Acute laryngitis refers to acute catarrhal inflammation of the laryngeal mucosa. It occurs more frequently during winter and spring and is a common acute respiratory tract infection.
Etiology
Infection
Acute laryngitis often follows a common cold, initially caused by a viral infection followed by secondary bacterial infection. Common causative viruses include influenza virus, parainfluenza virus, rhinovirus, and adenovirus. Common bacteria include Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae. The condition typically starts as acute catarrhal inflammation of the nasal cavity, nasopharynx, or oropharynx, which can spread downward to involve the laryngeal mucosa.
Excessive Voice Use
Overuse of the voice, such as prolonged talking, shouting, or intense and persistent coughing, can lead to acute laryngitis. Professions that involve frequent voice usage, such as teachers, actors, and salespersons, are more susceptible.
Allergic Reactions
Specific foods, gases, or medications can cause laryngeal mucosal swelling in individuals with hypersensitivity, resulting in acute laryngitis.
Other Factors
Laryngeal foreign bodies, trauma to the neck or pharynx, and injuries from examination instruments may lead to mucosal damage and laryngitis. Additionally, irritation from smoking or alcohol, exposure to cold, fatigue-induced weakened immunity, and inhalation of harmful gases or dust can also trigger the condition.
Symptoms
Acute laryngitis often develops after a cold and may be accompanied by systemic symptoms such as chills, fever, and fatigue. Local symptoms include the following:
Hoarseness
Hoarseness is the primary symptom of acute laryngitis. It occurs due to congestion and swelling of the vocal cord mucosa, initially causing a rough and low-pitched voice that may progress to hoarseness or even complete aphonia in severe cases.
Cough
Catarrhal inflammation of the laryngeal mucosa leads to cough and sputum production. If tracheitis or bronchitis accompanies the condition, coughing and sputum production become more pronounced.
Laryngeal Pain
Symptoms may include discomfort or pain in the larynx, which generally does not interfere with swallowing. Patients may experience dryness, burning sensations, or a foreign body feeling in the larynx. Mild pain in the larynx and anterior trachea may occur, and pain typically worsens during phonation.
Examination
Indirect laryngoscopy or flexible (electronic) nasopharyngolaryngoscopy shows acute congestion and swelling of the laryngeal mucosa, including the vocal cords. The inflammation is typically bilateral, symmetrical, and diffuse, with normal vocal cord mobility. Mucosal changes in acute laryngitis usually appear first in the vocal cords and may progress to involve congestion and swelling of the ventricular folds and subglottic mucosa. Swelling is most notable in the vocal cords and aryepiglottic folds.
Diagnosis
A history of cold symptoms or voice overuse, followed by hoarseness and other symptoms, along with findings of laryngeal mucosal congestion and swelling (especially vocal cord congestion) during indirect laryngoscopy, supports the diagnosis of acute laryngitis.
The most commonly used auxiliary examination is flexible (electronic) nasopharyngolaryngoscopy, which allows more detailed visualization of the supraglottic, glottic, and subglottic regions and assists in assessing the severity of the condition.
Treatment
Symptomatic Treatment
Nebulized inhalation can reduce laryngeal edema. Antitussive medications are used for severe coughing, while mucolytics or expectorants are prescribed for excessive sputum. Pain relief is provided for throat pain.
Etiological Treatment
Systemic antibiotics and corticosteroids are used when bacterial infection is present. Antiviral medications are administered for viral infections, and antibiotics are prescribed for secondary bacterial infections.
Supportive Treatment
Adequate sleep and rest, along with a balanced diet, are important in managing the condition.