Content

Introduction

Laryngitis is inflammation of the larynx and the vocal cords present in it.

The larynx is part of the upper respiratory tract, appears as a hollow cylinder supported by cartilage structures, muscles and ligaments that allow the movement of the vocal cords. It is located at the level of the neck just above the trachea.

The larynx performs three important functions:

  • channel the air, towards the trachea, bronchi, bronchioles and lungs (lower airways)
  • allow the emission of sounds (phonation), through the vibration of the vocal cords
  • prevent the food that is going to be swallowed to enter the respiratory tract, directing it correctly, thanks to the epiglottis (elastic-type cartilage lamina), into the esophagus from which it will then pass into the stomach

The most common disorders (symptoms) of laryngitis are:

  • hoarseness or loss of voice
  • sore throat
  • dry cough and irritating
  • feeling of itch in the throat
  • breathing difficulties

Laryngitis can appear suddenly (acute) or persist over time (chronic). There acute form, in general, it is caused by an "inflammation of viral origin (rarely bacterial) or by a vocal effort. chronic form it is due to the inhalation of irritating substances, such as cigarette smoke, gastroesophageal reflux or chronic sinusitis. Most laryngitis heals spontaneously, without the need for special treatments. However, if the disturbances (symptoms) continue over time it is good to contact your doctor.

Symptoms

The most common and typical disorders (symptoms) of laryngitis are:

  • lowering of the voice
  • aphonia (lack of voice)
  • difficulty speaking
  • dry throat
  • sore throat
  • feeling of itchy throat
  • cough dry and peevish
  • breathing difficulties

The symptoms (symptoms) typical of acute laryngitis usually appear suddenly and tend to get worse in a short time. The manifestations of chronic laryngitis, on the other hand, worsen slowly and progressively over several weeks. Acute laryngitis lasts about 10 days; if it persists for more than three weeks, it is referred to as chronic laryngitis.

Most laryngitis heals spontaneously without the need for treatment. In the event that after 10 days there are still problems, it is advisable to contact your doctor to trace the precise cause of the problem and set the most appropriate therapy.

Causes

The causes of laryngitis are numerous and different depending on whether it is acute or chronic laryngitis.

There acute form it can be caused by:

  • viral infections, the most common form of laryngitis. The main viruses responsible are: influenza, parainfluenza and cold viruses (rhinovirus, respiratory syncytial virus, coronavirus, adenovirus)
  • bacterial infections, very rare. Haemophylus influenzae type b can cause a particularly severe form of laryngitis affecting the epiglottis (epiglottitis)
  • exanthematous diseases, both of viral and bacterial origin such as measles, chicken pox, whooping cough can be associated with acute laryngitis
  • non-infectious causes, acute laryngitis can also arise from prolonged vocal effort (for example, speaking in a very loud tone of voice)

Chronic laryngitis may appear as a result of:

  • chronic inhalation of irritants, such as dust, smoke and toxic substances
  • allergies or use of asthma inhalers
  • chronic abuse of alcohol
  • cigarette smoke, heavy smokers often suffer from chronic laryngitis
  • gastroesophageal reflux disease
  • chronic sinusitis, inflammation of the mucous membrane that lines the sinuses
  • fungal-type infections, rare, affect individuals with a weakened defense system of the organism (immunocompromised) or develop as a consequence of therapies with inhaled corticosteroids (aerosols)
  • laryngeal cancer

Diagnosis

In the most severe or chronic cases, to assess the actual state of health of the larynx and vocal cords, the doctor can perform an instrumental examination, laryngoscopy:

  • indirect laryngoscopy, a very simple procedure which consists in introducing a small mirror at the back of the mouth to see, with the help of a light source, the larynx
  • direct laryngoscopy, carried out using a laryngoscope, a flexible fiber optic tube equipped with a camera connected to a computer. It is inserted through the nose and allows you to explore all the organs up to the throat. Compared to indirect laryngoscopy, the examination is much more accurate since it allows a better visualization of the larynx and vocal cords. It also allows the removal of laryngeal tissue to perform a possible biopsy in case of suspected tumor of the larynx

If the doctor suspects the presence of a tumor of the larynx, he may also order other tests such as computed tomography (CT) and nuclear magnetic resonance (MRI).

Therapy

Most laryngitis is of viral origin and therefore heals spontaneously within a week without resorting to specific treatments.

To speed up healing and relieve the ailments (symptoms) caused by laryngitis, it is useful:

  • do not talk, unless strictly necessary and not too loudly
  • drink plenty of fluids, especially water, to avoid dehydration of the mucous membranes. Instead, alcoholic beverages and coffee should be avoided
  • not smoking, also try to avoid secondhand smoke and dry and dusty environments
  • take anti-inflammatory drugs (paracetamol, ibuprofen), in case the person complains of pain in the throat and headache

If the cause of laryngitis, on the other hand, is gastroesophageal reflux, the doctor may prescribe drugs that decrease the acidity of gastric secretions (antacids or proton pump inhibitors).

Laryngitis of allergic origin must be treated with antihistamines and it is necessary to avoid contact with allergens (substances responsible for allergy). The use of corticosteroids is not recommended, except in the case of complications such as, for example, laryngotracheobronchitis.

Prevention

There is no surefire way to prevent laryngitis. However, some simple guidelines may help, including:

  • wash your hands often
  • avoid contact with people with upper respiratory infections, like colds
  • avoid clearing your throat and coughing, so as not to worsen the present ailments (symptoms)
  • do not smoke and avoid secondhand smoke, smoking dries the throat and irritates the vocal cords
  • avoid irritants
  • avoid eating spicy foods
  • drink a lot of water
  • humidify the rooms

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