Introduction
Laryngitis is an inflammation of the larynx. A distinction is made between an acute and a chronic form. While the acute form is usually caused by bacteria or viruses, the causes of chronic laryngitis are usually long-term stress on the vocal folds, for example through misuse of tobacco or alcohol, inhalation of dry, dusty air, excessive strain on the vocal cords or reflux of gastric juice into the esophagus. In rare cases, especially if the voice is not protected, an acute inflammation can develop into a chronic inflammation.
Cause
Acute laryngitis is usually caused by viruses, parainfluenza viruses are particularly common, but others (influenza viruses, adenoviruses, rhinoviruses, enteroviruses or RS viruses) are not uncommon. Bacteria usually appear in this clinical picture as so-called superinfection, which means that they sit on an already inflamed larynx. In most cases, the acute form develops in the context of an upper respiratory tract disease, such as a cold or sinusitis, but sometimes an inflammation can also rise from below, for example in bronchitis. Harmful substances rarely lead to the typical picture of an acute inflammation.
Classification
Acute laryngitis is divided into three groups according to its exact location in relation to the glottis: The inflammation of the supraglottis (epiglottitis) is bacterially caused, takes a highly acute course and represents a life-threatening emergency, the remaining variants of the larynx inflammation are however rather harmless and heal with most concerning within some days again by itself.
- There is the supraglottic inflammation (above the glottis)
- The glottal inflammation (in the area of the glottis) and
- The subglottic inflammation (below the glottis), often called pseudocroup.
Symptoms
The classic acute laryngitis is particularly noticeable through the two main symptoms coughing and hoarseness. The painful cough is often described as “barking”, especially in the case of subglottic laryngitis in small children. It often scratches the throat, so patients describe it as having the feeling of having to clear their throat permanently.
Hoarseness is often accompanied by a rough voice, which can sometimes even develop into complete loss of voice (aphonia). It is not uncommon for laryngitis to cause swallowing difficulties and pain, which occasionally leads to children refusing to eat. Fever only occurs in exceptional cases.
In very rare cases, an acute laryngitis can take a serious course and cause swelling of the soft tissues of the larynx, compressing the windpipe and causing breathing difficulties. This complication is more likely to occur in smaller children. Children can also get laryngitis.
The main symptom here is hoarseness in children. Symptoms of an inflammation of the vocal cordsIf the inflammation persists for three weeks or more, one speaks of a chronic laryngitis. Although it is in principle accompanied by the main symptoms of coughing and hoarseness, it differs in one important respect from the acute form of laryngitis.
On the one hand, the quality of the cough changes, which is now more of a irritable cough, and there is a permanent feeling of foreign bodies or even dryness (globus sensation) in the throat. In addition, the voice often changes, becoming somewhat deeper, quieter and less resilient, and the compulsion to clear the throat is now also more pronounced. However, those affected suffer less from pain than those with acute inflammation.
If the inflammation is caused by a gastric juice reflux, the symptoms often appear mainly at night. In the case of chronic inflammation, treatment and regular visits to the doctor are particularly important, as the chronically inflamed mucous membrane of the larynx can degenerate, resulting in a preliminary stage of laryngeal cancer. According to current knowledge, the degeneration risk of a chronic inflammation of the larynx is at least 10%.
Dry, tormenting cough, as well as a feeling of dryness which is accompanied by a coughing irritation, are typical symptoms of an acute laryngitis. In the two special forms of laryngitis, the occurrence of coughing can be helpful in the differential diagnostic differentiation.In laryngitis subglottica (pseudocroup), an inflammation below the glottis, the rough, dull cough, often described as “barking”, is characteristic. In comparison, epiglottitis (laryngitis supraglottica) is rarely accompanied by a cough. When it does, a slight clearing of the throat can be observed.
