Laryngitis - a common disorder - is an acute or chronic inflammation of the vocal cords. Acute laryngitis may occur as an isolated infection or as part of a generalized bacterial or viral upper respiratory tract infection. Repeated attacks of acute laryngitis cause inflammatory changes associated with chronic laryngitis.
Laryngitis is usually caused by a virus or occurs in people who overuse their voice. Occasionally, you 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 are especially at risk for cancer.
Signs and Symptoms
In acute laryngitis, the patient typically complains of hoarseness, ranging from mild to complete loss of voice. The patient also may report pain (especially when swallowing or speaking), a dry cough, and malaise.
In chronic laryngitis, hoarseness may be the patient's only complaint. Obtain a detailed patient history to help determine the disorder's cause.
Indirect laryngoscopy is used to confirm the diagnosis by revealing red, inflamed and, occasionally, hemorrhagic vocal cords with rounded rather than sharp edges and with exudate. Bilateral swelling that restricts movement but doesn't cause paralysis also may be apparent.
Resting the voice is the primary treatment. For viral infection, care is based on the patient's symptoms and includes analgesics and throat lozenges for pain relief. In addition, humidification, resting the voice, avoidance of smoking, elevating the head of the bed, drinking cold fluids, and advising the patient not to whisper is helpful. Bacterial infection requires antibiotic therapy. Severe, acute laryngitis may necessitate hospitalization. Occasionally, when laryngeal edema results in airway obstruction, a tracheotomy may be necessary. In chronic laryngitis, effective treatment must eliminate the underlying cause.
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