Laryngitis

Laryngitis Facts

  • Laryngitis is the medical term for inflammation and swelling of the larynx, which is also known as the voice box.
  • Most of the causes of laryngitis, such as common viruses infections or using your voice too much, are not serious.
  • A few causes, however, require medical attention and can be cause for concern such as laryngeal cancer.
  • As such, when laryngitis persists, be aware that this may indicate a more significant medical problem.

Laryngitis Causes

If the laryngitis is from a viral or bacterial infection, it is possible that the specific virus or bacteria can be contagious. However, if the laryngitis is from laryngeal cancer or overuse of the voice, it is not contagious.

Laryngitis Symptoms

The most common symptoms of laryngitis

  • Hoarseness
  • Feeling a tickle in the throat (that may be from reflux laryngitis)
  • The urge to constantly clear the throat (that may be from reflux laryngitis)
  • Fever
  • Cough (that can be from bronchitis or sinusitis)
  • Congestion

Often laryngitis may develop in addition to, or a few days after a sore throat. Even after the infection has resolved, the laryngitis may linger for a few weeks.

Laryngeal Papillomatosis Symptoms

Normally, voice is produced when air from the lungs is pushed past two side-by-side elastic muscles - called vocal folds or vocal cords - with sufficient pressure to cause them to vibrate. When the tumors interfere with the normal vibrations of the vocal folds, it causes hoarseness, which is the most common symptom of recurrent respiratory papillomatosis (RRP). Eventually, the tumors may block the airway passage and cause difficulty breathing.

Because the tumors grow quickly, young children with the disease may find it difficult to breathe when sleeping, or they may experience difficulty swallowing. Adults and children may experience hoarseness, chronic coughing, or breathing problems. The symptoms tend to be more severe in children than in adults; however, some children experience some relief or remission of the disease when they begin puberty. Because of the similarity of the symptoms, recurrent respiratory papillomatosis is sometimes misdiagnosed as asthma or chronic bronchitis.

SOURCE: NIDOCD. Recurrent Respiratory Papillomatosis or Laryngeal Papillomatosis.

When to Seek Medical Care for Laryngitis

When to call the doctor

Sometimes laryngitis may be more serious and may indicate laryngeal cancer. Several symptoms should cause a person to see a doctor:

  • High fever with a sore throat
  • Coughing up yellow or green phlegm (possibly suggestive of bronchitis or sinusitis)
  • Coughing up blood
  • Inability to drink liquids
  • A history of throat or breathing problems
  • Symptoms that last for 2 to 3 weeks despite resting the voice
  • Weight loss
  • Associated swelling in the neck
  • Throat pain or discomfort

Children are different than adults because they are more likely to become infected with different microbes, and potentially may be contagious depending on the infecting organism.

  • If a child just has a hoarse voice, with or without other symptoms of a virus such as low-grade fever (less than 100.5 F or 38 C) runny nose, muscle aches, cough, or nasal congestion, then the treatment is the same as for an adult.
  • If the child has a fever, a sore throat, won't eat or drink, or has a decreased number of wet diapers (indicating less than adequate drinking) you should take the child to see a doctor.

When to go to the hospital

Some situations can be life threatening, and you must not delay seeing a doctor. Go to a hospital's emergency department or call 911 if you experience any of the following.

  • Any trouble breathing
  • Feeling as if your throat is closing
  • Inability to swallow
  • Drooling
  • Need to sit upright to breathe

If a child is drooling, has a whistling noise in his or her throat when breathing, or has any trouble breathing at all, then the child needs to go to the hospital.

Laryngitis Diagnosis

Many times you can be evaluated with a thorough complete history and physical exam.

  • The doctor will pay particular attention to the affected patient's ears, nose, throat, and neck.
  • If symptoms are severe, particularly in children, the doctor may order a neck or chest X-ray.
  • The doctor may also choose to look at the patient's throat with a small, lighted scope. This thin scope is inserted through the nose after numbing the nose and nostrils. The procedure only takes a few minutes and may yield valuable information, especially regarding the status of the recurrent laryngeal nerve that controls the movement of the vocal folds (vocal cords).
  • Sometimes in children, rarely in adults, the doctor may order blood work such as a complete blood cell count (CBC).

Laryngitis Home Remedies

If the symptoms have been present for only a few days or occur immediately following an episode of using the voice more than normal, then the main treatment is to rest the voice as much as possible. It is imperative to over-hydrate the body by drinking a lot of fluids.

  • If the affected person has symptoms that suggest a virus is present, such as low-grade fever, cough, nasal congestion, runny nose, muscle aches, or feeling run down, then he or she should be sure to drink lots of fluids and take acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) for the symptoms.
  • Many people find inhaling steam, such as from a hot bath or shower, or a cool mist humidifier makes them feel better.
  • In all cases the affected individual should avoid smoking, areas where others are smoking, and avoid alcohol consumption.
  • Often times, these home remedies should cure the laryngitis or improve it significantly. However, if the home remedies do not make it better, then a doctor should be consulted.

Laryngitis Treatment

After a careful exam the doctor will decide on a course of treatment.

  • Most of the time, the doctor will recommend the home care actions and may recommend that the patient see an ear, nose, and throat specialist (otolaryngologist). The otolaryngologist may be recommended if the primary care doctor has concern that a more serious medical condition is present, or if the laryngitis has persisted for a long period of time.
  • If the doctor is concerned about a bacterial infection causing the laryngitis, then he or she will prescribe a course of antibiotics.
  • Sometimes, the doctor may choose to observe the patient in the office or the emergency department for a short period of time in order to be sure he or she is not getting worse quickly.

If the patient has any signs of respiratory distress or think the airway could swell and close, then he or she will be admitted to the hospital.

  • In some emergency situations, more commonly in children than adults, the danger of the throat swelling shut exists. This is usually from a contagious infection.
  • It may be necessary to place a breathing tube into the patient's throat in order to breathe for him or her (the procedure is called intubation).
  • The patient will then be placed on a ventilator (a machine to breathe for them).
  • In this situation, the patient will receive IV antibiotics and likely steroids.

Laryngitis Follow-up

  • If the person has received a prescription, it must be filled right away and the affected individual must take all of the medicine, as instructed. In order to properly treat the illness and prevent a recurrence the person must not cut treatment short after feeling better.
  • The affected person should try to rest the voice as much as possible, be aggressive about rehydration and drinking liquids, and avoid smoking and exposure to secondhand smoke.
  • The person should always report to a doctor if he or she has a worsening of symptoms or high fever.
  • If the person has any trouble breathing or feel as if the throat is closing, then he or she should go to the emergency department. Use 911 emergency services if indicated.

Laryngitis Prevention

Because most cases of laryngitis are caused by viruses, the best prevention is making sure to wash hands often, especially before touching the face, to minimize the transmission of contagious microbes. Despite these efforts, much like a common cold, it is impossible to eliminate the risk altogether.

For children, it is important to receive the Haemophilus influenzae vaccine in order to protect them from possibly life-threatening contagious bacterial infections. Otherwise, taking care not to overuse the voice is the only other preventive step.

Laryngitis Prognosis

Chronic laryngitis is a concern. If the a person has a change in his or her voice, or hoarseness that lasts more than 2 to 3 weeks, a doctor should be consulted. This long-term voice change could be caused by an easily treatable condition such as acid reflux or being exposed to a substance that continues to irritate the vocal cords. It might be the first sign of a serious condition, however, such as a tumor on the voice box that needs medical attention. The hoarseness may be due to a laryngeal papilloma on the vocal folds or more worrisome, a laryngeal cancer; other lesions that affect the recurrent laryngeal nerve may also cause hoarseness.

Reviewed on 11/20/2017

Medically reviewed by Joseph Palermo, DO; American Osteopathic Board Certified Internal Medicine

REFERENCE: Feierabend RH, Shahram MN. Hoarseness in adults. Am Fam Physician. 2009 Aug 15;80(4):363-70. Review.

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