What is laryngitis?

Causes and Symptoms

The larynx, located directly above the windpipe (trachea), is the short, hollow tube containing the vocal cords,
two heavily lined slits in a mucous membrane. Voiced sounds, such as vowels, result when air from the lungs induces vocal fold vibration. Laryngitis occurs when the folds are obstructed or do not vibrate properly; depending on the cause, laryngitis is classified as simple, chronic, diphtheritic, tuberculous, or syphilitic.

Simple laryngitis may be caused by bacterial infection (common cold, typhoid fever), a virus (influenza), or nonbacterial irritants (chemical fumes, dust, or tobacco smoke). The primary infection site is the mucous membrane lining the larynx. It becomes red and swollen, secreting a viscous discharge that impedes vocal fold vibration. In severe cases of viral infection, the larynx may become completely obstructed, causing suffocation.

Chronic laryngitis often results from excessive smoking, alcoholism, or consistent strain or abuse of the voice. It is an occupational hazard of auctioneers, orators, singers, and those who frequently shout for long periods, such as cheerleaders. Nondisease-induced chronic laryngitis may also be instigated by hysteria, allergic reaction, remote disease of the nerves serving the voice, strong external pressure against the larynx, or irritation caused by tubes inserted down the throat to sustain breathing.

Diphtheritic laryngitis occurs when diphtheria
afflicting the upper throat spreads to the larynx. The result may be a membrane of diseased cells infiltrating the mucous membrane and obstructing the vocal cords.

Tuberculous laryngitis is a secondary infection spread from the lungs. Tubular nodulelike growths are formed in larynx tissue, leaving ulcers on the surface. Starting at the vocal cords, this infection may spread over the entire larynx and eventually destroy the epiglottis and laryngeal cartilage.

Syphilitic laryngitis is one of the many complications of syphilis. Sores or mucous patches form in the larynx, eventually producing tissue destruction and scar formation. The mucous membrane becomes dry and covered with polyps (small bumps of tissue that project from the surface). These polyps distort the larynx, shorten the vocal cords, and produce persistent hoarseness.

Treatment and Therapy

Simple laryngitis is best treated by resting the voice. When it is absolutely necessary to speak, it should be with a soft, breathy voice, not a whisper. The throat should be kept well lubricated by frequent drinks of water and not cleared. Relative humidity in the recovery room should be maintained at 40 to 50 percent, and alcohol, tobacco, and decongestants should be avoided. Complete recovery usually occurs within several days.

A persistent hoarseness indicates a bacterial infection (usually curable by antibiotics) or polyps, cysts, or other fibrous growths on the vocal cords. These growths may become ulcerated and require surgical intervention. Although cancer of the larynx is not uncommon (2 percent of malignancies), it is usually completely curable if detected sufficiently early.

Systemic diseases not localized in the larynx, such as tuberculosis and syphilis, are best treated by antibiotics.

Bibliography:

Bellenir, Karen, and Peter D. Dresser, eds. Contagious and Noncontagious Infectious Diseases Sourcebook. Detroit, Mich.: Omnigraphics, 1996.

Colton, Raymond H., Janina K. Casper, and Rebecca Leonard. Understanding Voice Problems: A Physiological Perspective for Diagnosis and Treatment. 3d ed. Philadelphia: Lippincott Williams & Wilkins, 2006.

Icon Health. Laryngitis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, Calif.: Icon Health, 2004.

LaRusso, Laurie. "Laryngitis." Health Library, January 9, 2013.

Mayo Clinic. "Laryngitis." Mayo Clinic, June 28, 2012.

Ossoff, Robert H., et al., eds. The Larynx. Philadelphia: Lippincott Williams & Wilkins, 2003.

Sataloff, Robert T., ed. Reflux Laryngitis and Related Disorders. 4th ed. San Diego, Calif.: Plural, 2013.

Swartzberg, John Edward. Wellness Self-Care Handbook: The Everyday Guide to Prevention and Home Remedies to Over 150 Common Ailments. New York: Times Books, 1999.