Functional aphonia may be defined as a clinical entity in which there is sudden complete loss of voice without any demonstrable organic lesion in the neuromuscular apparatus used in voice production. In cases in which there is not complete loss of voice, a barely audible whispering note may be the only result of attempts at phonation. The condition may be precipitated without any forewarning, and the patient may retire in full possession of the voice only to awaken and find vocalization impossible. Likewise, after the condition has persisted for a variable time, the vocal powers may return as suddenly and as mysteriously as they disappeared, only too often, however, to be lost again.
E. C. MacLeod,1 in 1930, reporting her clinical observations in the treatment of a large number of patients, offered to differentiate two types of the disease:
True aphonia, in which there is little or no approximation
LELL WA. DIAGNOSIS AND DIRECT LARYNGOSCOPIC TREATMENT OF FUNCTIONAL APHONIA. Arch Otolaryngol. 1941;34(1):141–149. doi:10.1001/archotol.1941.00660040151015
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