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Laryngitis

Last updated: October 7, 2019

Summary

Laryngitis is an inflammation of the larynx that may manifest in acute or chronic forms. Acute laryngitis is commonly caused by viral infection of the nasopharynx that descends into the larynx or by severe damage to the vocal cords due to smoking or vocal strain. The primary symptoms are hoarseness (loss of voice) and a dry cough. Acute laryngitis may progress to chronic laryngitis if symptoms persists for more than three weeks. Direct or indirect visualization of the vocal cords and glottis (inflamed, hyperemic mucosa with edema and possibly exudates) is usually sufficient to diagnose the condition. Laboratory tests including complete blood count (CBC) and culture swabs should be carried out, particularly in chronic cases. Voice rest and cessation of smoking are the most important measures for treating the condition.

Definition

References:[1][2]

Etiology

References:[1][2]

Clinical features

References:[1][3]

Subtypes and variants

References:[4]

Diagnosis

Diagnosis of both forms of laryngitis is primarily based on clinical history, examination findings, and laryngoscopy.

Laryngoscopy

Laryngoscopy helps visualize the vocal cords and the supraglottic structures (glottis, arytenoids, aryepiglottic folds). Either of the following types of laryngoscopy can be implemented to establish a diagnosis.

  • Types
    • Indirect: can be performed during a routine physical examination
      • Does not allow for as much visualization as direct laryngoscopy
      • Caution is needed in suspected cases of acute epiglottitis, as it can trigger a laryngeal spasm, especially in children.
    • Direct: allows for detailed examination of the larynx, including vocal fold movement
      • Flexible endoscope (in patients who are awake)
      • Rigid laryngoscope (in patients under general anesthesia)
      • Can be used to obtain tissue for biopsy, cultures, and smears (to identify the presence of organisms)
  • Findings
    • Acute laryngitis
    • Chronic laryngitis

References:[1][3][5][6][7]

Treatment

The following modalities are used to treat both acute and chronic laryngitis:

References:[1]

References

  1. Shah RK. Acute Laryngitis. Acute Laryngitis. New York, NY: WebMD. http://emedicine.medscape.com/article/864671-overview. Updated: June 1, 2016. Accessed: April 20, 2017.
  2. Bruch JM, Kamani DV. Hoarseness in adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/hoarseness-in-adults.Last updated: August 22, 2016. Accessed: April 20, 2017.
  3. Amirlak B. Reflux Laryngitis. Reflux Laryngitis. New York, NY: WebMD. http://emedicine.medscape.com/article/864864-overview?src=refgatesrc1. Updated: December 1, 2015. Accessed: April 20, 2017.
  4. Ponka D, Baddar F. Indirect laryngoscopy. Can Fam Physician. 2013; 59 (11): p.1201.
  5. Jacobson AS, Urken ML, Teng MS. Head and Neck Diagnostic Procedures. Head and Neck Diagnostic Procedures. New York, NY: WebMD. http://www.medscape.com/viewarticle/521712_6. Updated: January 27, 2006. Accessed: August 20, 2017.
  6. Sataloff RT, Hawkshaw MJ, Gupta R. Laryngopharyngeal reflux and voice disorders: an overview on disease mechanisms, treatments, and research advances. Discov Med. 2010; 10 (52): p.213-224.
  7. Hanna GS. Acute supraglottic laryngitis in adults. J Laryngol Otol. 1986; 100 (8): p.971-975.