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Home > Ear, Nose & Throat > Throat > How to Treat and Prevent Laryngitis, Explained by an ENT

How to Treat and Prevent Laryngitis, Explained by an ENT

October 16, 2019 - Updated on July 16, 2021
7 min read
By Supriya Mathur, MD | Otolaryngologist

In this article:

  • About the Larynx
  • What Is Laryngitis?
  • What Are the Causes of Laryngitis?
  • Treatment for Laryngitis
  • How Can Laryngitis Be Prevented?
  • Is Honey Beneficial for Laryngitis?
  • Laryngitis Comorbidities
  • When to See a Doctor
  • Final Word

Laryngitis refers to a medical problem characterized by inflammation in the larynx. It is usually caused by a viral infection and resolves within 2 weeks.

laryngitis

However, in some cases, laryngitis may be prolonged due to an underlying complication. The following article discusses the causes, treatment, and prevention of laryngitis.

About the Larynx

anatomy of the larynx

The larynx is a tubular organ that contains the vocal cords within a skeletal framework made of cartilage. It is also called the voice box.

It is common knowledge that the vocal cords are required for sound production, which enables humans to talk. Aside from enabling oral communication, the vocal cords serve another vital function of protecting the airway by stimulating the cough reflex.

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The cough reflex is an internal mechanism that prevents foreign bodies, saliva, food, etc., from getting into the lungs.

What Is Laryngitis?

Laryngitis (1) is the inflammation of the larynx due to an infection or irritation. (2) This condition usually develops rapidly and is most often seen in an infectious setting. However, it resolves within 2 weeks and is known as acute laryngitis.

In some situations, laryngitis can last for a longer time. When laryngitis persists for more than 3 weeks, it is referred to as chronic laryngitis. (3)

Swollen vocal cords are unable to come together and vibrate to produce the normal voice. In most cases, laryngitis causes the patient’s voice to become unusually husky, raspy, or hoarse.

Laryngitis can also cause pain in the throat, which may be constant or aggravated by the movement of the vocal cords while talking or swallowing.

What Are the Causes of Laryngitis?

The most common cause of infectious laryngitis is a viral infection, which can spread from one person to another quite easily. Certain unhealthy habits and medical conditions can also irritate the larynx, leading to inflammation.

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Irritation-induced laryngitis (4) is not contagious and is usually associated with:

  • Excessive smoking
  • Acid reflux
  • Allergies
  • Excessive or incorrect use of your voice
  • Excessive vomiting
  • Severe coughing (5)

Treatment for Laryngitis

Most cases of laryngitis are mild and self-limiting and will go away with supportive care such as rest and fluids. Medical assistance may be warranted in the following cases:

1. Reflux of stomach contents (laryngopharyngeal reflux)

laryngopharyngeal reflux

Reflux of stomach contents (acid, enzymes) known as laryngopharyngeal reflux is a common cause of chronic laryngitis. (5)

Behavioral and lifestyle changes are the best way to control and curb this problem and include:

  • Eating small meals, especially dinner
  • Not laying down for 2–3 hours after a meal
  • Sleeping with the head elevated
  • Avoiding certain foods
  • Abstaining from smoking and alcohol
  • Losing weight

Sometimes acid reflux suppressants may also be needed.

2. Allergies and chronic sinusitis

Allergies and chronic sinusitis can also lead to laryngitis. Controlling them can be helpful in avoiding laryngitis.

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Control measures include:

  • Allergen avoidance
  • Taking antihistamines
  • Sinus rinsing
  • Using inhalers and/or nasal sprays

3. Vocal cord abuse

Vocal cord abuse can also pave the way for laryngitis. Individuals who use their voice a lot, such as singers, teachers, and public speakers, are prone to developing scars called vocal cord nodules that can lead to hoarseness.

Treating associated factors such as acid reflux and allergies, undergoing intense voice therapy, and voice rest can reverse the vocal cord nodules.

The following must also be implemented:

  • Voice therapy
  • Avoiding throat clearing
  • Appropriate hydration before using voice for speeches/singing
  • Refraining from excessive use, talking loudly, or screaming
  • Rest
  • Plenty of fluids
  • Using honey to soothe the throat

4. Bacterial laryngitis

Bacterial laryngitis is rare. In unimmunized children, it can lead to a deadly disease called epiglottitis, which can cause rapid swelling and blockage of the airway.

Children with an intense and sudden sore throat, drooling, and incomplete immunizations should be medically evaluated immediately. Antibiotics are not needed for most cases of acute laryngitis.

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5. Croup

Croup is a contagious viral infection that affects the larynx and part of the airway right below it. (6) The affected child may need medical evaluation and treatment with steam and steroids if the condition turns severe.

How Can Laryngitis Be Prevented?

tips for preventing laryngitis

The following tips may be helpful in the prevention of laryngitis:

  • The most common cause of infectious laryngitis is viral. Taking precautions such as hand washing, sleeping adequately, and eating healthy foods to support the immune system can help prevent infections.
  • Smoking has deleterious effects on the lining of the throat and larynx. It can also increase acid reflux and lower the resistance of the lining of the vocal cords/larynx. Smoking cessation and limiting your exposure to secondhand smoke are important for many reasons, including preventing and treating laryngitis.
  • Air pollution can also have a direct irritant impact on the larynx. People living in high pollution are more susceptible to laryngitis. Hence, it is advisable to limit exposure to air pollution in areas where this is a concern by wearing masks, staying indoors, and using air filters as necessary.

Is Honey Beneficial for Laryngitis?

When taken orally, honey washes over the swollen larynx and helps moisturize it from within. As a result, talking and swallowing become easier. Additionally, honey is known to possess certain antibacterial properties, (7) a low pH, high osmolarity, and the ability to produce hydrogen peroxide.

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All of these properties contribute to its therapeutic action against bacteria-induced laryngitis.

Laryngitis Comorbidities

It is common for laryngitis to be accompanied by other health problems such as:

1. Bronchitis

Many of the viruses that cause laryngitis can cause bronchitis as well. Hence, it is not uncommon to see the two occurring together, as opposed to laryngitis directly leading to bronchitis.

Similarly, irritants such as cigarette smoke, air pollution, allergies, and acid reflux that cause inflammation in your larynx can do the same damage in your lungs. Thus, the same pathogen or irritant can trigger the simultaneous onset of laryngitis and bronchitis as it spreads through the respiratory tract.

2. Earache

Laryngitis and earache can occur at the same time but not as commonly as seen in tonsillitis. The reason for ear pain may be twofold:

  • The irritation caused by an inflamed larynx may travel to the ear through the same sensory route. This kind of referred pain is more commonly observed when both the larynx and throat become inflamed.
  • Laryngitis may be accompanied by an earache if the inflammation affects both the lining of the upper throat (which is near the opening of the Eustachian tube located behind the nose) and the lining of the lower throat (which contains the larynx).

When to See a Doctor

  • Seek immediate medical attention for children showing signs of severe croup, high fever, difficulty breathing, and drooling.
  • Adults usually present with chronic laryngitis. They should seek an ENT consultation if their hoarseness has not resolved in 3 weeks.
  • Smokers and alcoholics are at an increased risk of laryngeal cancer and, therefore, should be alert for any signs of persistent hoarseness.

Final Word

Laryngitis often affects your voice due to the associated swelling. This may also be accompanied by throat pain or pain while swallowing.

While most cases of laryngitis will resolve in 2 weeks, consult a doctor if the condition is persistent. Avoid taking antibiotics as laryngitis is commonly caused by viral infections only. It is advised to rest your voice, use humidifiers, and take pain medication if needed to help manage laryngitis symptoms.

References
  1. JP; D. Laryngitis: types, causes, and treatments. Otolaryngologic clinics of North America. https://pubmed.ncbi.nlm.nih.gov/18328379/. Published 2008.
  2. Tristram D. Laryngitis, Tracheitis, Epiglottitis, and Bronchiolitis: Sore Throat, Change in Voice, Feverora Wheezing Infant in Respiratory Distress. Introduction to Clinical Infectious Diseases: A Problem-Based Approach. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153039/. Published October 15, 2018.
  3. SP; ZAV. Identification and Management of Chronic Laryngitis. Otolaryngologic clinics of North America. https://pubmed.ncbi.nlm.nih.gov/31101358/. Published 2019.
  4. Thomas CM, Jetté ME, Clary MS. Factors Associated With Infectious Laryngitis: A Retrospective Review of 15 Cases. The Annals of otology, rhinology, and laryngology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460979/. Published May 2017.
  5. Campagnolo AM, Priston J, Thoen RH, Medeiros T, Assunção AR. Laryngopharyngeal reflux: diagnosis, treatment, and latest research. International archives of otorhinolaryngology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297018/. Published April 2014.
  6. Johnson DW. Croup. BMJ clinical evidence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178284/. Published September 29, 2014.
  7. Mandal MD, Mandal S. Honey: its medicinal property and antibacterial activity. Asian Pacific journal of tropical biomedicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609166/. Published April 2011.
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