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Dysphonia (Loss of Voice): Acupuncture Treatment

Dysphonia or hoarseness can be caused by local inflammation or congestion, such as from a cold or shouting; it can also be due to nerve damage or compression, like after thyroid surgery or due to a throat tumor, and can even be psychogenic, as in functional dysphonia or hysterical aphonia. Acupuncture generally shows good effectiveness for dysphonia, especially for functional and spastic dysphonia.

Acupuncture points are selected from the throat reflex area in the front of the neck, the neck region, and the hand. Common points include Tiantu and Lianquan in the throat, Fengchi, Tianzhu, and Dazhui in the neck, and Hegu in the hand. The "Fuyin" point, discovered by the author, is also commonly used. These points often overlap with central reflex areas.

Fuyin Point Location and Needle Technique: Careful palpation in the posterior neck region, between the third and sixth cervical vertebrae, reveals sensitive cord-like nodules about 3-5 cun lateral to the midline on both sides. Needle insertion into these nodules with a 1-inch needle, employing the even reinforcing-reducing method, can elicit a sensation that sometimes radiates to the throat. The needle is retained for 5-10 minutes. During this time, the patient is engaged in speech exercises, such as repeating "A, Yi" or numbers in Chinese, or the alphabet in English. For functional or hysterical aphonia, voice usually returns to normal immediately after the first sound is produced. Combining acupuncture with psychological suggestion is beneficial for functional dysphonia.

The mechanism of acupuncture for dysphonia includes both functional regulation of the vocal cords and their motor nerves, and rebuilding the phonation reflex. The former has point specificity, best achieved by stimulating reflex or reflective points related to the throat, like reducing vocal cord edema, relieving vocal cord spasms, or paralysis of related nerves. The latter may lack point specificity and involve inducing the patient to mimic normal phonation while stimulating a sensitive point or non-acupoint on the body. In functional dysphonia, immediate effect is usually seen, suggesting that acupuncture serves as an inducement, with speech training playing a major role in rebuilding the phonation reflex.

Clinically, functional dysphonia can be induced by psychological stimuli or as a sequela of a cold causing hoarseness and voice loss. Once normal phonation is induced during acupuncture, other sounds usually return immediately. This phenomenon is believed to be due to speech being a reflex; when hoarseness and voice loss persist for 1-2 weeks due to a cold, a pathological conditioned reflex of phonation can develop. Even after recovery from the cold, this pathological phonation reflex can persist. Acupuncture combined with speech training can help the patient "re-find" the correct way to phonate, immediately normalizing the voice.



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