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Laryngitis

Laryngitis

The larynx is the voice box that allows us to speak, shout, whisper, and sing. The larynx consists of a cartilage skeleton that houses the vocal cords that are covered by a mucus lining. Muscles inside the larynx adjust the position, shape, and tension of the vocal cords, allowing us to make different sounds from whispering to to singing. Any change in the air flow (which is generated by the lungs exhaling air) across the vocal cords will affect the voice and the quality of the sound.

 

The larynx is located at the junction of the mouth and trachea and has a flap-like covering called the epiglottis, whose job it is to prevent food and saliva from entering the larynx during swallowing.

 

Laryngitis (larynx + itis = inflammation) is an inflammation of the voice box, causing a person to lose their voice. The quality of the voice becomes hoarse or gravelly-sounding or even too quiet or soft to hear.

 

Most of the causes of laryngitis, such as common viruses infections or using your voice too much, are not serious. A few causes, however, require medical attention and can be cause for concern such as laryngeal cancer.

Symptoms

Hoarseness, loss of voice, and throat pain are the primary symptoms of laryngitis.

 

Symptoms of laryngitis in adults

 

If the cause of laryngitis is infectious, affected individuals will have symptoms of:

  • Upper respiratory tract infection or cold.
  • Dry cough.
  • Sore throat.
  • Fever.
  • Swollen lymph nodes (lymph glands) in the neck.
  • Pain with swallowing.
  • A feeling of fullness in the throat or neck.
  • Runny nose.
  • Loss of voice.

 

Symptoms of laryngitis in infants and young children.

 

Air is brought into our lungs like a bellows, sucking air in through the mouth. In children with croup, there also may be difficulty breathing. As the child tries to breathe through a swollen and narrow larynx, the cartilage may collapse, just like when attempting to breathe through a straw.

 

As we age, the cartilage becomes stiffer and is able to withstand deeply indrawn breaths, but in children the cartilage is weaker and with each inspiration, the child may need to work hard to inhale.

 

In infants and young children, the classic signs and symptoms of an inflamed larynx caused by infection include:

  • croup, 
  • a hoarse barky cough,
  • fever.

 

Other symptoms of laryngitis

 

When the cause of laryngitis is not infectious, cough may be a significant symptom along with the hoarseness.

Causes

Laryngitis is usually caused by a virus or occurs in people who overuse their voice. Occasionally, a person may develop laryngitis from bacterial infections, and rarely, from infections such as tuberculosis, syphilis, or a fungal infection. People with prolonged laryngitis should see their doctor to be checked for tumors, some of which may be cancerous. Smokers and those who consume alcohol are especially at risk for cancer.

 

Laryngitis Contagious

 

If the laryngitis is from a viral or bacterial infection, it is possible that the specific virus or bacteria can be contagious. However, if the laryngitis is from laryngeal cancer or overuse of the voice, it is not contagious.

 

The health care practitioner can often diagnose laryngitis quickly at the doctor's office. The history of upper respiratory tract infection associated with loss of voice is reinforced by the patient answering questions in a hoarse voice. The examination is often brief and limited to the ears, nose, and throat, looking for other potential causes of the cold-like symptoms. If the throat is red and there is a concern about astrep throat in addition to the laryngitis, a throat swab for a strep screen may be done.

 

If the hoarse voice becomes chronic, the health care practitioner may want to take a more detailed history, accessing reasons why the larynx and vocal cords have become inflamed for a prolonged period of time.

 

Questions may be asked about:

 

  • Diet, use of alcohol, aspirin, ibuprofen, and smoking, all of which may cause gastroesophageal reflux disease. Alcohol and tobacco smoking can irritate the vocal cords.
  • Work and hobbies may reveal evidence of repeated chemical inhalation and exposure.
  • Exploration in regard to whether there may be thyroid disease, symptoms of stroke, or cancers of the head and neck.

 

Most cases of laryngitis need no testing to confirm the diagnosis. In those patients with chronic laryngitis, the necessity for blood tests, X-rays and other diagnostic tests will depend upon the patient presentation and the potential concerns that the health care practitioner has regarding the cause of the hoarseness.

 

Laryngoscopy is the most common test performed to look directly at the vocal cords and evaluate their function. Using a thin tube containing a lighted fiberoptic camera inserted through the nose into the back of the throat, an otolaryngologist (ear, nose, and throat specialist) can see whether the vocal cords are inflamed, if there are any polyps or nodules growing on them, and if they move appropriately with breathing and speaking.

Treatment

As with any other structure in the body that becomes inflamed, rest is the key to recovery. For laryngitis, this means limiting the amount of talking. If talking is required, the affected individual should avoid whispering and instead talk in a regular voice, regardless of how it sounds. Whispering requires the vocal cords to be stretched tightly and requires more work by the surrounding muscles and delays recovery time.

 

  • The treatment for viral laryngitis is supportive: plenty of fluids, humidified air, acetaminophen or ibuprofen for pain, and time for recovery.
  • For patients with significant laryngitis, a short course of steroids (prednisone, prednisolone, or dexamethasone) may be used to decrease the inflammation and shorten the course of symptoms. This treatment option is often considered for actors, singers, or other affected individuals who have to make a time sensitive presentation using their voice.
  • Dexamethasone as a single dose given orally (Decadron, DexPak) or by intramuscular injection (Adrenocot, CPC-Cort-D, Decadron Phosphate, Decaject-10, Solurex) may be used to treat croup.
  • The treatment of chronic laryngitis will be determined by the cause of the inflammation or loss of function. Discontinuation of smoking and alcohol use will have a positive effect.

 

Are there any home remedies for laryngitis?

 

It is reasonable not to seek medical care for most cases of laryngitis. Home treatment begins with resting the voice and keeping well hydrated. Symptoms may be controlled by exposure to humidified air. Often, the bathroom is the best place to create a highly humidified area.

 

  • Turn on the hot water in the shower until there is plenty of steam.
  • Make certain that all the hot water is drained from the tub or shower to prevent the risk of burns. 

 

  • Spend 15- 20 minutes breathing the warm moist air to help with symptoms.

 

A cold water vaporizer may also be used to help with humidity. Avoid hot water vaporizers because of the risk of burns.

 

Stay well hydrated, especially if the pain makes it difficult to swallow fluid.

 

Warm water gargles may be soothing. Alternatively, popsicles may offer comfort.

 

Tylenol and/or ibuprofen may be helpful in decreasing the amount of pain.

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