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Laryngitis

Definition

Laryngitis is swelling and irritation (inflammation) of the voice box (larynx) that is usually associated with hoarseness or loss of voice.

Causes, incidence, and risk factors

The voice box (larynx) is located at the top of the airway to the lungs (trachea). The larynx contains the vocal cords. When the vocal cords become inflamed or infected, they swell. This can cause hoarseness, and may sometimes block the airway.

The most common form of laryngitis is an infection caused by a virus, such as cold or flu viruses. It may also be caused by:

• Allergies
• Bacterial infection
• Bronchitis
• Gastroesophageal reflux disease (GERD)
• Injury
• Irritants and chemicals
• Pneumonia

Laryngitis often occurs with an upper respiratory infection.

Several forms of laryngitis occur in children that can lead to dangerous or fatal respiratory blockage. These forms include:

• Croup
• Epiglottitis

Symptoms

• Fever
• Hoarseness
• Swollen lymph nodes or glands in the neck

Signs and tests

A physical examination can determine whether hoarseness is caused by a respiratory tract infection.

Patients with hoarseness that lasts for more than a month (especially smokers) will need to see an ear, nose, and throat doctor (otolaryngologist) for tests of the throat and upper airway.

Treatment

Because most common laryngitis is caused by a virus, antibiotics may not help. Your health care provider will make this decision.

Resting your voice helps by reducing inflammation of the vocal cords. A humidifier may soothe the scratchy feeling that comes with laryngitis. Decongestants and painkillers may relieve the symptoms of an upper respiratory infection, if you have one.

Support Groups

Expectations (prognosis)

Laryngitis that is not caused by a serious condition should get better.

Complications

Rarely, severe respiratory distress may develop. This will require medical attention.

Calling your health care provider

Call your health care provider if:

• A small child who is not teething has difficulty breathing, swallowing, or is drooling
• A child less than 3 months old has hoarseness
• Hoarseness has lasted for more than 1 week in a child, or 2 weeks in an adult

Prevention

• Try to avoid people who have upper respiratory infections during cold and flu season.
• Wash your hands regularly.
• Avoid crowded places.

Stopping smoking may help prevent tumors of the head and neck or lungs, which may lead to hoarseness.

References

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 5th ed. St Louis, Mo; Mosby; 2010; chap 63.

Schwartz SR, Cohen SM, Dailey SH, et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg. 2009 Sep;141(3 Suppl 2):S1-S31.