The most common sign of laryngitis is hoarseness. Changes in your voice can vary with the degree of infection or irritation, ranging from mild hoarseness to almost total loss of your voice. If you have chronic hoarseness, your doctor may review your medical history and symptoms. He or she may want to listen to your voice and examine your vocal cords, and he or she may refer you to an ear, nose and throat specialist.
laryngitis
But with laryngitis, your vocal cords become inflamed or irritated. This makes the vocal cords swell, which distorts the sounds produced by air passing over them. As a result, your voice sounds hoarse. In some cases of laryngitis, your voice can become almost undetectable.
Laryngitis may be short-lived (acute) or long lasting (chronic). Most cases of laryngitis are triggered by a temporary viral infection and aren't serious. Persistent hoarseness can sometimes signal a more serious underlying medical condition.
In most cases laryngitis symptoms last less than a couple of weeks and are caused by something minor, such as a virus. Less often, laryngitis symptoms are caused by something more serious or long lasting. Laryngitis signs and symptoms can include:
You can manage most acute cases of laryngitis with self-care steps, such as resting your voice and drinking plenty of fluids. Strenuous use of your voice during an episode of acute laryngitis can damage your vocal cords.
Laryngitis that lasts longer than three weeks is known as chronic laryngitis. This type of laryngitis is generally caused by exposure to irritants over time. Chronic laryngitis can cause vocal cord strain and injuries or growths on the vocal cords (polyps or nodules). Chronic laryngitis can be caused by:
Most cases of laryngitis get better without treatment within a week. To help your vocal cords heal, it's important not to smoke, to avoid smoky environments, drink plenty of fluids (particularly water) and try to rest your voice as much as possible.
In some cases, it may be possible to treat the underlying cause of laryngitis. For example, if the symptoms are caused by an allergic reaction, you may be able avoid the substance you're allergic to, or take medication to help control your body's response to the substance.
Resting your voice helps to reduce inflammation of the vocal cords. A humidifier may soothe the scratchy feeling that comes with laryngitis. Decongestants and pain medicines may relieve the symptoms of an upper respiratory infection.
Rodrigues KK, Roosevelt GE. Acute inflammatory upper airway obstruction (croup, epiglottitis, laryngitis, and bacterial tracheitis). In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier;2020:chap 412.
In kids, it may lead to croup, a narrowing of the airways, or epiglottitis, an inflammation of the flap at the top of the larynx. This condition can be life-threatening, so get emergency treatment if you or a child in your care has had laryngitis and starts gasping or having any trouble breathing.
There are two types of laryngitis: acute and chronic. Acute laryngitis is temporary, common and usually improves once the underlying cause is treated. While some people are more prone to laryngitis, most adults develop the condition once every couple of years.
Laryngitis usually goes away on its own in a week or two. The best way to recover from laryngitis is to rest your voice and drink plenty of fluids. In some cases, your healthcare provider may prescribe medications to speed up the recovery process.
In most cases, laryngitis can be managed by resting your voice and staying hydrated. However, if your laryngitis symptoms last longer than two weeks, schedule an appointment with your healthcare provider.
Most of the time, laryngitis clears up on its own. If your symptoms are accompanied by severe pain, or if they last longer than two weeks, call your healthcare provider right away. They can help ease your discomfort and start you on the road to recovery.
Acute laryngitis is a temporary condition caused by overusing the vocal cords. It can also be caused by an infection. Treating the underlying condition causes the laryngitis to go away. Acute laryngitis can be caused by:
Laryngitis affects your vocal cords and voice box. Your doctor often starts with a visual diagnosis, using a special mirror to view your vocal cords. They might also perform a laryngoscopy to magnify the voice box for easy viewing. During a laryngoscopy, your doctor sticks a thin, flexible tube with a microscopic camera through your mouth or nose. Your doctor then looks for the following signs of laryngitis:
These treatments help reduce vocal cord and voice box swelling. Corticosteroids can treat and relieve symptoms of laryngitis, especially acute viral laryngitis. For chronic laryngitis, the best treatment will address the cause of the underlying problem.
Aside from a hoarse-sounding voice, changes to pitch and volume may occur with laryngitis. Speakers may experience a lower or higher pitch than normal, depending on whether their vocal folds are swollen or stiff.[1][9] They may also have breathier voices, as more air flows through the space between the vocal folds (the glottis), quieter volume[10] and a reduced range.[1]
Laryngitis can be infectious as well as noninfectious in origin. The resulting inflammation of the vocal folds results in a distortion of the sound produced there.[1] It normally develops in response to either an infection, trauma to the vocal folds, or allergies.[3] 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.[4]
Treatment is often supportive in nature, and depends on the severity and type of laryngitis (acute or chronic).[1] General measures to relieve symptoms of laryngitis include behaviour modification, hydration and humidification.[1]
Vocal hygiene (care of the voice) is very important to relieve symptoms of laryngitis. Vocal hygiene involves measures such as: resting the voice, drinking sufficient water, reducing caffeine and alcohol intake, stopping smoking and limiting throat clearing.[1]
The suggested treatment for viral laryngitis involves vocal rest, pain medication, and mucolytics for frequent coughing.[7] Home remedies such as tea and honey may also be helpful.[1] Antibiotics are not used for treatment of viral laryngitis.[1][17]
Antibiotics may be prescribed for bacterial laryngitis, especially when symptoms of upper respiratory infection are present.[7] However, the use of antibiotics is highly debated for acute laryngitis. This relates to issues of effectiveness, side effects, cost, and possibility of antibiotic resistance patterns. Overall, antibiotics do not appear to be very effective in the treatment of acute laryngitis.[5]
In severe cases of bacterial laryngitis, such as supraglottitis or epiglottitis, there is a higher risk of the airway becoming blocked.[7] An urgent referral should be made to manage the airway.[1] Treatment may involve humidification, corticosteroids, intravenous antibiotics, and nebulised adrenaline.[7]
Fungal laryngitis can be treated with oral antifungal tablets and antifungal solutions.[1][7] These are typically used for up to three weeks and treatment may need to be repeated if the fungal infection returns.[7]
Anti-reflux medications may be prescribed for patients with signs of chronic laryngitis and hoarse voice.[18] If anti-reflux treatment does not result in a decrease of symptoms, other possible causes should be examined.[1] Over-the-counter medications for neutralizing acids (antacids) and acid suppressants (H-2 blockers) may be used.[7] Antacids are often short-acting and may not be sufficient for treatment.[7] Proton pump inhibitors are an effective type of medication.[7] These should only be prescribed for a set period of time, after which the symptoms should be reviewed.[1] Proton pump inhibitors do not work for everyone. A physical reflux barrier (e.g. Gaviscon Liquid) may be more appropriate for some.[1] Antisecretory medications can have several side-effects.[1]
When treating allergic laryngitis, topical nasal steroids and immunotherapy have been found to be effective for allergic rhinitis.[7] Antihistamines may also be helpful, but can create a dryness in the larynx.[7] Inhaled steroids that are used for a long period can lead to problems with the larynx and voice.[7]
Acute laryngitis may persist, but will typically resolve on its own within two weeks.[1] Recovery is likely to be quick if the patient follows the treatment plan.[19] In viral laryngitis, symptoms can persist for an extended period, even when upper respiratory tract inflammation has been resolved.[17]
Laryngitis that continues for more than three weeks is considered chronic.[1] If laryngeal symptoms last for more than three weeks, a referral should be made for further examination, including direct laryngoscopy.[1] The prognosis for chronic laryngitis varies depending on the cause of the laryngitis.[19]
Acute laryngitis has an abrupt onset and is usually self-limited. If a patient has symptoms of laryngitis for more than 3 weeks, the condition is classified as chronic laryngitis. The etiology of acute laryngitis includes vocal misuse, exposure to noxious agents, or infectious agents leading to upper respiratory tract infections. The infectious agents are most often viral but sometimes bacterial.
Rarely, laryngeal inflammation results from an autoimmune condition such as rheumatoid arthritis, relapsing polychondritis, Wegener granulomatosis, or sarcoidosis. A case report showed a 2-year-old intubated patient who was given activated charcoal for poisoning, resulting in obstructive laryngitis. This unusual case demonstrates the myriad potential etiologies of acute laryngitis.
Chronic laryngitis, as the name implies, involves a longer duration of symptoms; it also takes longer to develop. Chronic laryngitis may be caused by environmental factors such as inhalation of cigarette smoke or polluted air (eg, gaseous chemicals), irritation from asthma inhalers, vocal misuse (eg, prolonged vocal use at abnormal loudness or pitch), or gastrointestinal esophageal reflux. Vocal misuse results in an increased adducting force of the vocal folds with subsequent increased contact and friction between the contacting folds. The area of contact between the folds becomes swollen. Vocal therapy has the greatest benefit in the patient with chronic laryngitis. 2ff7e9595c
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