Laryngitis – Causes, Symptoms, Treatment, and Prevention.

Definition

Laryngitis is inflammation in and around the mucus membranes of the larynx or voice box. The irritated larynx becomes swollen and painful, leading to a sore throat, hoarse voice and even a complete loss of voice. Most cases of laryngitis are caused by an infection.

Epidemiology

Accurate figures regarding acute laryngitis are not available, as the condition often goes unreported. The Royal College of General Practitioners reported an average incidence of 5.9 cases of laryngitis and tracheitis per 100,000 patients (all ages) per week in 2011.

Chronic laryngitis is a complex condition which is similarly under-reported and often goes unrecognised. Yearly incidence has been reported in one study as 3.47 per 1,000; lifetime incidence is said to be up to 21%.Women are affected more than men.

Types of Laryngitis

Two Main Types of Laryngitis

Type Determined by How Long Inflammation Lasts

Acute laryngitis: Short-lived inflammation of the larynx

Chronic laryngitis: Prolonged inflammation of the larynx

Risk factors

Risk factors for laryngitis include:

Having a respiratory infection, such as a cold, bronchitis or sinusitis

Exposure to irritating substances, such as cigarette smoke, excessive alcohol intake, stomach acid or workplace chemicals

Overusing your voice, by speaking too much, speaking too loudly, shouting or singing

Causes of Laryngitis

Acute laryngitis

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:

• Viral infections
• Straining your vocal cords by talking or yelling
• Bacterial infections
• Drinking too much alcohol

Chronic laryngitis

Chronic laryngitis results from long-term exposure to irritants. It’s usually more severe and has longer-lasting effects than acute laryngitis.

Chronic laryngitis can be caused by:

• Frequent exposure to harmful chemicals or allergens
• Acid reflux
• Frequent sinus infections
• Smoking or being around smokers
• Overusing your voice
• Low-grade yeast infections caused by frequent use of an asthma inhaler

Cancer, paralysis of the vocal cords, or changes in vocal cord shape as you age can also cause persistent hoarseness and sore throats.

Symptoms of Laryngitis

The symptoms of laryngitis are described below:

• Hoarse voice
• Complete voice loss and difficulty speaking
• Sore throat
• Difficulty eating
• Mild fever with chills, muscle pain and body ache
• Persistent cough
• Difficulty breathing
• Headache, swollen neck glands and body ache in cases caused by flu or the common cold.

Diagnosis and test

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 want to listen to your voice and to examine your vocal cords, and he or she may refer you to an ear, nose and throat specialist (otorhinolaryngologist).

These techniques sometimes are used to help diagnose laryngitis:

Laryngoscopy: Your doctor can visually examine your vocal cords in a procedure called laryngoscopy, by using a light and a tiny mirror to look into the back of your throat. Or your doctor may use fiber-optic laryngoscopy. This involves inserting a thin, flexible tube (endoscope) with a tiny camera and light through your nose or mouth and into the back of your throat. Then your doctor can watch the motion of your vocal cords as you speak.

Biopsy: If your doctor sees a suspicious area, he or she may do a biopsy taking a sample of tissue for examination under a microscope.

Treatment and medications

Acute laryngitis caused by a virus often gets better on its own within a week or so. Self-care measures also can help improve symptoms.

Chronic laryngitis treatments are aimed at treating the underlying causes, such as heartburn, smoking or excessive use of alcohol.

Medications used in some cases include:

• Antibiotics In almost all cases of laryngitis, an antibiotic won’t do any good because the cause is usually viral. But if you have a bacterial infection, your doctor may recommend an antibiotic.
• Corticosteroids Sometimes, corticosteroids can help reduce vocal cord inflammation. However, this treatment is used only when there’s an urgent need to treat laryngitis for example, when you need to use your voice to sing or give a speech or oral presentation, or in some cases when a toddler has laryngitis associated with croup.

Lifestyle and home remedies

Some self-care methods and home treatments may relieve the symptoms of laryngitis and reduce strain on your voice:

Breathe moist air: Use a humidifier to keep the air throughout your home or office moist. Inhale steam from a bowl of hot water or a hot shower.

Rest your voice as much as possible: Avoid talking or singing too loudly or for too long. If you need to speak before large groups, try to use a microphone or megaphone.

Drink plenty of fluids: To prevent dehydration (avoid alcohol and caffeine).

Moisten your throat: Try sucking on lozenges, gargling with salt water or chewing a piece of gum.

Avoid decongestants: These medications can dry out the throat.

Avoid whispering: This puts even more strain on your voice than normal speech does.

Prevention

To prevent dryness or irritation to your vocal cords:

Don’t smoke, and avoid secondhand smoke: Smoke dries your throat and irritates your vocal cords.

Limit alcohol and caffeine: These cause you to lose total body water.

Drink plenty of water: Fluids help keep the mucus in your throat thin and easy to clear.

Avoid clearing your throat: This does more harm than good, because it causes an abnormal vibration of your vocal cords and can increase swelling. Clearing your throat also causes your throat to secrete more mucus and feel more irritated, making you want to clear your throat again.

Avoid upper respiratory infections: Wash your hands often, and avoid contact with people who have upper respiratory infections such as colds.

Avoid Eating spicy foods: Spicy foods can cause stomach acid to move into the throat or esophagus, causing heartburn or gastroespohageal reflux disease (GERD)

Include whole grains, fruits and vegetables in your diet: These foods contain vitamins A, E and C, and keep the mucous membranes that line the throat healthy.