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Injuries that cause loss of vocal function
devil
vividanielle wrote in little_details
Searched: voicebox injury, loss of voice, mutism, sports injuries, causes of voice loss, throat injury, mandible injury, etc.

Setting: not entirely sure, either modern day or recent past, within about 20 years. Probably California, United States.

I need my character to lose vocal function permanently.


He should lose either his ability to use his voice, or the ability to move his mouth in such a way that he could speak properly. I would prefer the first option, but which one is more likely to happen as a result of sudden, one-time physical trauma? Which is more likely to permanently inhibit his speaking ability?

What kind of accident would be likely to cause that kind of damage?
I know most sports have the potential for causing such an injury, but for which sports is it the most likely? And what exactly would happen? Would he fall, for example in gymnastics/cycling/running etc? Or would it involve another person, like in wrestling?
What about car accidents?
Fist-fights? What about fights involving blunt objects? Where and how would someone have to hit this character in order to mess up his vocal ability or to badly break his jaw?
Are there any other types of injuries that would be plausible?

I know that's a lot of questions! But I have a lot freedom in the story at this point, and I'd like to know as much as I can about both options before I decide.

I was going to post a very similar question, nice one.

I looked into post-traumatic stress, or mutism rendered by shock, but apparently that never happens. So frustrating!

You may be able to get away with something like a serious case of vocal nodules, and just have him reluctant to do anything about it for some reason (people refuse treatment for the dumbest reasons, sometimes).

My uncle was in a car accident when he was young... apparently flying glass shards damaged his vocal chords and he can only speak quietly in a gravelly voice now. I don't know the details of his injury, though.

Pretty much any injury which damages one's ability to speak will also have other major effects; damaging the voice box impacts breathing, damaging the throat, tongue, or jaw will all have an effect on eating.

Your best bet is probably going to be traumatic damage to the larynx, although realistically, you're not going to get total mutism without associated breathing issues, and it's going to be tricky to find a way to damage the larynx badly enough to prevent him speaking, without killing him on the spot.

A stroke localized to Broca's Area could limit speech production (Broca's aphasia). (The stroke could be secondary or coincidental to the accident?)

This would not result in the inability to use his voice but in an impairment in his production of coherent language.

Right, but if his production is sufficiently impaired he might not even bother trying to speak. He'd still be able to laugh, cough, cry out in pain, etc., but articulating words might be so difficult he prefers to communicate in pantomime, drawings, etc. Robert Ornstein's book "The Right Mind" (which is not proper science, I know) includes a short interview with a Broca's patient who does just that.

The OP did say loss of vocal function. While someone with Broca's aphasia might find alternate forms of communication, he would still laugh, cough, etc, whereas damage to the larynx rendering him unable to produce sound would, well, render him unable to produce sound. If the desired result is to alter his method of communication, both are valid, but the details would be different.

Broca's aphasia also impairs comprehension in most cases, and the patients can't write or sign. Probably a lot more serious than the OP had in mind! It's a much bigger issue than just speaking.

I'm no expert on the subject, but I've read before about a guy with a physical disorder in which his vocal cords cross, and is unable to vocalize sounds. If anyone could enlighten me on this, that'd be great!

Thanks for bringing up this question, I've been meaning to ask something very similar.

There are a ton of similar posts about this, I'd start by reading through the Mutism tag.

Didn't even think of that. Thanks!

Mutism is not the neat little package fiction often makes it out to be. As sushidog said, any injury to the throat severe enough to render the voice useless is likely to impact breathing and eating. Any neurological/brain damage is also unlikely to be localized enough to affect only the voice. Broca or Wernicke's aphasias impact language production and comprehension respectively. Neither removes the ability to produce sound, but both impact the ability to communicate. Damage to appropriate areas of the brain could result in loss of muscle tone/control to the mouth or throat, but then you are back to the potential problems in eating and breathing, as well as an effect on your character's affect.

This is a subject that comes up a lot in this community. You will probably be able to find a fair amount of information and links just by browsing the tag.

That is not entirely true.

I have severe scar tissue on my vocal chords which changed my voice but I do breathe well.

This was from a severe lung injury where the vocal chords were damaged in process.

It's certainly not impossible, just not as common as the frequent requests to this community seem to wish. I think it was mostly the OP's focusing on blunt force to the throat that had me thinking more widespread damage. I will also admit my experiences with speech issues are on the neurological/motor end of things.

It seems inevitable that an injury severe enough to leave someone mute would have other effects. I could work with that, but it's looking like that kind of injury may not be a realistic way to go.

However, I'm actually finding some very interesting alternatives through browsing the tag -- thanks for the suggestion! :)

If medical accidents are also on your list, then almost any kind of throat surgery would carry that risk. I know my mother and aunt both risked losing their voices permanently when they had thyroid surgery. There's a comic out now as well that has a young boy losing his voice through surgery. http://comicsblips.dailyradar.com/story/review_stitches/

In 2002 I accidentally inhaled chemicals.
These burned my lungs and my vocal chords. I was on an iron lung in the hospital for 5 weeks and had a traecheostomy and a speaker box.

However, when in the hospital I was told there was a chance the scar tissue on my vocal chords would develop so that I would never be able to speak again.
I was very lucky. I can speak now, though my voice is markedly different.

Would it be alright if I asked you a couple of questions about that experience? (If not, I understand. I'm just very curious because this type of experience is something I had never considered.)

This might sound weird, but can you sing? Even if you aren't naturally a good singer, can you control the tone and volume of your voice very well?
What kinds of chemicals were they? And what were the circumstances when you inhaled them? Also, how long did it take for your voice to start functioning adequately again? If you don't mind me asking.

No problem. :)

I was intubated for 3 weeks but my throat began to close so they trached me (cut a hole in my throat between my clavicle bones and stuck a hose into my lungs that way.)

The damage is a cross between the intubation and the burning of the fuel.

I can sing. I actually used to sing for performances but I won't anymore. My voice changed *that* much.
I can control all tone and volume just fine, however I no longer have the same range (much, much shorter range) and I can not achieve the same volume (loud) without immediately going scratchy. Even yelling or talking loudly makes my voice super coarse, and the scratchiness lasts for about two days instead of until I drink water. So while I can control it all, there are still profound effects on the sustainability from it.

I am a sideshow performer and I was fire breathing at the time. The fuel itself (lamp oil) blew back into my face. I inhaled less than a 1/4 teaspoon and it did immediate damage. I had petrochemical/lipid pnuemonia.
However, I was informed by the doctor and my respiration therapist (I had to undergo therapy to breathe and swallow properly, in addition to talking) that professional cleaners using industrial cleaning solutions, people who deal with gasolene or other caustic liquids and even people who inhale their own vomit will suffer similar effects.

My voice was scratchy and weak for about 6 weeks. There was a very breathy quality to it because of the hole in my throat. Once that fully healed, it came back but I couldn't yell or be very loud for about 12 weeks after that.

Sometimes there is still a tightness in my throat when I try to call for my son. I also cough more than I ever used to because of that. It's been 8 years (to the day), just for a time line reference. I will never get my voice fully back to what it was.

Oh, and just so you know, people who are mute due to vocal chord damage can have a speaker box to act as vocal chords for them. I had one for awhile but I do know of people who have them permanently.

The two I know with them lost their vocal chords to cancer.
Just for additional options ;)

That was a lot more detail than I was expecting! Thank you :) Something like this may actually fit the story pretty well, and it seems a little more plausible than what I originally had in mind. epstarling commented about intubation as well, so perhaps I'll do some more research on that. Thanks again!

As another thought, you might consider a different type of injury all together that leads to the character being intubated. (Like a chest injury or perhaps something that requires surgery.)

I have seen many patients who have been intubated (had a breathing tube placed into their trachea) who end up with permanent voice changes; occasionally this also leads to inability to speak coherently (though they can usually still make noise). There can be trauma to the vocal cords during intubation or later on if the patient accidentally (or willfully) pulls out the endotracheal tube before the cuff on the end is deflated; the tube passes through the vocal cords on its way to the trachea. Sometimes permanent damage can also be caused by an infection that damages the vocal cord and can't be "coughed out" or otherwise cleared due to the presence of the tube.

Often these patients need surgery afterwards to correct the vocal cords, but they are often not successful. Some end up with breathing difficulties as a result (though not always) and have a permanent tracheostomy (hole in the neck below the vocal cords). Other things can lead to a tracheostomy as well. This will hinder someone's ability to speak.

Hope this helps

I cannot remember the name, but within the last year there was a case that made the national news of a college athlete (football, I believe) who was working in the weight room doing a bench press and somehow ended up dropping the weight and having the bar land across his throat. As I recall, they did immediate surgery. The last I had heard, he was doing much better than expected, and they thought he would eventually be able to play football again and was going to get his voice back - but I gathered that he easily could have lost it. Hope that helps - it was big news at the time, so if you know anyone who's a college ball fan, they could probably give you more info or a name.

I didn't know about this. It seems like this kind of injury might be somewhat rare, and I'm considering a lot of different (and equally unusual) things right now, lol... thanks for pointing this out! Could be a nice idea :)

I did some digging - this is one of the initial reports about the kid - if you google him, you should be able to find updates.

http://sports.espn.go.com/ncf/news/story?id=4512778

Maybe torture. If the character screams uncontrollably from the pain for a long time, it could damage his vocal cords enough that he'd loose his voice but not injure his ability to breath. Eventually he wouldn't be able to scream, but it sounds reasonable that he would continue to try and that way strain his vocal cords so much that he'd develop chronic scars tissue that would be bad enough to prevent him from speaking at all.

Really? I had considered some kind of prolonged screaming situation, but I didn't think it was even possible to scream yourself permanently hoarse. I'll do some research on this, thanks for the idea! :)

Because this hasn't been mentioned yet, I suggest you look up laryngectomy and glossectomy. The former removes the vocal chords, which makes the patient unable to produce voice; the latter means the removal of tongue, which makes articulation of speech sounds difficult.

There are ways to replace the lost voice after laryngectomy though it's not completely simple. After the operation, the character's going to be breathing through an opening in his throat, which causes other problems, but he'll probably be able to eat normally.
Laryngeal cancer is the most common reason for laryngectomies, so it would be best if you could give him that. If you want a sports injury, have him be hit on the throat. He could for instance fall when doing gymnastics so his throat hits a bar. (Cf. debrifan's post about the weightlifter.)

Glossectomy is performed on patients with a cancer on the tongue. The effects on speech (and eating) are worst when all or almost all of the tongue is removed, which is seldom the case; otherwise the patient often can regain much of their ability to speak.
I have hard time imagining an injury that would damage the tongue badly enough to demand an entire removal, but not kill the character.

I don't think breaking his jaw is is an effective way to make him permanently unable to speak. I believe in worst case a misshaped jaw would only affect his speech slightly. The important body parts for articulating speech sounds are the lips, hard and soft palate, tongue, and larynx.

Lol I was gonna do that too. But one question have to ask is; cant muteness cause loss of someone close to you? And can you have it back later in years?

Vocal fatigue from overuse, or post-viral laryngeal paralysis are also common causes of limited phonation

Question, if a person was hit by a car and had head and neck trauma (this is a child btw) could that, or probably more likely, damage maybe cause by surgery needed after, maybe a complication in the surgery or a mistake during it, leave someone without the ability to speak, but still be able to eat and breathe fine. I know that generally muteness comes with other side effects, and if it's a head problem that makes them mute then certain mental problems could still apply, but this person would need to be unable to talk even if they wanted to. If this isn't possible that's fine too, just wondering.