Laryngitis
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Laryngitis is more commonly seen in the winter season. The voice-box, which is located in the throat, helps us talk and sing etc. It contains vocal cords which are covered with two folds of a mucous membrane, viz., cartilage and muscles. When we speak, air passes through these cords, which vibrate to produce sound.
Laryngitis occurs when the vocal cords present in the larynx get inflamed due to an irritant such as a virus, bacteria, or allergen. This inflammation can cause the voice to become hoarse and distorted. Hoarseness (dysphonia) is when your voice sounds strained or breathy. The pitch and volume of your voice may be affected. Severe inflammation, in some cases, can cause the person to lose their ability to talk. Laryngitis can be acute or chronic in nature.
Types Laryngitis is broadly classified into two types: Acute Laryngitis and Chronic Laryngitis. Acute Laryngitis : The inflammation of the vocal cords is short-lived and gets better in a week or two. Chronic laryngitis: It is a prolonged inflammation of the vocal cords. It may last for longer than 3 weeks and is more commonly caused by misuse of the voice, vocal abuse, excessive use, being exposed to irritants for a long time. Ultimately, growth of nodules or polyps may occur. Some irritants can cause both of these types of laryngitis, while others may cause only one type. Both acute and chronic laryngitis is due to viral or bacterial infections. Sometimes they can also be due to an allergy or strain on the vocal cords. The good news here is that laryngitis is usually a minor ailment and most often resolves on its own.
Symptoms The symptoms of laryngitis are common in the sore throat as well. They are listed as follows:
Pain around the throat Tenderness in the lymph nodes around the base of the jaw and around the neck
Pain while talking and swallowing Red and inflamed back of the throat and Hoarseness of one’s voice. Difficulty in speaking Constant and irritating cough Trying to clear your throat repeatedly Raspy, braking voice Dry throat Causes and risk factors Causes: Acute laryngitis is caused due to:
Bacterial, fungal, or viral infections, or rarely, moulds . Particulate air pollutants like oven cleaners, spray paints, etc. The strain on the vocal cord due to a variety of reasons like talking loudly, screaming, etc. Cough that lasts for a long time. Injury to the larynx Causes of chronic laryngitis include :
Acid reflux due to Gastroesophageal reflux disease (GERD) may cause this too due to the stomach acid moving upwards towards the oesophagus may cause irritation to
the vocal cords.
Overuse of the vocal cords like singers or teachers. Allergies Auto-immune diseases like Wegner’s disease, polyangiitis, etc. Bacterial or fungal infections Constant use of oral inhalers or steroids Smoking tobacco or marijuana Chronic cough or chronic sinusitis Inhalation of certain irritants like smoke, chemical fumes, etc. Alcohol consumption Laryngopharyngeal reflux Allergies Inflammation of vocal cords due to voice misuse, secondary inflammation of the voice box due to other diseases like sinus, dehydration of larynx,
Constant clearing of throat , thick mucus in throat, etc.[3,4] Risk Factors
Factors that increase the risk of Laryngitis include
Professions like singing and teaching require more use of voice. People who work in occupations where screaming is required, where there is exposure to pollutants like spray paint, smoke, etc. Exposure to allergens can increase the risk Inhaling smoke or other allergic pollutants health problems like snoring sleep, apnoea, a weak immune system, GERD Use of oral inhalers for asthma Drinking too much alcohol.[5,7] Prevention Preventing laryngitis is fairly easy if these tips are followed: :
Keeping the throat mucus thin by drinking adequate water. Excessive tea or coffee intake should be avoided as it causes drying of mucous membranes. Make sure to get the flu vaccine to prevent upper respiratory tract infection. Upper respiratory tract infections are a major risk. Not drinking or smoking aggressively Take proper training to avoid injury to the larynx while singing Avoid clearing your throat repeatedly to reduce swelling of the vocal cords Taking antacids to reduce heartburn and avoid foods like caffeine, alcohol, and other acidic foods Follow good hygienic practices like washing hands , staying away from people who have upper respiratory tract infections. Raise your head while sleeping to reduce the acid reflux to the throat Avoid shouting and talking loudly. This causes excessive strain on the vocal cords and can lead to laryngitis If you know you suffer from the condition as a response to an allergen, try to stay away from the offending substance. Avoid smoking and being in the company of people who do. Smoking irritates the throat, often causing it to become inflamed. If you are prone to throat infections, make sure you gargle with warm water and a pinch of salt every time you get back from a crowded place. This helps wash away any infectious agents that might have settled in the throat.[4,6] Diagnosis
A doctor will usually diagnose laryngitis based on the symptoms like loss of voice or change in voice that lasts for 7 to 10 days. Apart from that, he/she may check your lymph nodes and throat for swelling and redness. An indirect laryngeal examination using a mirror may be used to check for redness or swelling in the larynx. Symptoms like loss of voice or change in voice that persists typically between seven to ten days are used for its diagnosis. In acute laryngitis, laryngoscopy may help. In severe cases of chronic laryngitis, your doctor will prescribe a throat swab (where a tiny sample is taken from the back of your throat) and may examine your voice box for any signs of diseases that might be more serious. Endoscopy using a flexible tube may be needed in cases where laryngitis occurs repeatedly. This is done in a process called laryngoscopy. This is an office-based procedure done in an out-patient department . In this procedure, a flexible tube containing a camera is put in through the nose or the mouth, and the vocal cords are seen as they move when you breathe and phonate.Treatment Treatment is dependent on :
Severity and type of laryngitis Age, health conditions, if any, medical history Tolerance to medicines, therapies or procedures.[9] Since laryngitis is a condition that usually resolves on its own, it is fairly simple to treat.
Your doctor will prescribe some antibiotics (in case the infection is due to a bacterial infection),
Plenty of voice rest is an essential part of the treatment. Antipyretics (if you suffer from a fever due to the infection),
Other medications may include:
Antacids and similar medicines that reduce stomach acid secretion, which can reduce chronic laryngitis due to GERD and heartburn. Vocal therapy to reduce laryngitis due to strain in the voice. Corticosteroids to reduce the swelling in the vocal cords. This is used only when you need to use your voice urgently.
Anti-allergic medications like antihistamines to resolve laryngitis due to allergies. Stop smoking and drinking if that is the underlying cause of laryngitis. Treatment of symptoms like a cough can be treated with cough syrups Lozenges and solutions for reducing pain Surgery to remove growths [4,6] Lifestyle/management The following changes will help with controlling laryngitis
Prevent the throat from drying up by drinking adequate water. Do not drink alcohol and caffeinated drinks
Keep the throat lining moist by gargling with salt water, chewing gum or using lozenges.
Visit a vocal therapist to help with vocal cord training. Avoid using decongestants as they dry the throat Do not smoke and stay away from dusty or polluted environments. Eat a diet that doesn’t cause heartburn.[4,6] Prognosis and complications Prognosis
Acute laryngitis goes away in 2 weeks with basic treatment. To resolve chronic laryngitis, the underlying cause will have to be determined. Once the cause is treated, laryngitis will subside . [10]
Complications
Sometimes laryngitis in children can cause severe respiratory blockage like croup or epiglottitis.
Laryngitis can also spread the infection to other parts of the respiratory tract Hoarseness and loss of voice can affect some people’s livelihood Vocal polyps may form and pose to be a problem In very rare cases, respiratory infection can lead to hospitalisation.[10,11] Tip: A hoarse voice is a sign of many more conditions including, cancer. If you suffer
from prolonged hoarseness of your voice or from a throat infection that won’t go
away, please visit your doctor immediately .
ALTERNATIVE TREATMENTS
Home remedies can be used to resolve the symptoms of laryngitis, reduce the strain on the vocal cords and help them to heal. The following can be helpful:
Avoid straining your vocal cords by talking. Rest your voice and do not whisper. Whispering increases the strain on the vocal cords. Try to talk softly if it is necessary. Use humidifiers to retain the moisture in the air. Inhaling steam also helps. You could also have warm water, soups and green tea to help soothe the throat and relieve the pain and irritation associated with it. Natural remedies like drinking ginger tea and having honey can also help a lot. References 1.Laryngology & Larynx Disorders: Overview, Conditions & Treatments Cleveland Clinic [Internet] Available at : https://my.clevelandclinic.org/health/articles/14520-laryngology Accessed on Jun 22, 2021 2.Hoarseness: Causes, Treatment & Definition Cleveland Clinic. [Internet] Available at : https://my.clevelandclinic.org/health/diseases/17105-hoarseness Accessed on Jun 22, 2021 3.Understanding Laryngitis The voice foundation [Internet] Available at https://voicefoundation.org/health-science/voice-disorders/voice-disorders/laryngitis/u understanding-laryngitis/ Accessed on Jun 22, 2021 4.Laryngitis - causes, treatment | Southern Cross NZ [Internet] Available at : https://www.southerncross.co.nz/group/medical-library/laryngitis-causes-treatment Accessed on Jun 22, 2021 5.Laryngitis Mercy Health [Internet] Available at https://www.mercy.com/health-care-services/primary-care-family-medicine/conditions/ laryngitis# Accessed on Jun 22, 2021 6.Laryngitis NHS inform [Internet] Available at https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/laryngitis Accessed on Jun 22, 2021. 7.Laryngitis | Winchester Hospital [Internet] Available at : https://www.winchesterhospital.org/health-library/article?id=11713 Accessed on Jun 22, 2021 8.Mazurek H, et al Acute subglottic laryngitis. Aetiology, epidemiology, pathogenesis and clinical picture Adv Respir Med. 2019; 87: 308–316 9.Treatment for Vocal Cord Disorders | Stanford Health Care [Internet] Available at : https://stanfordhealthcare.org/medical-conditions/ear-nose-and-throat/vocal-cord-dis-orders/treatments.html Accessed on Jun 22, 2021 10.Laryngitis Dove med [Internet] Available at https://www.dovemed.com/diseases-conditions/laryngitis/ Accessed on Jun 22, 2021 11.Laryngitis: MedlinePlus Medical Encyclopedia [Internet] Available at : https://medlineplus.gov/ency/article/001385.htm Accessed on Jun 22 , 2021
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