Endoscopic image of inflamed larynx caused by acid reflux.
|Classification and external resources|
Laryngitis is an inflammation of the larynx. It causes hoarse voice or temporary loss of the voice due to irritation of the vocal folds (vocal cords). Laryngitis is one possible cause of dysphonia, the medical term for a vocal disorder.
Laryngitis is categorised as acute if it lasts less than three weeks and chronic if it lasts over three weeks. The chronic form occurs mostly in middle age and is much more common in men than women. Antibiotics do not appear to be very useful in the acute form.
Signs and symptoms
- Dry, sore, burning throat
- Coughing (both a causal factor and a symptom of laryngitis)
- Dysphagia (difficulty in swallowing)
- Sensation of swelling in the area of the larynx
- Cold or flu-like symptoms (which, like a cough, may also be a causal factor for laryngitis)
- Swollen lymph nodes in the throat, chest, or face
- Coughing out blood
- Shortness of breath, predominantly in children
- Increased production of saliva
In early stages, erythema (reddening) and edema (swelling) of epiglottis, aryepiglottic folds, arytenoids and ventricular folds occur. In late stages, the vocal folds and subglottic structures are also involved. There are sticky secretions between folds and in the interarytenoid region. Sometimes, submucosal hemorrhage is seen, especially in cases of vocal abuse. Acute membranous laryngitis, a condition resembling acute membranous tonsillitis, is caused by pyogenic nonspecific organisms. It has to be differentiated from laryngeal diphtheria. In some cases, tightening of the chest may be present due to COPD or other relevant breathing disorders.
Often referred to as the 'pink eye' of the throat, laryngitis can be infectious as well as noninfectious in origin. Chronic laryngitis may also be caused by more severe problems, such as nerve damage, sores, polyps, or hard and thick lumps (nodules) on the vocal cords.
- Acid reflux disease, resulting in laryngitis gastrica
- Excessive or chronic coughing, smoking, or alcohol consumption
- Inflammation due to overuse of the vocal cords
- Prolonged use of inhaled corticosteroids for asthma treatment
- Thermal or chemical burns
- Laryngeal trauma, including iatrogenic (caused by endotracheal intubation)
- Viral laryngitis can be caused by rhinovirus, influenza virus, parainfluenza virus, adenovirus, coxsackievirus, coronavirus, and RSV.
- Bacterial laryngitis can be caused by group A streptococcus, streptococcus pneumoniae, C. diphtheriae, M. catarrhalis, haemophilus influenzae, bordetella pertussis, bacillus anthracis, and M. tuberculosis. Bacterial infections usually follow a pre-existing viral infection.
- Fungal laryngitis can be caused by Histoplasma, Blastomyces, Candida (especially in immunocompromised persons), and rarely by Cryptococcus and Coccidioides.
- Acute laryngitis
- Chronic laryngitis
- Granulomatous laryngitis
- Pseudomyxomatous laryngitis
- General measures: Vocal rest is important. Steam inhalations with tincture of benzoin or oil of pine or eucalyptus help loosen secretions.[medical citation needed] Cough suppressants are sometimes prescribed to reduce cough. For a severely inflamed larynx, a humidifier or vaporizer is used to moisten inhaled air.
- If laryngitis is caused by gastroesophageal reflux, an H2-inhibitor (such as ranitidine) or proton-pump inhibitor (such as omeprazole) is used to reduce gastric acid secretions.
- If laryngitis is caused by thermal or chemical burns, steroids are prescribed.
- In viral laryngitis, drinking sufficient fluids is helpful.
- If laryngitis is due to a bacterial or fungal infection, appropriate antibiotic or antifungal therapy is given.
- If persistent hoarseness or loss of voice (dysphonia) is a result of vocal cord nodules, physicians may recommend a course of treatment that may include a surgical procedure and/or speech therapy.
Most cases of laryngitis are viral and resolve without treatment with sufficient vocal rest. Laryngitis, hoarseness, or breathiness that lasts for more than two weeks may signal a voice disorder and should be investigated by a vocology certified SLP (speech-language pathologist) or a laryngologist (voice specialized ENT).
Following recovery from a viral laryngitis, resulting symptoms can persist for a long time.
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