LARYNGITIS

DEFINITION It is the inflammation of larynx leading to oedema of laryngeal mucosa and underlying structures.

ETIOLOGY INFECTIOUS: Viral laryngitis can be caused by rhinovirus, influenza virus, parainfluenza virus, adenovirus, coronavirus, and RSV. Bacterial laryngitis can be caused by group A streptococcus, streptococcus pneumoniae, C. diphtheriae, M. catarrhalis,haemophilus influenzae, bordetella pertussis, and M. tuberculosis. Fungal laryngitis can be caused by Histoplasma, Candida (especially in immunocompromised persons)

NON INFECTIOUS Inhaled fumes Acid reflux disease Allergies Excessive coughing, smoking, or alcohol consumption. Inflammation due to overuse of the vocal cords Prolonged use of inhaled corticosteroids for asthma treatment Thermal or chemical burns Laryngeal trauma, including iatrogenic one caused by endotracheal intubation

Predisposing factors Smoking Psychological strain Physical stress Acid reflux Frequent sinus infectionsr Types – acute (less then 3 weeks)and chronic (more than 3 weeks )

Pathophysiology Due to etiological factors The mucosa of the larynx becomes congested and may become oedematous. A fibrinous exudate may occur on the surface. Signs and symptoms Sometimes infection involves the perichondrium of laryngeal cartilages producing perichondritiis.

CLINICAL FEATURES Husky, high pitched voice. Body aches, Fever, Malaise. Dysphonia (hoarseness) or aphonia (inability to speak) Dysphagia (difficulty in swallowing) Dyspnea (difficulty in breathing), predominantly in children Dry, burning throat Dry irritating paroxysmal cough. Cold or flu-like symptoms  Swollen lymph nodes in the throat, chest, or face Hemoptysis (coughing out blood) Increased production of saliva. CLINICAL FEATURES

Signs of acute URTI. Dry thick sticky secretions. Dusky red and swollen vocal cords. congestion of laryngeal mucosa.

TREATMENT SUPPORTIVE Voice rest. Steam inhalation. Cough suppressants. Avoid smoking and cold climet. Fluid intake.

TREATMENT DEFINITIVE If laryngitis due to  gastroesophageal reflux, an H2-inhibitor (ranitidine) or proton-pump inhibitor (omeprazole) is used to reduce gastric acid secretions. If laryngitis is caused by thermal or chemical burns, steroids are used. In viral laryngitis, drinking sufficient fluids will be helpful. If laryngitis is due to a bacterial or fungal infection, appropriate antibiotic or antifungal therapy is given.

To improve vocal hygiene Drinking lot of fluids - Drink 7-9 glasses of water per day; herbal tea and chicken soup also provides soothing effect. maintaining good general health - Exercise regularly. Avoiding smoking - They are bad for the heart, lungs and vocal tract. Eating a balanced diet - Include vegetables, fruits and whole grain foods. Avoid dry, artificial interior climates. Do not eat late at night - may have problems when stomach acid backs up on the vocal cords. Use a humidifier to assist with hydration.