Laryngitis is an illness whereby the larynx becomes swollen and inflamed. It can be an acute (short-term) or chronic (long-term) condition, although in most cases, the condition is temporary and has no serious consequences.
The larynx, also referred to as the voice box, is the area of the throat that is home to the vocal cords - two small folds of mucous membrane covering cartilage and muscle that vibrate to produce sound. The larynx is used in the processes of breathing, swallowing, and talking.
Here are some key points about laryngitis. More detail and supporting information is in the main article.
- Viral infections such as colds are the most common cause of laryngitis
- Chronic laryngitis is often caused by lifestyle factors, such as the continual exposure to irritants
- Children with laryngitis can develop another respiratory illness called croup
- Additional testing such as laryngoscopy can be recommended in more severe cases
- Acute laryngitis is best treated with self-care measures and rest
What is laryngitis?
When functioning normally, the vocal cords open and close smoothly to produce the sounds that make up the voice. When a person has laryngitis, their vocal cords are inflamed, changing the flow of air in the throat.
Laryngitis is a condition where the larynx, also known as the voice box, becomes inflamed.
This change in air flow leads to a distortion in the sounds that are produced.
Laryngitis is characterized by a voice that becomes hoarse or gravelly, and can sometimes be too quiet to hear properly.
Laryngitis commonly manifests quickly with symptoms lasting for no more than 2 weeks. If the symptoms last for longer than 3 weeks (chronic laryngitis) this suggests a more serious underlying cause that warrants further investigation.
In chronic laryngitis, the vocal cords can become strained and develop growths such as polyps or nodules.
Causes of laryngitis
A number of conditions can cause laryngitis, with acute and chronic forms of laryngitis typically resulting from different factors.
The most common cause of laryngitis is a viral infection, often similar to those that cause the common cold or flu. Overusing the voice - cheering at an event, for example - can also cause inflammation of the larynx.
In very rare instances, acute laryngitis can be caused by diphtheria, a bacterial infection. Most people in the United States are immunized against this infection, however.
Overusing the voice through cheering or singing can cause inflammation of the larynx.
Chronic laryngitis is typically caused by irritation of the larynx resulting from such things as:
- Acid reflux, or gastroesophageal disease (GERD), a condition where stomach acid and contents are brought back up into the throat
- Bacterial, fungal, or parasitic infection
- Chronic sinusitis
- Excess coughing
- Exposure to inhaled irritants, such as allergens or toxic fumes
- High alcohol intake
- Habitual misuse or overuse of voice (in singers, for example)
- Smoking, including secondhand smoke
- Use of inhaled steroid medicines (asthma inhalers, for instance)
Not all hoarseness occurs as a result of an infection or laryngitis. Chronic hoarseness may be unrelated to laryngitis, with the cause varying in severity. Some causes of hoarseness include:
- Age-related changes to the vocal cords
- Paralysis of the vocal cords as a result of another condition
Symptoms of laryngitis
Laryngitis can be associated with a broad range of symptoms in adults, including:
Common symptoms of laryngitis include hoarseness, coughing, and painful swallowing.
- Cold or upper respiratory tract infection
- Dry cough (as well as bloody saliva in non-infectious laryngitis)
- Difficult or painful swallowing
- Feeling of fullness, tickling, or rawness in throat
- Runny nose
- Shortness of breath
- Sore or dry throat
- Swollen lymph nodes in the neck
- Vocal weakness or loss of voice
Laryngitis in children
Symptoms of laryngitis in children can vary slightly from symptoms in adults. The condition is often characterized by a hoarse barking cough and fever, and may also present as croup - a contagious respiratory illness common among children. Although croup is usually a simple illness to treat, severe cases require medical attention.
Medical attention is recommended for children experiencing any of the following symptoms:
- Difficulty with breathing
- Difficulty with swallowing
- Fever with a temperature higher than 103 degrees Fahrenheit (39.4 Celsius)
- Increased drooling
- Loud, high-pitched breathing sounds made when inhaling
These symptoms can also indicate another condition called epiglottitis - a condition involving inflammation of the epiglottis (the tissue surrounding the trachea or windpipe). Both adults and children can develop epiglottitis, and the condition can be life-threatening in certain cases.
Tests and diagnosis
Laryngitis is typically diagnosed through a physical examination that assesses the patient's ears, nose, throat, and voice. No additional testing is required for most diagnoses.
The most common symptom of the condition is hoarseness, so doctors will take care to listen to the patient's voice. They may also ask questions about lifestyle, potential exposure to airborne irritants, and other related diseases.
If a patient presents with chronic hoarseness, a doctor may recommend additional testing to fully examine the vocal cords. A laryngoscope can be used to observe the motion of the vocal cords when in use and to determine the presence of any polyps or nodules on the vocal cords. A biopsy can be carried out if a suspicious area of tissue requires further assessment.
Anyone who has symptoms that last longer than 2 weeks should consult their physician. In some cases, a doctor may refer a patient to an otolaryngologist - an ear, nose, and throat (ENT) specialist.
Treatments for laryngitis
Cases of acute laryngitis are often best treated with rest, home remedies, and self-care measures that can relieve symptoms. In this case, rest means limiting use of the larynx by reducing or refraining from talking, singing, or otherwise making noises that use the voice box. Whispering should also be avoided as this requires that the vocal cords are tightly stretched, hampering their recovery.
Drinking plenty of water can reduce the risk of laryngitis as it prevents dryness in the vocal cords.
Other simple self-care home remedies:
- Avoid decongestants - these dry out the throat
- Breathe moist air
- Use acetaminophen or ibuprofen to control pain
- Refrain from smoking, and avoid second-hand smoke or other irritants
- Drink plenty of fluids
In cases of laryngitis caused by bacterial infection, antibiotics may be prescribed. However, the latest Cochrane review found that the risks of prescribing antibiotics for acute laryngitis typically outweigh the benefits. Corticosteroids may be prescribed to reduce vocal cord inflammation in cases where the laryngitis needs to be resolved urgently (such as for professional singers or speaker, or in infants with severe croup).
Chronic laryngitis may require more extensive treatment, and this is determined by the cause of the inflammation. If the laryngitis is caused by another condition - GERD or sinusitis, for example - then treatment for the associated condition can lead to an improvement in the laryngitis.
Lifestyle changes may be required in some cases. For example, if singing is deemed to be the cause of laryngitis, the patient may need to alter the way in which they sing. Speech training may be recommended in such cases. Quitting smoking and avoiding alcohol consumption can also help, as can avoiding inhaled irritants such as chemical fumes.
Surgery may be required in cases where the vocal chords have been damaged as a result of polyp or nodule growth.
A number of measures can be taken to prevent dryness and irritation to the vocal cords and minimize the risk of laryngitis; such measures include:
- Avoid clearing the throat
- Take steps to prevent upper respiratory infections, such as practicing good hygiene and avoiding contact with people who have contagious infections
- Quit smoking and avoid second-hand smoke where possible
- Drink plenty of water
- Limit or eliminate alcohol and caffeine intake as these can increase the risk of dehydration.