APHONIA (aphonia; grech, and - otritsa. + phöne a sound, a voice) — lack of a sonorous voice at the kept shepotny speech.
And. not only throats, a nervous system, but also some general diseases can be a symptom of various diseases.
And. divide on true (or guttural), paralytic, spastic and functional.
True (guttural) aphonia arises at diseases of a throat (tumors, hems, etc.) when are badly closed or badly true voice folds vibrate. At tumors, both high-quality, and malignant, And. keeps with firmness and improvement does not occur if the reason which caused it is not liquidated.
Paralytic aphonia it is usually caused unilateral (more rare bilateral) by dysfunction of the lower guttural nerve which innervates the majority of internal muscles of a throat. Sometimes And. it can be caused by a disease of a nervous system — a syringobulbia or a myelosyringosis. Paresis or paralysis of the lower guttural nerve can arise owing to an injury (including at a thyroid gland operations), at tumors of lungs, a thyroid gland, bodies of a mediastinum, a trachea, gullet. And. can develop also because of a prelum of the lower guttural nerve an aortic aneurysm (at the left), and also owing to its toxic defeat at flu and respiratory viral infections.
Spastic aphonia arises because of a spasm of the internal muscles of a throat narrowing a glottis that can be caused by irritation of a mucous membrane of a throat and throat caustic chemical substances; as the reason also the mental injury can serve.
Functional aphonia can arise at acute or hron, laryngitis at patients with neurosises. The symptom «bezglasiya» in these cases persistently keeps though local changes in a throat disappeared.
Forecast at spastic and functional And. in most cases favorable; at true and paralytic — is less favorable.
Treatment depends on the reason which caused And.
At true And. delete a tumor, excise hems etc., provide rest of the voice device (the shepotny speech, unirritating food, etc.), carry out physiotherapeutic procedures (e.g., an electrophoresis with potassium iodide).
Paralytic And. not always gives in to treatment. At And. an influenzal etiology antiinflammatory therapy (antibiotics, streptocides etc.), faradisation of a throat, fortifying means (an aloe, strychnine, oryzamin) lead, as a rule, to treatment. Elimination paralytic And. other etiology (an aortic aneurysm, a tumor of a gullet etc.) depends on a possibility of elimination of the reason which caused it.
At spastic and functional And., in addition to the general actions for strengthening of a nervous system, apply respiratory gymnastics, fonopedichesky exercises, faradisation of a throat, provide rest of the voice device. From medicamentous means appoint tranquilizers, bromides, Tinctura Valerianae inside, injections of solution of strychnine.
Bibliography Yermolaev V. G., Lebedeva Η. T. and Morozov V. P. Guide to a phoniatrics, L., 1970; Yu with with about N of River. A singing voice, the lane with fr., M., 1974.
I. I. Potapov.