• Laryngitis

    Definition

    Laryngitis is swelling of the voice box. This swelling usually includes the vocal cords. The swelling can make it difficult to speak.
    The Larynx
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    Causes

    Common causes of laryngitis include:
    • Upper respiratory tract infection—often caused by a virus, like a cold
    • Bacterial or fungal infections—much less common
    • Irritation caused by voice overuse—from yelling, singing, and speaking loudly for extended periods of time
    • Airborne irritants—such as cigarette smoke, pollen, dust, and mold
    • Laryngopharyngeal reflux disease (LPRD)—stomach acid rises up in the throat and irritates the vocal cords
    Other causes of hoarseness or voice loss include:
    • Noncancerous growths on the focal cords
    • Functional dysphonia—abnormal use of the vocal mechanisms despite normal anatomy
    • Laryngeal papilloma—growths on the larynx caused by HPV infection
    • Muscle tension dysphonia—a voice disorder caused by excessive or unequal tension while speaking
    • Reinkes edema—an accumulation of fluid in the vocal cords, usually associated with smoking
    • Spasmodic dysphonia—a condition resulting in irregular voice breaks
    • Vocal cord paralysis—weakness or immobility of the vocal cords
    • Side effects from inhaled medications used for asthma

    Risk Factors

    Factors that increase your risk of laryngitis include:

    Symptoms

    Symptoms include:
    • Hoarseness (raspiness, breathiness, and strain) or loss of voice
    • Changes in volume (loudness) or in pitch (how high or low the voice is)
    • Sore throat
    • Cough

    Diagnosis

    Your doctor will ask about your symptoms and medical history, and perform a physical exam.
    Your doctor should examine you if you experience the following:
    • Hoarseness that has no obvious cause or has lasted longer than 2-3 weeks
    • Hoarseness with difficulty swallowing or breathing, coughing up blood, a lump in the neck, or throat pain out of proportion to that usually seen with the common cold
      • For some of these symptoms, emergency medical evaluation is indicated. If you have any questions about how quickly to seek care, call your doctor or a local emergency facility.
    • Complete loss of voice or severe change in voice lasting longer than a few days
    You may be referred to an otolaryngologist, also called an ENT (ear, nose, throat) doctor, if your laryngitis does not have an easily identified cause or cure.
    An ENT doctor will also ask about your medical history. Your voice box will be examined with a flexible, lighted scope. The doctor may place a mirror in the back of your mouth to see your voice box. Other tests may be done to evaluate swallowing or other processes related to normal voice.

    Treatment

    Laryngitis caused by seasonal allergies, cold or flu, or other viral respiratory infections will usually go away on its own. It may take up to two weeks. To help you heal:
    • Rest your voice.
    • Drink plenty of fluids.
    • Avoid smoking.
    • Take nonprescription pain relievers (like acetaminophen, ibuprofen) as needed.
    • Try steam inhalation.

    Treating the Underlying Illness

    Treatment of acid reflux will often relieve laryngitis.
    Antibiotics may be needed if the laryngitis is associated with a bacterial or fungal infection.

    Voice Therapy

    Laryngitis as a result of voice overuse will usually go away on its own within a few days.
    Voice therapy may be needed to treat voice problems. It may be used when there is regular vocal overuse. Voice therapy consists of:
    • Voice education
    • Healthy use of the voice
    • Instruction in proper voice technique and use of the breathing muscles
    If you are diagnosed with laryngitis, follow your doctor's instructions.

    Prevention

    You may not be able to prevent some of the illnesses and disorders that can cause laryngitis. However, to prevent and treat mild hoarseness related to laryngitis do the following:
    • If you smoke, quit.
    • Avoid secondhand smoke.
    • Avoid agents that can dehydrate the body, such as alcohol and caffeine.
    • Drink plenty of fluids.
    • Humidify your home.
    • Avoid acidic or spicy foods if you are prone to gastroesophageal reflux disease (GERD).
    • Try not to use your voice too loudly or for too long.
    • Seek professional voice training.
    • Avoid speaking or singing when your voice is injured or hoarse.

    RESOURCES

    Family Doctor http://familydoctor.org

    National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    References

    Acute laryngitis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 24, 2011. Accessed January 3, 2013.

    Common problems that can affect your voice. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/commonvoiceproblems.cfm. Accessed January 3, 2013.

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