Treatment of Laryngitis

Key Glossary Terms

Laryngitis
Inflammation of the voice box (larynx); can result from many causes; specific cause needs to be identified for correct diagnosis and proper treatment plan

Inflammation
Response to injury that results in swelling, redness, and/or pain

Glossary

Treating laryngitis involves treating the underlying cause and/or removing the irritant from the environment. (For more information, see Understanding the Disorder.)

• Hydration is an important component of laryngitis treatment. In most cases of laryngitis, either the mucous secretions are excessively thick or the lubrication of the larynx is decreased.
  • Drinking water helps to maintain the thin character of the mucosal lubrication.
  • Steam or mist humidifiers can help to lubricate the vocal folds.
  • Avoiding exposure to drying agents such as caffeine or dehydrating medications can also help to preserve the lubrication of the larynx. (For more information, see Laryngitis Sicca.)
• Limiting voice use allows the vocal fold tissue to heal without the added trauma and stress caused by trying to phonate with swollen vocal folds. Voice rest can help to accelerate the healing process.
• Surgery is rarely indicted for laryngitis.

Key Information

Multifactorial Voice Disorders

In some cases, the laryngitis masks or leads to an incomplete diagnosis. Thus, despite appropriate treatment for laryngitis, some patients fail to improve due to the failure to recognize other laryngeal problems. Common problems that can be missed when laryngitis is present include vocal fold paresis, muscle tension dysphonia, and functional dysphonia.

Need for Identification of Cause for Proper Treatment

When the primary cause of the laryngitis is not directly treated, and only the inflammation and the irritation of the larynx are addressed with anti-inflammatory medications such as steroids, the laryngitis will continue. A definitive cause for the laryngitis must be determined after careful review of the patient's history, symptoms, and laryngeal examination to ensure proper treatment.

The optimal treatment for laryngitis should first involve the identification and subsequent removal or minimization of the irritating source of the laryngitis. Then, and only then, should the inflammation and irritation of the larynx be treated. In other words, patients should generally not be treated with steroids without a specific identified cause for the laryngitis.

Red Flag

Use of Steroids Controversial

Use of inhaled steroids for laryngitis is highly controversial. According to current best practices, use of inhaled steroids for the treatment of laryngeal irritation and inflammation is rare.

Inhaled steroids are designed to treat asthma and other pulmonary conditions; in fact, most patients who have asthma describe throat irritation from the inhaled steroid medication itself or the associated propellant of the medication.

Patients should consult with their physician as to possible complications of steroid medication.

If left untreated, laryngitis is thought by some physicians to lead to the development of hyperfunctional voice disorders such as muscle tension dysphonia, which may contribute to the formation of nodules, polyps, cysts, scarring, hyperkeratosis, and Reinke's edema. (For more information, see Vocal Fold Scarring, Reinke's Edema, and Vocal Fold Nodules, Polyps, Cysts, and Reactive Lesions.)