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by LaRusso L

Laryngitis

Definition

Laryngitis is swelling of the voice box, including the vocal cords. Vocal cords normally create sounds by opening and closing. Swelling makes movement of the vocal cords difficult which makes you sound hoarse or prevents sounds at all.
The Larynx
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Causes

Laryngitis is caused by irritation, overuse, or infection of the voice box. Some of the most common irritants include:
Less often laryngitis may be caused by certain medical conditions such as:
  • Noncancerous growths on the vocal cords
  • Functional dysphonia—abnormal use of the vocal mechanisms despite normal anatomy
  • Laryngeal papilloma—growths on the larynx caused by HPV infection
  • Muscle tension dysphonia—a voice disorder caused by excessive or unequal tension while speaking
  • Reinkes edema—an accumulation of fluid in the vocal cords, usually associated with smoking
  • Spasmodic dysphonia—a condition resulting in irregular voice breaks
  • Vocal cord paralysis—weakness or immobility of the vocal cords
  • Autoimmune and granulomatous conditions

Risk Factors

Factors that may increase your chance of laryngitis include:
  • Upper respiratory tract infection—often caused by a virus, like a cold
  • Yelling, singing, and speaking loudly for extended periods of time
  • Inhaling airborne irritants—such as cigarette smoke or chemicals
  • Allergies to dust, mold, and pollen
  • Uncontrolled gastroesophageal reflux disease (GERD)—stomach acid that rises up in the throat
  • Using inhaled asthma medications
  • Excess alcohol consumption
  • Bacterial or fungal infections—much less common

Symptoms

Laryngitis may cause:
  • Hoarseness (raspiness, breathiness, and strain) or loss of voice
  • Changes in volume (loudness) or in pitch (how high or low the voice is)
  • Sore throat
  • Painful swallowing
  • Cough
  • Runny nose

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Most laryngitis can be diagnosed by your symptoms and history. Your doctor may recommend further tests if you have:
  • Hoarseness that has no obvious cause or has lasted longer than 2-3 weeks
  • Hoarseness with difficulty swallowing or breathing, coughing up blood, a lump in the neck, or throat pain that is more severe than expected with the common cold (emergency medical evaluation is indicated)
  • Complete loss of voice or severe change in voice lasting longer than a few days
You may be referred to a specialist, if your laryngitis does not have an easily identified cause or cure.
Your voice box may be examined with a flexible, lighted scope. Other tests may also be done to evaluate swallowing or other processes related to normal voice.

Treatment

Laryngitis will often go away on its own once the underlying cause is managed. Underlying causes may require medication, treatment, or simply time.
Swelling and discomfort of the vocal cords can be managed with home care such as:
  • Resting your voice
  • Drinking plenty of fluids
  • Avoiding smoking or second hand smoke
  • Over-the-counter pain relievers
  • Steam or cold mist inhalation
Other steps will depend on the cause of laryngitis, for example:
  • Vocal overuse requires resting your voice.
  • Cold, flus, or other viral respiratory infections will usually go away on their own. It may take up to two weeks for your voice to completely return.
  • Laryngitis caused by seasonal allergies
  • Management of acid reflux with medications and lifestyle changes.
  • Antibiotics may be needed if the laryngitis is associated with a bacterial or fungal infection.

Voice Therapy

Voice therapy may be needed to treat some voice problems such as regular vocal overuse or chronic laryngitis. Voice therapy consists of:
  • Voice education
  • Healthy use of the voice
  • Instruction in proper voice technique and use of the breathing muscles

Prevention

You may not be able to prevent some of the illnesses and disorders that can cause laryngitis. To prevent and treat mild hoarseness related to laryngitis:
  • Talk to your doctor about quitting smoking
  • Avoid secondhand smoke
  • Avoid agents that can dehydrate the body, such as alcohol and caffeine
  • Drink plenty of fluids
  • Humidify your home
  • Get or maintain GERD treatment
  • Try not to use your voice too loudly or for too long
  • Seek professional voice training
  • Avoid speaking or singing when your voice is injured or hoarse

RESOURCES

Family Doctor—American Academy of Family Physicians
http://familydoctor.org
National Institute of Allergy and Infectious Diseases
http://www.niaid.nih.gov

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca
Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References

Acute laryngitis. EBSCO DynaMed website. Available at: hhttp://www.ebscohost.com/dynamed. Updated June 24, 2011. Accessed January 3, 2013.
Common problems that can affect your voice. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/common-problems-can-affect-your-voice. Accessed January 3, 2013.

Revision Information

  • Reviewer: David Horn, MD
  • Review Date: 08/2014
  • Update Date: 09/30/2013