Disease: Laryngitis

    Laryngitis facts

    • Laryngitis is an inflammation of the voice box (larynx).
    • Causes of laryngitis include upper respiratory infection or cold; overuse of the voice box by talking, singing, or shouting; gastroesophageal reflux disease (GERD), reflux laryngitis; chronic irritation of the vocal cords; smoking; exposure to secondhand smoke; or exposure to polluted air.
    • Laryngitis is contagious only if it is caused by an infection.
    • The most common symptoms of laryngitis are hoarseness, loss of voice, and throat pain.
    • Symptoms of laryngitis in adults include dry, sore throat, pain with swallowing, and a feeling of fullness in the throat or neck. If the laryngitis is caused by an infection additional symptoms of fever, swollen lymph nodes, may be experienced.
    • Symptoms of laryngitis in infants in children include croup, hoarse barky cough, and fever.
    • Chronic laryngitis, in which the symptoms last for weeks may be caused by by gastroesophageal reflux disease, smoking, constant exposure to secondhand smoke, air pollution, or alcohol use.
    • Chronic inflammation due to laryngitis may cause the formation of nodules or polyps on the vocal cords.
    • Treatment of laryngitis is usually symptomatic with voice rest, humidified air, and certain home remedies for symptom relief.
    • If symptoms of laryngitis persist for more than three weeks or continue to recur, contact your health care professional for further evaluation.
    • Complications of laryngitis from GERD include pneumonia, chronic bronchitis, and vocal cord paralysis.

    What is 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 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 and sometimes too quiet or soft to hear. Because there is inflammation, throat pain is often an associated symptom.

    Picture of the larynx and trachea

    What causes laryngitis?

    • Laryngitis is an inflammation of the vocal cords. Most commonly, acute laryngitis is caused by an infection that inflames the vocal cords.
    • Laryngitis may also be caused by voice overuse with excess talking, singing, or shouting.
    • Chronic laryngitis, often described as lasting for more than three weeks may be caused by prolonged alcohol use, smoking, constant exposure to secondhand smoke, exposure to polluted air, and excess coughing.
    • Gastroesophageal reflux disease (GERD) may cause reflux laryngitis and chronic cough, if acid and digestive juices from the stomach reflux up into the esophagus and back of the throat. Sometimes people are aware of the presence of the acid and experience waterbrash, a sour taste in their mouth. Repeat spills of acid onto the vocal cords will cause a chemical irritation and result in inflammation and swelling of the cords that hinders appropriate vibration and generation of sound.
    • Chronic irritation of the vocal cords may also cause polyps or nodules to form on the vocal cords, which may affect the ability of the vocal cords to vibrate, which causes chronic hoarseness.
    • Stroke may also cause vocal cord muscle paralysis and lead to a weak, hoarse voice and swallowing problems.
    • Damage to the muscles or to the nerves that control them may lead to hoarseness. These nerves may be damaged if there has been trauma to the neck or if surgery has been performed and the nerves inadvertently irritated or severed.
    • Tumors in the neck and chest may compress the nerves and cause them to function poorly.
    • Thyroid inflammation and enlargement can also cause irritation of nerves that supply the vocal cord muscles.
    • Not all individuals who have lost their voice have an infection. Not all hoarseness is due to a primary inflammation of the vocal cords.
    • Diphtheria is rarely a cause of laryngitis-like symptoms because most people in the United States have been immunizxed and are protected against this infection. However, with primary immunization decreasing, and people failing to keep their immunizations up to date, there exists a potential for new outbreaks. Recent outbreaks of diphtheria have been documented in Russia and Thialand.

    What are the symptoms of laryngitis?

    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 a viral infection:

    • 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 children

    Air enters into our lungs like a bellows, the ribs swing out, and the diaphragm (the muscle that separates the chest from the abdomen) pushes down, sucking air through the mouth and nose, past the larynx and into the trachea and lungs. In children with croup, breathing becomes difficult. As the child tries to inhale 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 The maturing of laryngeal cartilage and widening of airways usually occurs by age 6 or 7.

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

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

    Other symptoms of laryngitis

    When the cause of laryngitis is not infectious, cough may be a significant symptom along with the hoarseness. There also can be a fullness felt in the throat. The patient also may complain of difficulty swallowing and have shortness of breath. Rarely, the patient can cough up blood-tinged saliva if the inflammation causes minor bleeding.

    Is laryngitis contagious?

    Laryngitis is only contagious if it is caused by an infection. Laryngitis, upper respiratory infections, and colds are commonly a viral infection spread by aerosol droplets.

    Disease transmission can be minimized or prevented by covering the nose and mouth when coughing and sneezing, and proper hygiene habits (wash your hands often, don't share food utensils, wipe down door handles).

    How is laryngitis diagnosed?

    The health care professional often can make the diagnosis of 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 a streptococcal throat infection (strep throat) in addition to the laryngitis, a throat swab for a rapid strep test.

    If the hoarse voice becomes chronic, the health care professional may want to take a more detailed history, trying to learn why the larynx has become inflamed for a prolonged period of time.

    Questions may be asked:

    • Diet, use of alcohol, aspirin, ibuprofen, and smoking, all of which may cause gastroesophageal reflux disease. Alcohol and smoking can irritate the vocal cords.
    • Work and hobbies may reveal evidence of repeated chemical inhalation and exposure to air pollution.
    • Any signs or symptoms that suggest the potential of thyroid disease, stroke, or cancers of the head and neck will be explored.

    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 professional 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. This procedure uses a thin tube containing a lighted fiberoptic camera that is inserted through the nose into the back of the throat. The health care practitioner performing the procedure can see whether the vocal cords are inflamed, if there are any polyps or nodules growing on them, and if the vocal cords move appropriately with breathing and speaking. This test is often performed by an otolaryngologist (ear, nose, and throat specialist), but many other physicians and specialists are trained to perform direct laryngoscopy. Indirect laryngoscopy may be attempted using a mirror placed in the back of the throat to visualize the vocal cords.

    What is the treatment for laryngitis?

    As with any other structure in the body that becomes inflamed, rest is the key to recovery. For laryngitis, this means resting the voice and 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, including staying well hydrated by drinking plenty of fluids, breathing humidified air, taking acetaminophen or ibuprofen for pain control. Patience is required to allow time for the vocal cords to rest and recover.
    • For patients with significant laryngitis that have pain and difficulty swallowing, 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.

    Learn more about: dexamethasone

    What is 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 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 and sometimes too quiet or soft to hear. Because there is inflammation, throat pain is often an associated symptom.

    Picture of the larynx and trachea

    What causes laryngitis?

    • Laryngitis is an inflammation of the vocal cords. Most commonly, acute laryngitis is caused by an infection that inflames the vocal cords.
    • Laryngitis may also be caused by voice overuse with excess talking, singing, or shouting.
    • Chronic laryngitis, often described as lasting for more than three weeks may be caused by prolonged alcohol use, smoking, constant exposure to secondhand smoke, exposure to polluted air, and excess coughing.
    • Gastroesophageal reflux disease (GERD) may cause reflux laryngitis and chronic cough, if acid and digestive juices from the stomach reflux up into the esophagus and back of the throat. Sometimes people are aware of the presence of the acid and experience waterbrash, a sour taste in their mouth. Repeat spills of acid onto the vocal cords will cause a chemical irritation and result in inflammation and swelling of the cords that hinders appropriate vibration and generation of sound.
    • Chronic irritation of the vocal cords may also cause polyps or nodules to form on the vocal cords, which may affect the ability of the vocal cords to vibrate, which causes chronic hoarseness.
    • Stroke may also cause vocal cord muscle paralysis and lead to a weak, hoarse voice and swallowing problems.
    • Damage to the muscles or to the nerves that control them may lead to hoarseness. These nerves may be damaged if there has been trauma to the neck or if surgery has been performed and the nerves inadvertently irritated or severed.
    • Tumors in the neck and chest may compress the nerves and cause them to function poorly.
    • Thyroid inflammation and enlargement can also cause irritation of nerves that supply the vocal cord muscles.
    • Not all individuals who have lost their voice have an infection. Not all hoarseness is due to a primary inflammation of the vocal cords.
    • Diphtheria is rarely a cause of laryngitis-like symptoms because most people in the United States have been immunizxed and are protected against this infection. However, with primary immunization decreasing, and people failing to keep their immunizations up to date, there exists a potential for new outbreaks. Recent outbreaks of diphtheria have been documented in Russia and Thialand.

    What are the symptoms of laryngitis?

    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 a viral infection:

    • 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 children

    Air enters into our lungs like a bellows, the ribs swing out, and the diaphragm (the muscle that separates the chest from the abdomen) pushes down, sucking air through the mouth and nose, past the larynx and into the trachea and lungs. In children with croup, breathing becomes difficult. As the child tries to inhale 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 The maturing of laryngeal cartilage and widening of airways usually occurs by age 6 or 7.

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

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

    Other symptoms of laryngitis

    When the cause of laryngitis is not infectious, cough may be a significant symptom along with the hoarseness. There also can be a fullness felt in the throat. The patient also may complain of difficulty swallowing and have shortness of breath. Rarely, the patient can cough up blood-tinged saliva if the inflammation causes minor bleeding.

    Is laryngitis contagious?

    Laryngitis is only contagious if it is caused by an infection. Laryngitis, upper respiratory infections, and colds are commonly a viral infection spread by aerosol droplets.

    Disease transmission can be minimized or prevented by covering the nose and mouth when coughing and sneezing, and proper hygiene habits (wash your hands often, don't share food utensils, wipe down door handles).

    How is laryngitis diagnosed?

    The health care professional often can make the diagnosis of 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 a streptococcal throat infection (strep throat) in addition to the laryngitis, a throat swab for a rapid strep test.

    If the hoarse voice becomes chronic, the health care professional may want to take a more detailed history, trying to learn why the larynx has become inflamed for a prolonged period of time.

    Questions may be asked:

    • Diet, use of alcohol, aspirin, ibuprofen, and smoking, all of which may cause gastroesophageal reflux disease. Alcohol and smoking can irritate the vocal cords.
    • Work and hobbies may reveal evidence of repeated chemical inhalation and exposure to air pollution.
    • Any signs or symptoms that suggest the potential of thyroid disease, stroke, or cancers of the head and neck will be explored.

    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 professional 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. This procedure uses a thin tube containing a lighted fiberoptic camera that is inserted through the nose into the back of the throat. The health care practitioner performing the procedure can see whether the vocal cords are inflamed, if there are any polyps or nodules growing on them, and if the vocal cords move appropriately with breathing and speaking. This test is often performed by an otolaryngologist (ear, nose, and throat specialist), but many other physicians and specialists are trained to perform direct laryngoscopy. Indirect laryngoscopy may be attempted using a mirror placed in the back of the throat to visualize the vocal cords.

    What is the treatment for laryngitis?

    As with any other structure in the body that becomes inflamed, rest is the key to recovery. For laryngitis, this means resting the voice and 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, including staying well hydrated by drinking plenty of fluids, breathing humidified air, taking acetaminophen or ibuprofen for pain control. Patience is required to allow time for the vocal cords to rest and recover.
    • For patients with significant laryngitis that have pain and difficulty swallowing, 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.

    Learn more about: dexamethasone

    Source: http://www.rxlist.com

    As with any other structure in the body that becomes inflamed, rest is the key to recovery. For laryngitis, this means resting the voice and 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, including staying well hydrated by drinking plenty of fluids, breathing humidified air, taking acetaminophen or ibuprofen for pain control. Patience is required to allow time for the vocal cords to rest and recover.
    • For patients with significant laryngitis that have pain and difficulty swallowing, 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.

      Source: http://www.rxlist.com

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