative and qualitative alteration of phonation brings with it a series of vocal characteristics or signs which differ according to the type of dysphoniadepending on the organic or functional origin. The signs of these alterations of phonation can manifest themselves in isolation or combined with each other, and it is frequent that the symptoms, in the form of complaints of the patient, coincide with the following signs:

• Hoarseness
• Monotone voice
• Tremulous voice
• Episodes of aphonia
• Changes in voice intensity
• Loss of treble
• Sensation of shortness of breath when speaking

In addition to this, the patient usually indicates that he/she has non-phonatory symptoms:

• Cough
• Itching
• Clearing of the throat to clear the voice
• Foreign body sensation when swallowing
• Mild to moderate sore throat Pain when speaking

Symptoms of aphonia

In the case of aphonia, the two main symptoms are the most extreme hoarseness and the absolute inability to speak.. There are not the same symptoms as in dysphonia, such as a trembling voice or loss of treble, because there is no voice at all. As for non-phonatory symptoms, these are similar to those of dysphonia, being the following:

• Sore throat
• Spasm in the vocal cords
• Difficulty in swallowing solids and liquids.

How does voice loss occur?

The progression from dysphonia to aphonia is gradual. We can consider aphonia as the last step, the final station of a process of voice alteration and damage in which no precautions have been taken to avoid losing the voice, either temporarily or permanently. The main reasons why you may experience a decrease in the voice are:

• Inflammation of the larynx and swelling of the vocal cords.
• Stomach acid reflux: these acids end up irritating the vocal cords.
• Viral infections such as colds can irritate and inflame the vocal cords.
• Vocal cord hemorrhage.

As we can see, the main phenomenon involved in aphonia and dysphonia are inflammations in the vocal cords, two flexible bands of muscular tissue that are the main cause of vocal cord inflammation.The vocal cords, two bands of flexible muscular tissue found at the entrance of the trachea. The vocal cords are like any other muscle, that is, they need to be warmed up and cared for so that they are not injured. When they are overexerted, they can be damaged and, if they are not properly treated or their injury is not remedied, the problem will end up getting worse.

Inflammation in the vocal cords makes the front part of the vocal cords unable to vibrate, while the back part of the vocal cords is left with a space that does not close properly, causing the air to escape without being able to get into the vocal folds.The combination of these two problems causes air to escape without producing sound. The combination of these two problems makes it impossible to articulate intelligible sounds, no matter how hard the vocal cords are squeezed.

Treatment and prevention

Dysphonia and aphonia are two degrees of the same problem: inflammation of the vocal cords.. For this reason, the solution is the same for both conditions, the deflation of the cords, first letting them rest and, if necessary, resort to pharmacology. It is essential not to force the voice, since it can create a vicious circle in the inflamed cords, swelling and damaging them even more. And, to prevent these two problems, you should avoid using a tone of voice that is too high or shouting too often.

Contrary to what popular culture suggests, you should not speak in whispers when you are dysphonic and intoned.. In fact, otolaryngologists say that whispering is just the opposite of what you should do, since this action tightens the vocal cords even more, aggravating dysphonia and leading directly to aphonia. What should be done is to try to speak normally, with the voice that comes out or, directly, avoid saying anything, since the best treatment is total rest.

Following a healthy lifestyle is an ally to avoid these two problems.. Foods with vitamin A, such as dairy products, carrots, broccoli or spinach, help to regenerate and repair tissues, while foods with vitamin E, such as nuts and avocado, stimulate the defenses, and it is essential to keep the throat well hydrated. And, of course, tobacco and alcoholic beverages should be avoided at all costs.

Can something more serious happen?

Normally, cases of dysphonia are solved in a matter of days, however, if not, you should see a doctor to assess the severity of the case. Most likely this professional will prescribe painkillers to reduce throat discomfort, as well as rest..

But sometimes what is behind the aphonia and dysphonia can be much more serious, a medical condition that requires urgent pharmacological and surgical intervention and caused by something as dangerous as a tumor. It may also be due to some congenital malformation, such as alterations in the laryngeal membranes, angiomas, laryngeal papillomas....

In adulthood, dysphonia can be caused by neurological problems of the larynx, such as spastic dysphonia, which is characterized by voice spasms that prevent regular vocal flow, in Parkinson's disease or myasthenia gravis. It can also occur due to endocrinological causessuch as myxedema in hypothyroidism or climacteric changes.