laryngitis

Acute Laryngitis. Acute laryngitis may be caused by overuse of the voice, allergies, irritating dust or smoke, hot or corrosive liquids, or even violent weeping. It also occurs in viral or bacterial infections, and is frequently associated with other diseases of the respiratory tract. In adults, a mild case begins with a dry, tickling sensation in the larynx, followed quickly by partial or complete loss of the voice. There may be a slight fever, minor discomfort, and poor appetite, with recovery after a few days. Other more uncomfortable symptoms can include a feeling of heat and pain in the throat, difficulty in swallowing, and dry cough followed by expectoration; the voice may be either painful to use or absent. Swelling of the larynx and epiglottis may impair breathing. Increasing difficulty in breathing may be a sign of edematous laryngitis, or croup.

Treatment requires that the patient refrain from talking. The room temperature should be steady and warm. The air is kept moist with a humidifier or vaporizer. An ice bag on the throat often is soothing. In some cases, antibiotics may be necessary.

Children are especially vulnerable to laryngitis because of the smallness of their air passages. Most cases in children subside within a few days, but if inflammation and swelling continue to increase, severe dyspnea occurs.

Chronic Laryngitis. After repeated attacks of the acute type, chronic laryngitis may develop. This is caused mostly by continual irritation from overuse of the voice, tobacco smoke, dust, or chemical vapors, or by a chronic nasal or sinus disorder. Often the moist mucous membrane lining the larynx becomes granulated. The granulation can proceed to thickening and hardening of the mucous membrane, which changes the voice or makes it hoarse. There is little or no pain, though there may be tickling in the throat and a slight cough. Chronic laryngitis that has persisted for a number of years may result in chronic hypertrophic laryngitis, a condition in which there is a permanent change in the voice because of hypertrophy of the membrane lining the larynx.

Treatment for chronic laryngitis is the same as for the acute form, with elimination of all sources of irritation and reinfection. Hoarseness that lasts longer than 2 weeks may be a warning of tumor or cancer of the larynx, or of a tumor in the thorax that presses on the recurrent laryngeal nerve, which controls the larynx.

Other Forms of Laryngitis. Paroxysmal laryngitis is a nervous disorder affecting infants that seems to be associated with enlarged adenoids and rickets. It consists of unexplained spasms in which the larynx closes, cutting off the air passage, and then suddenly opens. Sometimes the condition may be fatal. Treatment of this form of laryngitis calls for removal of adenoids.

Other types include diphtheritic laryngitis, tuberculous laryngitis, traumatic laryngitis, and allergic laryngitis. Treatment of diphtheritic and traumatic laryngitis often involves intubation or tracheostomy in order to admit air. Allergic laryngitis, often caused by smoking or other irritants, is treated in the same way as other allergies.