A rare presentation of psychogenic aphonia following hip surgery

Psychogenic aphonia, a form of conversion disorder, is characterized by a sudden loss of voice without an identifiable organic cause. It is often linked to psychological stressors, and its occurrence in the postoperative setting is rare. We report a middle-aged woman who underwent implant removal surgery under spinal anesthesia for a migrated screw in her right hip joint. She experienced mild chest discomfort and throat heaviness intraoperatively, which resolved upon repositioning. Postoperatively, she developed aphonia along with a sensation of heaviness in her throat. Laryngoscopy ruled out structural causes, and imaging studies, including a magnetic resonance imaging of the brain, excluded a cerebrovascular event. Initial treatment for suspected laryngeal edema due to anaphylaxis showed no significant improvement. A psychiatric evaluation found no major underlying psychiatric illness or stressors. Her symptoms gradually resolved within 2 weeks without any specific psychiatric intervention. This report highlights that conversion aphonia is an important condition that needs to be kept as a differential diagnosis in patients presenting with sudden voice loss in the postoperative setting, but only after excluding organic causes. Early recognition and appropriate psychological support can aid in faster recovery.