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LaryngitisIntroduction The larynx, or voice box, joins the back of the throat to the windpipe. The vocal cords that vibrate to produce sound are in the larynx. Laryngitis is inflammation of the larynx and is a common condition of the throat. Acute laryngitis is usually caused by a viral infection. It can sometimes occur at the same time as a cold and often gradually gets worse over a 2-3 day period. After this time, it usually eases, disappearing completely within a week. However, afterwards, you may have a croaky voice for a while until the inflammation of your vocal cords settles down and the virus is out of your system. Chronic laryngitis lasts much longer than acute laryngitis (sometimes weeks or months) and it is sometimes caused by persistent acute laryngitis. It is a condition that commonly affects smokers and singers. Symptoms Symptoms of acute laryngitis can begin suddenly and usually get worse over 2-3 days. However, after this time, your symptoms will often improve and you will usually feel much better within a week. Symptoms of laryngitis include: a hoarse voice, throat pain, difficulty speaking, sore throat, mild fever, headache, irritating cough, and a constant need to clear your throat. If you have laryngitis, you may not be able to talk at all, or you may only be able to whisper or croak. This gets worse as the day progresses and happens because the vocal cords are inflamed. Your croaky voice may last for a week after the other symptoms have gone. Laryngitis is often linked to another illness, such as a cold, flu, a throat infection (pharyngitis) or tonsillitis. Therefore, you may also experience a number of other symptoms, such as swollen neck glands, a runny nose, pain on swallowing and feeling tired and achy. Chronic laryngitis takes longer to develop and can last for weeks, or even months. It can lead to lasting hoarseness as a result of permanent damage to the larynx. Chronic laryngitis commonly recurs, particularly in people who overuse their voice, such as professional singers, or teachers who are unable to rest their voice for any length of time. Occasionally, swelling of the larynx may cause breathing difficulties. This is not very common in adults but sometimes happens in young children with smaller, narrower windpipes. You should see your GP as soon as possible if you, or your child, experiences difficulty breathing. Causes Acute laryngitis is caused by a viral infection, usually linked to the common cold or an upper respiratory infection. Laryngitis may also be a feature of bronchitis, pneumonia, or flu. Chronic (long-term) laryngitis may be caused by recurrent acute laryngitis that never fully gets better. It can also be made much worse by smoking, which aggravates the vocal cords and leads to a permanently husky voice. If you have had a hoarse voice for longer than 2-3 weeks, your GP may refer you to an ENT (ear, nose and throat) specialist. The inflammation of the larynx, can be caused by: drinking large amounts of alcoholic spirits, suffering shock or trauma, voice overuse or misuse, upper gastrointestinal disease, irritants or chemicals. Another cause of laryngitis may be a benign (non-cancerous) cyst on a vocal cord. However, a tumour (cancer) on the vocal cord does not commonly cause laryngitis. Diagnosis Most cases of acute laryngitis can be treated by the patient and there is no need to visit your GP. However, you should see a doctor if your: symptoms are very severe and last longer than 2-3 weeks, swollen glands appear in your neck without symptoms of infection, or swollen glands do not go down within 2-3 weeks after the infection has cleared up. An ear, nose and throat (ENT) specialist may be asked to examine your larynx if the symptoms do not clear up. This may involve a direct visual examination of the inside of your larynx using an instrument called a laryngoscope (a flexible, tube with a light that is used to look at your larynx). The specialist may also carry out an indirect examination of your airway using a mirror. Your larynx may be covered with mucus, be red and swollen and your vocal cords may look thicker, more rounded, and be stiffer than normal. If nodules (small lumps) are found on your vocal cords, further examination and treatment may be needed. Treatment Acute laryngitis usually gets better without treatment within a week. To help your vocal cords heal, it is important not to smoke, and you should also avoid being in a smoky environment. Other ways to treat laryngitis are listed below. Drink plenty of fluids, particularly water, even though it may be painful to swallow. This will ensure that you do not become dehydrated. Try to avoid excessively swallowing or coughing because it will irritate your vocal cords. Painkillers, such as paracetamol or ibuprofen, taken at regular intervals, may help to ease any associated headaches and fever. Gargling and lozenges will not actually reach the larynx but may soothe a sore throat. Various gargling solutions are available over-the-counter (OTC) from pharmacies. You should gargle for 3-4 minutes, but should not swallow the solution afterwards. Menthol inhalation and air humidifiers may help to clear your airways. Try to rest your voice and avoid shouting, singing, talking or whispering for long periods. If you overuse your voice when the vocal cords are inflamed, it may make the inflammation worse and take longer for your normal voice to return. Vocal therapy may help, particularly if you are at risk of permanently damaging your voice. As laryngitis is caused by a virus, antibiotics will not help and are not usually prescribed for general use. However, antibiotics may be prescribed if your laryngitis is severe and is caused by an infection. Prevention As laryngitis is a viral infection and often occurs at the same time as a cold or other infection, there is no obvious way of prevention. However making small changes to your lifestyle can help. These changes should include: good personal hygiene (washing your hands before and after eating and after using the toilet), avoiding people who are ill, particularly if you are prone to laryngitis, avoiding smoking, avoiding irritants, such as smoke, particularly if you have a cold or other respiratory infection, avoiding clearing your throat as this can make your symptoms worse, try swallowing instead, and raising your head off your bed with pillows when you are sleeping. This will protect your larynx from any acid reflux from your stomach during sleep. Professional singers or people who use their voice excessively on a daily basis are particularly prone to laryngitis, so it is essential that they receive proper training so they do not damage or misuse their voice. Steam inhalations can bring relief to people suffering from laryngitis and often the addition of certain essential oils can help. The best ones to try are Benzoin, Lavender, Sandalwood and Thyme. |
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