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Written by Dr Mary-Louise Montague, specialist registrar in otolaryngology, Ninewells Hospital,
Dundee
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What is laryngitis?
The larynx is the organ of voice. When we speak, two membranes
in the larynx - the vocal cords - vibrate to make sound. Laryngitis refers to
inflammation or irritation of the tissues of the larynx. It is the bane of
performers and other professionals who depend on their voice for their art and
livelihood.
What causes laryngitis?
Almost every person has experienced acute (sudden onset)
laryngitis, usually associated with a viral infection of the upper airways. But
the inflammation can be caused by any kind of injury including:
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infection
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vocal overuse
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smoking and other inhaled irritants
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drinking of spirits
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contact with caustic or acidic substances (including acid
reflux from the stomach)
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allergic reaction
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direct trauma.
Why do the symptoms sometimes persist?
A more perplexing problem for professional voice users is
laryngitis that is not associated with any signs of infection but which recurs
or persists. This form of laryngitis, which lasts weeks or months, is termed
chronic laryngitis.
Acute laryngitis may become chronic if the appropriate
preventive measures are not adhered to rigidly.
What are the symptoms of laryngitis?
In acute laryngitis from a viral upper-respiratory infection,
the voice becomes hoarse or is reduced to a whisper.
The most common symptom of early mild ‘irritative’ laryngitis
is a feeling of postnasal drip with chronic throat clearing due to a sensation
of secretions in the throat.
In chronic irritative laryngitis loss of voice quality with
voice use, a feeling of irritation or of a lump in the throat, dryness or
soreness (often worst in the morning upon wakening) may be features in addition
to hoarseness (which often comes and goes).
Pain with laryngeal movements such as speaking or swallowing, is
typical of more severe laryngitis. Chronic cough and wheeze brought on by
exercise are signs of more advanced inflammation.
How is laryngitis diagnosed?
The diagnosis can be confirmed by inspection of the larynx by
an ENT (ear, nose and throat) specialist. The earliest sign may be slight
redness and dryness of the laryngeal lining with stringy mucus between the
vocal cords. In chronic laryngitis the vocal cords often appear
thickened.
How is laryngitis prevented or treated?
In acute laryngitis due to a cold the viral infection is almost
always quickly conquered by the body’s immune system and lasts at most a few
days. It is still best to rest the voice while the larynx is inflamed. This
along with steam inhalations and avoidance of smoke and other irritants is
usually sufficient. Antibiotics are rarely necessary.
Lifestyle changes are often the most important factor in the
prevention of chronic laryngitis.
These should include:
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cessation of
smoking and avoidance of smoky
environments
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avoidance of food and liquids for two to three hours before
retiring in order to prevent having active acid secretion by the stomach during
sleep.
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raising the head of the bed, which protects the larynx from
acid reflux from the stomach during sleep.
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medication to reduce acid production by the stomach if
symptoms persist despite these measures.
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avoidance of throat clearing as this can worsen symptoms. It
should be substituted by swallowing to clear bothersome throat
secretions.
Voice therapy may be helpful in cases of faulty voice
production.
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Last updated 04.10.2005
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