Laryngitis

Laryngitisis aninflammationof thelarynx. It causes hoarsevoiceor temporary complete loss of the voice because of irritation to thevocal folds(vocal cords). Dysphoniais the medical term for a vocal disorder, of which laryngitis is one cause.Laryngitis is categorised asacuteif it lasts less than three weeks. Otherwise it is categorised aschronic, and may last over three weeks. The chronic form occurs mostly in middle age and is much more common in men than women.CausesLaryngitis can be infectious as well as noninfectious in origin.Noninfectious causes Acid reflux disease, resulting inlaryngitis gastrica Allergies Excessive coughing,smoking, or alcohol consumption. Inflammation due tooveruseof the vocal cords Prolonged use of inhaled corticosteroids for asthma treatment Thermal or chemical burns Laryngeal trauma, includingiatrogenicone caused byendotracheal intubationInfectious causes Viral laryngitiscan be caused byrhinovirus,influenza virus,parainfluenza virus,adenovirus,coxsackievirus,coronavirus, andRSV. Bacterial laryngitiscan be caused bygroup A streptococcus,streptococcus pneumoniae,C. diphtheriae,M. catarrhalis,haemophilus influenzae,bordetella pertussis,bacillus anthracis, andM. tuberculosis. Bacterial infections usually follow pre-existing viral infection. Fungal laryngitiscan be caused byHistoplasma,Blastomyces,Candida(especially in immunocompromised persons), and rarely byCryptococcusandCoccidioides.Laryngitis can occasionally lead topneumonia, eitherviral pneumoniaorbacterial pneumonia.Symptoms Dysphonia(hoarseness) oraphonia(inability to speak) Dry, sore, burning throat Coughing, both a causing factor and symptom of laryngitis Dysphagia(difficulty in swallowing) Sensation of swelling in the area of thelarynx Cold orflu-like symptoms(which, like a cough, may also be the causal factor for laryngitis) Swollenlymph nodesin the throat, chest, or face Fever Hemoptysis(coughing out blood) Dyspnea(difficulty in breathing), predominantly in children Increased production of saliva.SignsIn early stages, erythema (reddening) andedemaofepiglottis,aryepiglottic folds,arytenoidsandventricular foldsoccurs. In late stages, thevocal foldsand subglottic structures are also involved. There are sticky secretions between cords and in interarytenoid region. Sometimes, submucous hemorrhage is seen, especially in case of vocal abuse.Acute membranous laryngitis, a condition resemblingacute 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 disorder.Pathology Acute laryngitis Chronic laryngitis Granulomatous laryngitis Pseudomyxomatous laryngitisTreatment General measures: Voice rest is important.Steam inhalations withtincture of benzoinor oil ofpineoreucalyptushelp loosen secretions. Cough sedatives are given to reduce cough. For a severely inflamed larynx, ahumidifierorvaporizeris used to moisten the air inhaled by person. If laryngitisgastroesophageal reflux, an H2-inhibitor (such asranitidine) or proton-pump inhibitor (such asomeprazole) is used to reducegastric acidsecretions. If laryngitis is caused by thermal or chemical burns, steroids are used. 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 ofvocal cord nodules, physicians may recommend a course of treatment that may include a surgical procedure and/orspeech therapy.Prognosis Most cases of laryngitis are viral and resolve without treatment with sufficient voice rest. Laryngitis, hoarseness, or breathiness that lasts for more than two weeks may signal a voice disorder and should be followed up with a voice pathologist. This is typically avocologycertifiedSLP(speech language pathologist) or a laryngologist (voice specializedENT).

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