Anatomically, the larynx represents the separation between the airways and the entrance to the gastrointestinal tract. During breathing, the entrance to the trachea is closed by the epiglottis. If a person takes in food in the oral cavity, it begins to chew and thus initiates the act of swallowing, the epiglottis closes and lies on the trachea.
This mechanism normally prevents the passage of food into the respiratory tract. Pain that occurs in the larynx is not uncommon. However, the mechanisms responsible for this can vary greatly from one another.
Roughly speaking, inflammatory processes in the larynx, infections by viral or bacterial pathogens, functional disorders and malignant changes can lead to pain in the larynx. The diagnosis is usually made using a mixture of physical function tests and imaging techniques. Even the most appropriate therapy is determined by the underlying disease. Due to the large number of diseases that can lead to pain in the larynx, it is impossible to make a generally valid prognosis.
Causes
Pain in the larynx can be caused by various factors. In everyday clinical practice, a distinction is made between rather “harmless” and “more serious” diseases. Even a minimal mechanical trauma (for example, a small injury in the nasopharynx) can cause severe pain in some patients, the localization of which is attributed to the larynx.
In such cases it is also noticeable that the pain increases both during eating and drinking. The most common diseases that lead to pain in the larynx are Furthermore, laryngeal pain can occur after vomiting.
- Acute laryngitis (synonym: pseudocroup)
- Epiglottitis
- Epiglottis edema
- Chronic Laryngitis
- Diphtheria
- Laryngeal Paralysis
- Benign tumors of the larynx
- Vocal fold nodules
- Throat Cancer
- Cancer of the vocal fold
Synonym: Pseudocroup (Main article) The disease known as “acute laryngitis” is a sudden inflammation of the larynx accompanied by pain.
In the vernacular, acute laryngitis is better known as “pseudocroup“. Triggered by bacterial and/or viral pathogens, it causes local swelling in the area of the respiratory tract and larynx. As a result, the diameter of the airways (especially in children) becomes enormously narrowed.
In addition to the larynx pain felt by the affected patients, acute laryngitis is characterized by a typical “barking” cough and pronounced shortness of breath, especially in children. In the area of the thorax and abdomen of the affected children, clear retractions can be observed as an indication of difficult breathing. For the parents of children suffering from an acute attack with pain in the larynx, it is extremely important to remain calm and to present the child to a pediatrician as soon as possible.
In addition, cold humid air is considered to be particularly helpful. In winter, it is therefore important to open the window and to step in front of the open window with the affected child wrapped in a warm blanket. On hot summer days, the open refrigerator can be used.
In most cases, even these simple measures show a significant improvement within a few minutes. Treatment at the doctor’s is usually done by inhaling bronchodilator substances and, if necessary, by applying a cortisone suppository (rectodelt). Epiglottitis (inflammation of the larynx) is a disease caused by bacterial pathogens.
In most cases, bacterial colonization of the larynx is based on an immune system weakened by viruses. One speaks of a bacterial superinfection. Since the mucous membranes are severely affected in the presence of such an inflammation of the larynx, the result is severe pain and corresponding general symptoms (e.g. fever).
In addition, most of the affected patients suffer from swallowing difficulties with pain, hoarseness, coughing and shortness of breath. The most common pathogen causing laryngitis is Haemophilus Influenza. For this reason, the only effective prophylaxis is an early vaccination already in infancy.
Epiglottitis is a potentially life-threatening disease. Diphtheria is a highly contagious, acute infectious disease of the upper airways.The germ responsible for this clinical picture is a Gram-positive Corynebacterium diphtheriae. Already two to six days after infection (incubation period: 2-6 days) the first symptoms appear in affected patients.
In addition to severe pain in the larynx, patients usually experience fatigue, nausea and increasing fever. The pain in the throat felt by the patient usually increases significantly in intensity during the act of swallowing. Yellowish-white coatings can be seen in the area of the infected person’s tonsils.
These coatings can spread over the entire throat area within a very short time. In addition to the already described pain in the throat, a foul-sweetish halitosis is one of the typical symptoms of diphtheria. If the noses are also colonized by pathogens, the pain usually occurs together with a thin or purulent blood rhinitis.
Patients in whom the entire throat area is colonized are referred to as laryngeal diphtheria (synonym: croup). The affected patients also suffer from severe pain in the larynx. In addition, they exhibit a barking cough, increasing hoarseness and loss of voice (aphonia).
Breathing is also severely restricted in the affected patients. Pain and clearly audible whistling noises (stridor) occur especially during inhalation. The treatment of diphtheria with pain in the larynx is done by administration of antitoxins and antibiotics (penicillin).
Throat cancer (technical term: laryngeal carcinoma) is caused by the formation of malignant cells in the area of the larynx. The painful tumor of the larynx is one of the most common malignant diseases in Germany. The symptoms (e.g. pain) differ significantly depending on the exact location of the tumor.
The most important risk factors for the development of a tumor of the larynx are the consumption of tobacco products and alcoholic beverages. In addition, various viruses can be involved in the development of a laryngeal tumor with pain. Other important risk factors are asbestos, nickel, chromium, arsenic and benzpyrene.
The treatment of a laryngeal tumor with pain depends on the location of the tissue growth. In early stages, partial surgical removal of various parts of the larynx may be appropriate. Advanced forms of the disease can be treated by a combination of surgery, chemo- and radiotherapy.
The most important diagnostic tools used to determine the cause of laryngeal pain are the detailed doctor-patient consultation (anamnesis), physical examination and various imaging procedures. A so-called laryngoscopy is usually performed to examine the larynx. This method is an imaging procedure that in most cases can be performed completely without pain.
During the direct laryngoscopy, the treating doctor uses a thin blade and a small lamp. In this way, the larynx can be seen and any changes can be examined directly. During indirect laryngoscopy, a mirror and a small lamp are used.
In this way, the treating physician can see down to the vocal folds and thus assess their appearance and mobility. Furthermore, in case of pain in the larynx, a so-called microlaryngoscopy can be performed for a more precise assessment. However, this procedure must usually be performed under general anesthesia.
The advantage of microlaryngoscopy for laryngeal pain is the direct removal of tissue samples. In addition, computer tomography (CT) and magnetic resonance imaging (MRT) images can be obtained. The taking of blood samples to determine different blood values is also useful.
