ABSTRACTThree patients in a neurosurgical unit following road traffic accident are described. Patient A was aphonic post‐traumatically. Voice returned suddenly and spontaneously three months post trauma. Patient B, with a severe closed head injury, presented with localised oedema of the vocal cords and laryngeal stridor caused by removing his own endotracheal tube thirteen days post trauma, resulting in aphonia. Voice returned gradually over the next sixteen days. Patient C sustained a spinal injury in addition to a severe closed head injury. He was also aphonic post trauma. The initial stage of this was thought to be traumatic mutism. A residual lower motor neurone dysarthrophonia remained, however. Various explanations for the aphonia are explored; in particular for Patient A the possibility is discussed of frontal lobe‐limbic involvement, nerve damage at both upper and lower motor neurone levels and right hemisphere involvement. Diagnoses of aphonia following head injury and therapeutic procedures are discus