Laryngitis

The larynx, or voice box, is an organ found in the upper region at the back of the throat that contains the vocal cords which are responsible for the vocal sounds that we make. The vocal cords comprise of two membranous folds that ideally open and close smoothly and create sounds with their movement and vibration as air passes over them.

Position of the larynx in the throat region
Illustration from Mayo Foundation for Medical Education and Research
Vocal fold movement
Illustration from Pearson Edexcel

Laryngitis refers to the inflammation of the vocal cords, thereby disrupting their function and the sound subsequently produced. The condition may be acute (short-term, lasting from 1-3 weeks) or chronic (long-term, lasting over three weeks).

Comparison of a normal and inflamed larynx
Illustration from Medicspot

Symptoms

The most common symptoms of laryngitis include:

  • hoarseness of the voice
  • weakening or, sometimes, complete loss of the voice
  • sore or dry throat
  • persistent dry cough
  • tickling feeling in the throat
  • constant need to clear the throat

In some cases, particularly in children, sufferers may also run a slight temperature, experience a loss of appetite or, rarely, have some difficulty breathing.

Complications

Laringitis is often linked to other conditions such as the cold, flu or bronchitis. So, people who are more prone to these illnesses might find themselves at a higher risk of developing laryngitis. Rarely, in some cases where laryngitis is caused by infection, the infection may spread to other parts of the respiratory tract as well.

Causes

The most common cause of acute laryngitis is viral infection, usually of the upper respiratory tract. Bacterial or fungal (e.g. thrush) infections are less commonly associated with laryngitis. Apart from this, straining of vocal cords (such as screaming, loud singing or cheering, infants/children crying constantly) may also be a causal factor for acute laryngitis.

Chronic laryngitis may be caused by reasons such as:

  • smoking or vaping
  • exposure to inhaled irritants/allergens such as chemical fumes, inhaled medications
  • excessive alcohol intake
  • chronic sinusitis (resulting in needing to clear the throat frequently)
  • acid reflux, or GERD, causing acid to travel up to the throat from the stomach
  • habitual overuse of vocal cords (such as for singers, cheerleaders)
  • vocal cord paralysis resulting from nerve injury in trauma, surgery, illness, etc.
  • some cancers

Diagnosis

Observation of any of the above-mentioned symptoms, particularly a change in or loss of voice, generally leads to a clinical diagnosis of laryngitis. In some cases, a laryngoscopy (using an endoscope – a cable with a camera at the end of it, inserted through the mouth or nose) may be carried out to get a closer look at the vocal cords.

Prevention

Some measures that can be practised in order to prevent the incidence of laryngitis include:

  • careful use of the vocal cords, avoiding excessive shouting, loud singing, cheering, etc.
  • avoiding smoking and exposure to second-hand smoke, fumes and other allergens
  • limiting intake of alcohol
  • avoiding frequent consumption of caffeinated or carbonated beverages that could dry the throat out
  • avoiding clearing the throat too often, and seeking treatment for conditions such as chronic sinusitis
  • drinking water frequently and staying hydrated to help flush out excessive mucus in the throat
  • avoiding excessive consumption of spicy food that could trigger an acid reflux
  • avoiding contact with people who have upper respiratory infections (cold, flu, etc.) and washing hands frequently in order to avoid incidence of such infections
  • maintaining a healthy diet that includes vitamins A, C and E which help to keep the mucous membranes of the vocal cords and throat robust

Treatment

The principal mode of treatment for laryngitis is to give the vocal cords plenty of rest. This involves avoiding talking unless necessary, and not whispering or shouting when doing so as both of these put excess strain on the vocal cords.

Apart from this, the patient:

  • may be prescribed medication to help alleviate any infection that might be present
  • would be advised to drink plenty of fluids and keep their home environment moist (e.g. by using a humidifier or keeping bowls of water around the house)
  • may be prescribed corticosteroids to reduce inflammation, particularly if a quick recovery is needed (e.g. for work that includes a lot of vocal use)
  • may be referred to a speech and language therapist for voice therapy to help them improve the general use of their vocal cords

Cover illustration from 123RF

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