Sudden Loss of Voice After Cold: Causes and Remedies - Otolaryngology

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Sudden loss of voice (complete aphonia) after a cold?


Hello Doctor: I started experiencing cold symptoms last Tuesday (March 12) including fever, runny nose, sore throat, nasopharyngeal inflammation, cough, and phlegm.
Yesterday, due to persistent coughing, I took cough syrup containing codeine phosphate three times.
Currently, I have minimal symptoms, only occasional dry cough.
However, this morning (March 17), I woke up to find that I am completely unable to speak.
I was able to talk normally until Saturday.
The doctor advised me to take oral corticosteroids (without performing an endoscopy) and said to return if I still have no voice.
I have never experienced loss of voice with a cold before, and I usually have no issues with my vocal cords or speaking.
I am quite worried and would like to know if this condition will gradually improve.
Is it related to the cough syrup containing codeine? Additionally, if I feel a sensation of something in my throat and want to clear it, should I hold back or is it better not to clear it (I read online that clearing the throat can put a lot of strain on the vocal cords)? What is the best way to care for my throat in the coming days? Thank you for your response, Doctor.

Evelyn, 30~39 year old female. Ask Date: 2024/03/17

Dr. Zheng Jueyi reply Otolaryngology


Hello, a common cause of sudden loss of voice is related to edema of the vocal cords or surrounding tissues.
Oral corticosteroids can be taken, and symptoms usually improve gradually within a week.
This condition is not related to cough syrup.
It is recommended to drink plenty of water, speak less, and maintain a light diet.
If there is a sensation of a foreign body in the throat, sipping a small amount of water can help alleviate it.

Reply Date: 2024/03/17

More Info


Sudden loss of voice, especially following a cold, can be concerning and is often attributed to several factors related to the upper respiratory tract. In your case, the symptoms you experienced, including fever, nasal congestion, sore throat, and cough, are typical of a viral upper respiratory infection, commonly known as a cold. The subsequent loss of voice can be linked to laryngitis, which is inflammation of the larynx (voice box) that can occur due to viral infections, excessive coughing, or even irritants such as smoke or strong odors.

Regarding your concern about the cough syrup containing codeine phosphate, it is important to note that while codeine is an effective cough suppressant, it is not typically associated with causing voice loss directly. However, codeine can lead to dryness in the throat, which might exacerbate any existing irritation or inflammation, potentially contributing to voice changes. It’s also worth mentioning that excessive coughing can strain the vocal cords, leading to temporary hoarseness or loss of voice.

The use of oral corticosteroids, as prescribed by your doctor, is a common approach to reduce inflammation in the larynx and should help alleviate your symptoms. Most cases of laryngitis resolve within a week, especially with proper care. It is essential to rest your voice as much as possible during this time, as overuse can prolong recovery. Staying hydrated by drinking plenty of fluids can also help soothe the throat and keep the vocal cords lubricated.

As for the sensation of having something stuck in your throat, it is advisable to avoid frequent throat clearing. While it may provide temporary relief, clearing your throat can actually cause more irritation to the vocal cords and may worsen your symptoms. Instead, try sipping water or swallowing to alleviate the sensation. If the feeling persists, it may be beneficial to consult with a healthcare professional for further evaluation.

In terms of throat care during this period, consider the following recommendations:
1. Hydration: Drink plenty of water to keep your throat moist. Herbal teas with honey can also be soothing.

2. Humidification: Use a humidifier in your room to maintain moisture in the air, which can help soothe an irritated throat.

3. Avoid Irritants: Stay away from smoke, strong odors, and other irritants that can exacerbate throat discomfort.

4. Rest Your Voice: Limit talking, whispering, and avoid shouting. If you need to communicate, consider writing things down.

5. Warm Salt Water Gargle: Gargling with warm salt water can help reduce throat inflammation and provide relief.

6. Lozenges: Throat lozenges can help soothe irritation and keep your throat moist.

If your voice does not return after a week or if you experience additional symptoms such as difficulty breathing, severe pain, or persistent cough, it is crucial to follow up with your healthcare provider. They may recommend further evaluation, including laryngoscopy, to assess the condition of your vocal cords.

In summary, while your sudden loss of voice is likely related to the viral infection and subsequent inflammation, following the prescribed treatment and taking care of your throat should lead to gradual improvement. Remember to listen to your body and seek medical advice if your symptoms do not resolve or worsen.

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