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Laryngitis

What is laryngitis?

Inflammation of the vocal cords can alter the way the vocal cords come together and vibrate, causing voice changes. Voice change caused by laryngitis, or voice box inflammation, can be accompanied by constant throat pain or pain with talking or swallowing.

What are the causes of laryngitis?

  • Infection: viral, bacterial or fungal infections of the voice box (some inhaled medications can increase the risk of voice box infections)

  • Poor vocal hygiene: This term refers to the development of poor voice box health and inflammation that is usually due to many different causes, including voice abuse, voice misuse, dehydration or indirect voice box inflammation secondary to sinus or mouth issues.

  • Inhaled irritants, such a smoking, or other inhaled irritants from the environment

  • Autoimmune disorders: Several different autoimmune disorders, including granulomatosis with polyangiitis (Wegener’s disease) or pemphigoid/pemphigus, can cause vocal cord inflammation.

  • Laryngopharyngeal reflux (LPR): Stomach contents that come up into the throat from the esophagus can cause vocal cord inflammation and voice changes. Other symptoms common in patients with LPR include a sore or dry throat, frequent throat clearing, a sensation of thick mucus or phlegm in the throat and chronic dry cough. Both acid and nonacid enzymes from the stomach can cause irritation of the throat and vocal cords.

Laryngitis Treatment

Based on your diagnosis after a complete workup, an individual treatment plan will be developed. Treatment options include:

  • Medication to clear up a suspected infection

  • Voice therapy with a speech-language pathologist to improve the care and use of your voice

  • Avoidance of irritants or environmental allergies that caused the laryngitis and a possible follow-up appointment with an allergist to diagnose and treat any allergies may be indicated.

  • Patients with LPR often respond well to a combination of lifestyle modifications and medications. While the diagnosis of LPR is often made clinically based on your history and exam in the clinic, formal diagnosis may require testing, such as pH probe and impedance testing . In most cases, suspected LPR is treated based on your history and symptoms, since these treatments often improve the health of your throat and voice box even if you do not have LPR. If you do not respond well to aggressive diet and lifestyle changes and anti-acid medications, and formal testing shows that you do have LPR, you may be referred to general surgery for consideration of anti-reflux surgery.

  • Any diagnoses made for patients with autoimmune disorders are based upon biopsies or blood work. Your diagnoses will be discussed with you and may involve referral to a rheumatologist to discuss treatment options.

  • Some patients will be treated with oral steroids with or without voice rest to help diagnose an inflammatory voice problem. However, for long-term voice problems secondary to vocal fold inflammation, it is best to avoid long-term steroid use if possible and to treat any underlying problems.

Reviewed by Clint Allen, M.D., from the Department of Otolaryngology-Head and Neck Surgery.

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