Overview

Laryngitis is an inflammation of the larynx, commonly known as the voice box, which is located in the throat and plays a crucial role in breathing, voice production, and protecting the airway during swallowing. This condition leads to hoarseness, loss of voice, throat discomfort, and sometimes coughing. Laryngitis can be acute (short-term) or chronic (long-term), depending on the duration and underlying cause. Most cases of acute laryngitis are caused by viral infections and resolve within a few days, while chronic laryngitis often requires more extensive evaluation and management.

Causes

Laryngitis can result from a variety of factors, depending on whether it is acute or chronic:

• Viral infections: The most common cause of acute laryngitis, often associated with colds or flu.
• Bacterial infections: Less common but can cause more severe symptoms.
• Voice overuse: Excessive speaking, shouting, or singing can strain the vocal cords and lead to inflammation.
• Allergies: Allergic reactions can cause chronic irritation of the larynx.
• Gastroesophageal reflux disease (GERD): Stomach acid refluxing into the throat can lead to chronic laryngitis.
• Smoking and exposure to irritants: Tobacco smoke and environmental pollutants can chronically irritate the larynx.
• Fungal infections: Common in people with weakened immune systems or prolonged inhaled steroid use.
• Autoimmune conditions: Rarely, autoimmune diseases can cause persistent laryngeal inflammation.

Symptoms

The most prominent symptom of laryngitis is voice changes, but other symptoms may also occur:

• Hoarseness: The voice becomes rough, raspy, or weak.
• Loss of voice: Complete or partial inability to speak.
• Sore throat: Discomfort or pain in the throat.
• Dry throat: Sensation of dryness and irritation.
• Dry cough: Persistent, non-productive cough.
• Tickling sensation: Feeling of a lump or tickle in the throat.
• Difficulty speaking: Talking may cause strain and fatigue.
• Fever and cold symptoms: Common in viral laryngitis, such as runny nose and body aches.

Diagnosis

Diagnosing laryngitis typically involves clinical assessment, with further tests if symptoms persist or are severe:

• Medical history: A review of recent infections, voice use, environmental exposures, and acid reflux symptoms.
• Physical examination: Checking for throat redness, swelling, and associated respiratory symptoms.
• Laryngoscopy: Using a thin, flexible tube with a camera to visualize the vocal cords and larynx, especially in chronic cases.
• Voice assessment: Evaluation by an ENT specialist or speech therapist if voice changes are prolonged.
• Additional tests: Blood tests or throat cultures may be done if a bacterial or fungal cause is suspected.

Treatment

Treatment depends on the underlying cause and severity of laryngitis:

• Resting the voice: Limiting speaking and avoiding shouting to allow the vocal cords to heal.
• Hydration: Drinking plenty of fluids to soothe the throat and keep mucus thin.
• Steam inhalation: Breathing in moist air helps reduce throat dryness and irritation.
• Pain relief: Over-the-counter pain relievers like acetaminophen or ibuprofen can ease discomfort.
• Antibiotics: Only prescribed if a bacterial infection is confirmed.
• Antifungal treatment: For fungal laryngitis, especially in immunocompromised individuals.
• Treating acid reflux: Proton pump inhibitors (PPIs) or antacids help in cases linked to GERD.
• Allergy management: Antihistamines or allergy avoidance strategies in allergic laryngitis.
• Smoking cessation: Quitting smoking significantly improves symptoms in chronic laryngitis.
• Voice therapy: In chronic cases, speech therapy may help correct improper voice usage.

Prognosis

The prognosis for laryngitis is generally very good, especially in acute cases:

• Acute laryngitis: Most people recover fully within 1 to 2 weeks with conservative treatment.
• Chronic laryngitis: May take longer to resolve and requires management of underlying causes.
• Minimal complications: When treated promptly, laryngitis rarely leads to serious complications.
• Possible long-term voice changes: Repeated or untreated laryngitis can lead to lasting hoarseness or vocal fatigue.
• Excellent recovery rate: With proper care, including voice rest and addressing contributing factors, most people regain their normal voice and throat comfort.

Overall, laryngitis is a common and usually harmless condition that responds well to conservative treatments and preventive measures.