Laryngitis, inflammation of the larynx

In short, laryngitis is an inflammation of larynx, also known as „voice box“. Usually, it is just unpleasant, as most of the causes of laryngitis aren’t serious (such as using your voice, i.e. speaking too much, or common virus infections), but there are a few causes that can be cause for concern and that require medical attention.

What is larynx?

Larynx is an organ that is a part of the respiratory tract, located in the neck. Its functions include breathing and sound production, and it also protects the trachea against the food going down the wrong way. Larynx is where vocal cords, or vocal folds, are placed, and they are usually the first ones that suffer if the inflammation of larynx takes place. That is where sound is made, and that’s why it is called, and widely known as, the “voice box”
What causes laryngitis?
Most commonly, the laryngitis is caused by a viral infection that inflames the vocal folds, or by a physical damage to larynx.

The most common type of infection that causes acute laryngitis is viral infections, such as the flu, or common cold. Acute laryngitis symptoms include hoarseness, throat pressure, easy pain, and cough, less often shortness of breath, fatigue and fever. . Examination usually diagnoses symmetrical redness of vocal cords with adhesive secretion between them. Inflammation may subside after a few days while hoarseness may last longer, even two or three weeks.



Measles, mumps and varicella virus that causes herpes can also cause laryngitis, but less often, as well as bacterial infections and fungal infections, that in most cases attack the people with weakened immune system, as a result of chemotherapy or due to conditions as HIV.

Physical damage of larynx usually occurs when you use your voice too much, or misuse it. This type of laryngitis is referred to as mechanical laryngitis. Your vocal cords vibrate in a faster rate than usual – and than they should – when you sing or speak for long periods of time, or when you shout or sing loudly. That kind of excessive vibration damages the surface of the vocal cords, and they become swollen. Prolonged coughing or frequent clearing of your throat can do the same, as well as direct injuries of the larynx, like accidents or sports injuries.

Other causes of laryngitis include: smoking, because the smoke can cause long term inflammation; allergic reactions; alcohol misuse; and laryngopharyngeal reflux, or LFR, when stomach acid leeks up into the throat and irritates the larynx.

What are the symptoms of laryngitis?

The symptoms usually begin suddenly, and then get worse for two or three days. After that they should improve, and usually within a week you should feel better, but it can last up to three weeks. The symptoms of laryngitis include hoarse voice, sore throat, difficult speaking, headache, mild fever, irritating cough. You may only able to whisper, or you may not be able to talk at all. You may experience some other laryngitis symptoms as well, because laryngitis is often linked to another illness – cold, tonsillitis, flu, …

How is laryngitis diagnosed?

A medical diagnosis is most often not required, because laryngitis is a condition that will usually get better by itself within a few weeks without the need for treatment. The cases when you should visit your physician are if it lasts for longer than three weeks, if you are having trouble breathing, or if you have some additional symptoms, such as high temperature or swollen glands, which could suggest that you have an infection that is more serious.  The diagnosis (when necessary) is based on medical history, examination and – an indirect view of the larynx, as well as the microbiological analysis if it is considered necessary.

With chronic laryngitis most common among the edema is edema of the epiglottis (the lid larynx), which makes it difficult to swallow and that, in most cases, makes it difficult to breathe, other edema can affect vocal cords, especially their bottom surface, causing a delay in breathing or dyspnea, which can sometimes lead to may produce serious danger of asphyxia.

Chronic laryngitis will require you to consult with your doctor to find out what is causing the symptoms, possibly the overuse of your voice, smoking or drinking alcohol. If you don’t have any of these habits, the next causes that your physician will look for are allergic reaction, or viral or bacterial infection. This will require you to take blood tests, and a small tissue sample from your throat.

The next stop, if the tests above can’t confirm the cause, is to see an ENT (ear, nose and throat) specialist. He could recommend any, or all, of the following tests: computerized tomography (CT) scan, magnetic resonance imaging (MRI) or the biopsy. Now, don’t be alarmed, but these tests are usually used to be certain that your laryngitis isn’t caused by laryngeal cancer. It is not common, but it is very important to rule it out quickly, or confirm it early – if discovered early, the treatment will be far more effective.

Another often used test is laryngoscopy, a test that examines your throat with a fiber-optic camera to see if there are any damages. This test isn’t painful, but it can be unpleasant, because the camera may trigger your gag reflex.

How to treat laryngitis?

There are two objectives of laryngitis treatment: to remove the lesion and to check if it is benign and bring voice back to normal.

Even without treatment laryngitis tends to get better within a week, if you don’t smoke and avoid smoking environments, which will help your vocal cords heal. You should also drink plenty of water, which will ensure that you don’t get dehydrated, even if it hurts to swallow. If your laryngitis is followed by a headache or fever, you can take paracetamol or ibuprofen, or just an aspirin if you’re under 16; don’t take any antibiotics on your own, since laryngitis is usually caused by a virus. And if you can, avoid speaking, or try to speak softly, but not to whisper – whispering can actually damage the larynx even more.

If your laryngitis is prolonged, the treatment will depend on what is causing it, and only your physician can give you the right one. That may include antihistamines if the cause is an allergy, proton-pump inhibitors, if it’s caused by GORD (gastro-oesophageal reflux disease), a vocal therapy the symptoms are due to misusing or overusing your voice – or some other treatment.

How to prevent laryngitis?

We saw that the causes of laryngitis are many and different. The prevention of mechanical damage due to an injury isn’t something you can control, obviously. As far as viral laryngitis goes, there isn’t much you can do to prevent it, except for some general rules of thumb when your health is concerned, like maintaining good personal hygiene, avoiding people who are ill, not smoking, avoiding irritants, such as smoke. Professional speakers or singers, or people who use their voice excessively for any reason, should receive the proper training, so they don’t damage their voice.