Laryngitis, or inflammation of the larynx, is an infection of the larynx, which is part of the upper respiratory tract. In the following, the clinical picture with course and therapy is described in more detail.
What is laryngitis?
Schematic diagram showing the anatomy of the vocal cords and their various diseases. Click to enlarge. Laryngitis is also known as laryngitis; the most common triggers are viruses or bacteria. Laryngitis is divided into acute and chronic forms, which are evaluated by an otolaryngologist. Acute laryngitis can often occur in addition to bronchitis, sinusitis or a cold. In addition to the viral infection, a second infection then develops due to bacteria, which eventually triggers the laryngitis. Chronic laryngitis, on the other hand, may be present if inflammation of the vocal folds has occurred for several weeks. In this case, the mucous membrane of the entire larynx is inflamed and swollen. Both forms are manifested by hoarseness, dry cough and sore throat. In the acute form, the affected person has a rough voice or even a loss of voice, pain when swallowing and a feeling of dryness in the throat. In the chronic form, a foreign body sensation in the throat is typical, as well as frequent irritating cough.
Causes
There are, in addition to the above-mentioned causes, others, such as smoking, intense heat, pollutants in the air or an overload of the voice. Mostly, however, viral pathogens are the cause of acute laryngitis, for example, the adenoviruses or rhinoviruses. If the voice is not sufficiently protected, it can turn into chronic laryngitis. Other causes of chronic laryngitis are long-term inhalation of chemicals (occupational) or tobacco smoke, constantly air-conditioned and relatively dry room air, breathing through the mouth, frequent rhinitis or tonsillitis. Singers can also suffer from this due to overuse of the vocal cords.
Symptoms, complaints and signs
The typical symptoms of laryngitis or laryngitis are dry irritating cough, a lumpy feeling in the throat and severe hoarseness. The symptoms are triggered by an inflammation of the laryngeal mucosa. A distinction is made between an acute and a chronic form of the disease. Most of the symptoms of laryngitis are caused by viruses. If bacterial pathogens are also present, this can lead to complications and significantly more severe symptoms. Rather rarely are exclusively bacterial pathogens responsible for the occurring complaints. These usually occur in the context of a severe cold or a flu-like infection. The first signs that it is more than an ordinary cold are found in barking cough and severe hoarseness. Breathing may be difficult. Severe sore throat and difficulty swallowing in the larynx or below also indicate an infection in that area. If symptoms worsen to the point of more severe difficulty breathing or higher fever, a physician should be consulted. The symptoms of chronicized laryngitis are similar without an acute infection being the trigger. In this case, chronic irritation of the laryngeal mucosa is the cause of the persistent symptoms. People with frequent exposure to pollutants or industrial exhaust inhalation, chronic smokers, or those with chronicized inflammation of the sinuses and bronchi often all exhibit symptoms of laryngitis.
Disease progression
The course of laryngitis can be positively influenced by prompt treatment. Especially if the causes are eliminated, nothing can stand in the way of a quick recovery. For example, sparing the voice is already very supportive, even if no voice is already audible, speaking should be avoided as much as possible. In case of inconsistent treatment, a chronic inflammation can develop up to a functional voice disorder. Normally, laryngitis can progress without complications if treated properly and quickly. In children, however, there is a risk of respiratory distress due to swelling of the vocal folds. In any case, laryngitis must be treated, as it may become chronic and may even develop into a precancerous condition.Acute laryngitis should also be monitored by a physician.
Complications
Laryngitis (inflammation of the larynx) usually heals well after a few days with a little rest. However, complications may occur. In a particularly severe course, the vocal folds are covered with white fibrin. This is called fibrinous laryngitis. If the inflammation is very severe, the vocal cords may swell to such an extent that acute respiratory distress occurs. If the internal structures of the larynx are also inflamed, persistent voice disorders may occur after the inflammation has subsided. These manifest themselves in a hoarse, breathy vocal sound and rapid vocal fatigue. The cause is incomplete closure of the vocal folds, which can, however, be restored with targeted vocal exercises. If bacteria are the cause of laryngitis, it can also be progressive. In this case, phlegmons or abscesses form in the larynx. The first symptoms are severe pain on swallowing, which often radiates to the ears. Antibiotics are helpful here. In extreme cases, the laryngeal cartilages are affected, leading to shortness of breath and severe pain when palpating the larynx. In addition to antibiotics, surgical intervention is required, in which the abscess is opened. If such laryngitis remains untreated, so-called Reinke’s edema sometimes develops in the course. This is a growth on the vocal cords that is filled with fluid. Reinke’s edema should be surgically removed.
When should you go to the doctor?
People who suffer from sore throat and difficulty swallowing should see a doctor. If the symptoms persist for several days, increase in intensity, or spread further, medical care should be sought. Hoarseness, changes in vocalization, and decreased vocal strength should be monitored and treated by a physician. Often, sufferers can only communicate in whispers because the impairment of the vocal cords is severe and prevents the usual vocalization. If an irritating cough occurs with or without expectoration, a visit to the doctor is advisable. If there is frequent throat clearing, scratchy sensations in the throat, or a foreign body sensation in the throat, a physician should be consulted for clarification of symptoms. A feeling of illness, general malaise, and internal weakness should be examined by a physician. If a fever or elevated body temperature occurs, a doctor’s visit is required to determine the cause. If there is a refusal to take in food or fluids, a decrease in weight or a feeling of internal dryness, a doctor should be consulted as soon as possible. There is an undersupply of the organism, which must be treated. If there is a decrease in the usual level of performance, sleep disturbances, increased irritability or an increased need for sleep, a doctor should be consulted.
Treatment and therapy
Laryngitis must be treated in any case! Pollutants should be avoided, especially if you are also a smoker. Equally irritating are hot spices or alcohol. If the workplace is the reason for laryngitis, it may be that only after a change of job an improvement occurs, respectively that further laryngitis or a chronic one can be avoided. In case of inflammation during a cold or bronchitis, of course, these should also be treated. It is possible that even with antibiotics must be treated. To help cough up thick mucus, the family doctor will also prescribe secretion-relieving and anti-swelling medications. Since dry air promotes laryngitis, steam inhalations are also recommended. It should be – especially then – breathed through the nose. Since children are at risk of respiratory distress, they should stay in the hospital for a few days as a precaution. If overuse is the trigger of laryngitis, it may be possible to learn proper voice insertion from a speech therapist.
Outlook and prognosis
The prognosis of laryngitis is favorable. Under optimal conditions, the disease heals completely within a few days. Consequential damage or impairment is not expected in most cases. Medical care is not absolutely necessary. With sufficient rest and sparing, the affected person often experiences relief from the symptoms within a short period of time and subsequently freedom from symptoms.If the consumption of harmful substances such as nicotine is refrained from, this significantly improves the recovery process. In the case of a weakened immune system or other existing diseases, consultation with a doctor is recommended. The doctor will support the healing process by administering medication and can give important advice on how to deal with the disease in general. In exceptional cases, an unfavorable course of the disease develops. In these patients, surgical intervention becomes necessary in addition to the administration of medication. If an abscess has formed, it is opened during the operation. This allows fluids that have formed to be drained off and relieves the symptoms. If edema has developed, it is also surgically removed. If no further complications occur during surgery, the patient is usually discharged from treatment as cured within a few days. Some rest is still required for regeneration and a subsequent check-up visit. Subsequently, freedom from symptoms occurs in this case as well.
Prevention
Acute laryngitis can only be prevented to a limited extent, as it is usually a sudden concomitant disease of colds. However, it can be prevented with a strong immune system, for example, through exercise, a healthy diet and fresh air. At the first signs of laryngitis, a doctor should be consulted to treat as soon as possible. Protective masks should always be worn in occupations involving harmful substances and smoking should be stopped if susceptible. Singers should pay attention to the correct use of their voice.
Aftercare
Laryngitis can be optimized in its healing through consistent aftercare and also prevented from flaring up again as part of prevention. Contact persons for the patient in this context are the ENT physician, but also the family doctor. In some cases, a visit to a speech therapist’s office also proves helpful. Follow-up care is closely linked to the cause of the laryngitis. If the cause was an infection, aftercare also includes stabilizing the immune system again. This can be achieved through sufficient sleep, a healthy diet and exercise in the fresh air. If the laryngitis was caused by heavy vocal strain and has also affected the vocal cords, the speech therapist can improve speech practice. Occupational groups that have to speak a lot particularly benefit from this and can prevent a recurrence of laryngitis in many cases. In any case, smoking should be avoided after laryngitis in order not to further affect the irritated region. Sufficient liquid as well as sucking sweets, for example with sage, are optimal. Hot milk with honey, a classic among home remedies, can also be included in aftercare. It moistens the mucous membranes and can stop renewed bacterial growth. Whispering and throat clearing are not recommended during and after laryngitis.
What you can do yourself
If laryngitis is suspected, a doctor should be consulted first. Medical treatment can then be supported by some self-help measures and home remedies. Initially, bed rest and warmth apply. The larynx should not be stressed too much for a few days so that the inflammation can heal without complications. A warm larynx is best achieved by warm compresses or by a hot, damp towel. Since dry air affects the mucous membranes, the humidity in the bedroom should be adjusted. The best way to do this is to use a humidifier or damp cloths over the heating. Classic remedies such as warm milk with honey or herbal tea relieve the pain. Inhaling steam, preferably with additives such as anise, eucalyptus, fennel or chamomile, helps against throat clearing attacks. For acute symptoms, small sips of cool water are recommended. Hot water also helps – a glass with some lemon juice and diluted tea and the pain should subside. Caffeine and nicotine should be avoided during laryngitis. Vitamins and an overall healthy and balanced diet are better. If the symptoms do not recede despite all these measures, a visit to the doctor is recommended.
