Struggling to Speak: Voice Loss and Its Causes - Otolaryngology

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It sounds like you are experiencing a complex and frustrating set of symptoms related to your voice and throat, which have persisted for several years. Given the variety of opinions you've received from different medical professionals, it is understandable that you feel confused about the best course of action.
From your description, it seems that you are dealing with a combination of voice loss, throat discomfort, and potential neurological or structural issues related to your neck. The symptoms you mention—such as needing to clear your throat frequently, experiencing pain in your throat and neck, and having difficulty speaking—can be indicative of several underlying conditions.

Firstly, voice loss or hoarseness can often stem from issues with the vocal cords themselves. Conditions such as vocal cord nodules (commonly referred to as "singer's nodules"), polyps, or even inflammation of the vocal cords can lead to a weak or hoarse voice. These conditions can be exacerbated by overuse of the voice, poor vocal technique, or even environmental factors such as allergies or acid reflux, which can cause post-nasal drip and throat irritation.

The need to clear your throat frequently and the sensation of having something stuck in your throat could suggest that you might be experiencing laryngopharyngeal reflux (LPR), where stomach acid irritates the throat and larynx. This condition can lead to chronic throat discomfort and voice issues.
Additionally, the pain in your neck and shoulders, along with the difficulty in speaking, could be related to cervical spine issues, such as degenerative disc disease or cervical spondylosis, which you mentioned was diagnosed as degenerative cervical spondylitis. This condition can lead to nerve compression, which might affect the muscles involved in voice production.

Given the complexity of your symptoms, it is crucial to approach this issue from multiple angles. Here are some recommendations:
1. Ear, Nose, and Throat (ENT) Specialist: Since you have already seen several specialists, it might be beneficial to revisit an ENT for a thorough evaluation, including a laryngoscopy to visualize your vocal cords directly. This can help identify any structural issues or inflammation.

2. Voice Therapy: Working with a speech-language pathologist who specializes in voice therapy can be beneficial. They can provide exercises to improve vocal technique and reduce strain on your vocal cords.

3. Neurological Evaluation: Since you mentioned symptoms that could relate to nerve issues, consulting with a neurologist may help rule out any neurological conditions that could be impacting your voice and throat function.

4. Physical Therapy: Given your neck pain and the potential for cervical spine issues, physical therapy focused on the neck and upper back may help alleviate some of the discomfort and improve your overall posture, which can positively affect your voice.

5. Lifestyle Modifications: Consider lifestyle changes that could help, such as staying hydrated, avoiding irritants (like smoke and strong odors), and practicing good vocal hygiene (such as avoiding yelling or whispering).

6. Dietary Considerations: If reflux is a concern, dietary modifications may be necessary. Avoiding spicy foods, caffeine, and large meals before bedtime can help reduce symptoms.

7. Follow-Up: Keep a detailed log of your symptoms, including when they occur and any potential triggers. This information can be invaluable for your healthcare providers in determining the best treatment plan.

In conclusion, your situation is multifaceted, and it may take a coordinated approach involving various specialists to arrive at a definitive diagnosis and effective treatment plan. Don't hesitate to seek a second opinion or ask for referrals to specialists who can provide a comprehensive evaluation of your symptoms. Your voice is an essential part of your communication and identity, and addressing these issues is crucial for your overall well-being.