Laryngitis

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Not to be confused with Pharyngitis.
For other uses, see Laryngitis (disambiguation).
Laryngitis
Laryngitis gastrica.jpg
Endoscopic image of inflamed larynx caused by acid reflux.
Classification and external resources
Specialty Otorhinolaryngology
ICD-10 J04.0, J37.0
ICD-9-CM 464.0-464.4, 476.0-476.1
DiseasesDB 29347
MedlinePlus 001385
eMedicine ent/353 ent/354
Patient UK Laryngitis
MeSH D007827

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).[1] 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.[citation needed] Antibiotics do not appear to be very useful in the acute form.[2]

Signs and symptoms[edit]

Laryngitis
  • 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
  • Fever
  • 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.

Causes[edit]

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.[3]

Noninfectious[edit]

Infectious[edit]

Laryngitis can occasionally lead to pneumonia, either viral pneumonia or bacterial pneumonia.

Diagnosis[edit]

  • Acute laryngitis
  • Chronic laryngitis
    • Granulomatous laryngitis
    • Pseudomyxomatous laryngitis

Treatment[edit]

  • General measures: Vocal rest is important.[9] 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.

Antibiotics do not appear to be very useful.[2]

Prognosis[edit]

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.[10]

References[edit]

  1. ^ a b Wood, John; Athanasiadis, Theodore; Allen, Jacqui (October 9, 2014). "Laryngitis" (PDF). The BMJ. The BMJ. 331 (09). Retrieved September 25, 2016. 
  2. ^ a b Reveiz, L; Cardona, AF (23 May 2015). "Antibiotics for acute laryngitis in adults.". The Cochrane database of systematic reviews. 5: CD004783. doi:10.1002/14651858.CD004783.pub5. PMID 26002823. 
  3. ^ Tamparo, Carol (2011). Fifth Edition: Diseases of the Human Body. Philadelphia, PA: F. A. Davis Company. p. 357. ISBN 978-0-8036-2505-1. 
  4. ^ Titze IR, Lemke J, Montequin D (1997). "Populations in the U.S. workforce who rely on voice as a primary tool of trade: a preliminary report". J Voice. 11 (3): 254–9. doi:10.1016/S0892-1997(97)80002-1. PMID 9297668. 
  5. ^ Popolo PS, Svec JG, Titze IR (2005). "Adaptation of a Pocket PC for use as a wearable voice dosimeter". J. Speech Lang. Hear. Res. 48 (4): 780–91. doi:10.1044/1092-4388(2005/054). PMID 16378473. 
  6. ^ Titze IR, Hunter EJ, Svec JG (2007). "Voicing and silence periods in daily and weekly vocalizations of teachers". J. Acoust. Soc. Am. 121 (1): 469–78. doi:10.1121/1.2390676. PMID 17297801. 
  7. ^ Nix J, Svec JG, Laukkanen AM, Titze IR (2007). "Protocol challenges for on-the-job voice dosimetry of teachers in the United States and Finland". J Voice. 21 (4): 385–96. doi:10.1016/j.jvoice.2006.03.005. PMID 16678386. 
  8. ^ Carroll T, Nix J, Hunter E, Emerich K, Titze I, Abaza M (2006). "Objective measurement of vocal fatigue in classical singers: a vocal dosimetry pilot study". Otolaryngol Head Neck Surg. 135 (4): 595–602. doi:10.1016/j.otohns.2006.06.1268. PMID 17011424. 
  9. ^ Laryngitis - Treatment NHS Choices
  10. ^ Dominguez, L. M., & Simpson, C. B. (December 01, 2015). Viral laryngitis. Current Opinion in Otolaryngology & Head and Neck Surgery, 23, 6, 454-458.

External links[edit]