Laryngitis medical therapy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(21 intermediate revisions by 10 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Laryngitis}}
{{Laryngitis}}
{{CMG}}; {{AE}} {{chetan}}, {{Alonso}}, {{AG}}
==Overview==
There is no treatment for viral laryngitis; the mainstay of therapy is supportive care. The mainstay of therapy for infectious causes of laryngitis is antimicrobial therapy. Medical therapy for laryngitis due to [[gastroesophageal reflux]] includes acid suppression therapy such as either [[omeprazole]] or [[ranitidine]].


{{CMG}}
==Medical Therapy==
==Medical Therapy==
===Viral laryngitis===
*There is no treatment for viral laryngitis; the mainstay of therapy is supportive care.
*[[Ibuprofen]] and [[aspirin]] may help alleviate fever and some of the discomfort associated with laryngitis.
*Patients are advised to avoid [[Speech communication|speaking]] when possible. They are instructed to speak softly, but to avoid whispering, which further strains the voice.<ref name=Mayo> Laryngitis. Mayo Clinic (2015). http://www.mayoclinic.org/diseases-conditions/laryngitis/basics/lifestyle-home-remedies/con-20021565 Accessed on November 2, 2016</ref>
*Throat clearing is not advised. The act of clearing one's throat may aggravate the laryngitis.
*Humidifiers and warm showers can also help alleviate some symptoms.
*[[Steroids]] may be prescribed to help accelerate the healing if significant inflammation is present.


Correct treatment depends on a correct diagnosis of the underlying cause of laryngitis. The most prevalent cause of a missed diagnosis of laryngeal [[cancer]] is a belief that persistent hoarseness is due to laryngitis. Should hoarseness last for more than 3 weeks, one should consult an otolaryngologist (ear, nose, and throat physician) for an examination including direct visualization of the vocal cords. This examination may also detect the presence of [[vocal fold nodules|vocal cord nodules]], a structural change resulting in persistent hoarseness or loss of voice.
===Gastroesophageal reflux laryngitis===
*The mainstay of therapy for [[gastroesophageal reflux]] laryngitis is an [[H2 antagonist]] (e.g.: [[ranitidine]]) or a [[proton-pump inhibitor]] (PPI) (e.g.: [[omeprazole]], [[esomeprazole]], [[pantoprazole]]). These drugs may be prescribed for a period between 4-6 weeks.


If laryngitis is due to a viral cause:
===Bacterial laryngitis===
*The patient may be prescribed a course of antibiotics however, there is little evidence to demonstrates the efficacy of oral antibiotics for laryngitis.


* [[Ibuprofen]] and [[aspirin]] may help alleviate fever and some of the discomfort associated with laryngitis.
===Antibiotic Therapy===
* Patients are advised to avoid [[Speech communication|speaking]] when possible.  They are instructed to speak softly, but to avoid whispering, which further strains the voice.<ref>Mayoclinic.com.  2006.  [http://www.mayoclinic.com/health/laryngitis/DS00366/DSECTION=9 Laryngitis: Self care]</ref>
* Antibiotic use is not associated with significant improvement of objective symptoms<ref name="Reveiz-2005">{{Cite journal  | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | last3 = Ospina | first3 = EG. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume =  | issue = 1 | pages = CD004783 | month =  | year = 2005 | doi = 10.1002/14651858.CD004783.pub2 | PMID = 15674965 }}</ref><ref name="Reveiz-2007">{{Cite journal  | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | last3 = Ospina | first3 = EG. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume = | issue = 2 | pages = CD004783 | month =  | year = 2007 | doi = 10.1002/14651858.CD004783.pub3 | PMID = 17443555 }}</ref><ref name="Reveiz-2013">{{Cite journal  | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume = 3 | issue = | pages = CD004783 | month =  | year = 2013 | doi = 10.1002/14651858.CD004783.pub4 | PMID = 23543536 }}</ref><ref name="pmid26002823">{{cite journal| author=Reveiz L, Cardona AF| title=Antibiotics for acute laryngitis in adults. | journal=Cochrane Database Syst Rev | year= 2015 | volume= | issue= 5 | pages= CD004783 | pmid=26002823 | doi=10.1002/14651858.CD004783.pub5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26002823  }} </ref> and is not a first-line therapy for the treatment of acute laryngitis.<ref name="Schwartz-2009">{{Cite journal  | last1 = Schwartz | first1 = SR. | last2 = Cohen | first2 = SM. | last3 = Dailey | first3 = SH. | last4 = Rosenfeld | first4 = RM. | last5 = Deutsch | first5 = ES. | last6 = Gillespie | first6 = MB. | last7 = Granieri | first7 = E. | last8 = Hapner | first8 = ER. | last9 = Kimball | first9 = CE. | title = Clinical practice guideline: hoarseness (dysphonia). | journal = Otolaryngol Head Neck Surg | volume = 141 | issue = 3 Suppl 2 | pages = S1-S31 | month = Sep | year = 2009 | doi = 10.1016/j.otohns.2009.06.744 | PMID = 19729111 }}</ref>
* [[Nasal breathing]] is very important so as not to dry the [[throat]].
*[[Fusafungine]], a locally acting antibiotic, has been shown to increase the number of asymptomatic patients by the fifth day of disease.<ref name="pmid15626253">{{cite journal| author=Lund VJ, Grouin JM, Eccles R, Bouter C, Chabolle F| title=Efficacy of fusafungine in acute rhinopharyngitis: a pooled analysis. | journal=Rhinology | year= 2004 | volume= 42 | issue= 4 | pages= 207-12 | pmid=15626253 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15626253  }} </ref>
* Throat clearing is very bad. The act of clearing one's throat is very stressful and may aggravate the laryngitis.
* Humidifiers and warm showers can also help alleviate some symptoms.
* Airborne irritants such as smoke and allergens may exacerbate the condition.
* Gargling with a salt water rinse is suggested. Mouth rinses containing [[alcohol]] can dry the throat and may exacerbate a viral case of laryngitis (however, these can be helpful when the cause of the infection is bacterial).
* A tea of [[ginger]] may help reduce swelling of the vocal cords and relieve symptoms.
* [[Steroid]] medications may be prescribed to help accelerate the healing of the inflammation present.


If laryngitis is due to [[gastroesophageal reflux]]:
==References==
 
* The patient may be instructed to take a nonprescription medication such as Zantac or Prilosec for a period of 4-6 weeks.
 
If laryngitis is due to a bacterial or fungal infection:
* The patient may be prescribed a course of antibiotics or anti-fungal medication.


If persistent hoarseness or loss of voice (''sometimes called'' "laryngitis") is a result of [[vocal fold nodules|vocal cord nodules]]:
{{reflist|2}}
* Physicians may recommend a course of treatment that may include a surgical procedure and/or speech therapy.
* Reduction of high-impact stress to the vocal cords caused by loud, frequent, and rapid speech is recommended.
 
==References==
{{Reflist|2}}


[[Category:Emergency mdicine]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Inflammations]]
[[Category:Otolaryngologic Disease]]
[[Category:Otolaryngology]]
[[Category:Otolaryngology]]
[[Category:Pulmonology]]
[[Category:Gynecology]]
[[Category:primary care]]
[[Category:Urology]]
[[Category:Needs overview]]
[[Category:Pediatrics]]

Latest revision as of 22:29, 29 July 2020

Laryngitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Laryngitis from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Laryngitis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Laryngitis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Laryngitis medical therapy

CDC on Laryngitis medical therapy

Laryngitis medical therapy in the news

Blogs on Laryngitis medical therapy

Directions to Hospitals Treating Laryngitis

Risk calculators and risk factors for Laryngitis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chetan Lokhande, M.B.B.S [2], Alonso Alvarado, M.D. [3], Anthony Gallo, B.S. [4]

Overview

There is no treatment for viral laryngitis; the mainstay of therapy is supportive care. The mainstay of therapy for infectious causes of laryngitis is antimicrobial therapy. Medical therapy for laryngitis due to gastroesophageal reflux includes acid suppression therapy such as either omeprazole or ranitidine.

Medical Therapy

Viral laryngitis

  • There is no treatment for viral laryngitis; the mainstay of therapy is supportive care.
  • Ibuprofen and aspirin may help alleviate fever and some of the discomfort associated with laryngitis.
  • Patients are advised to avoid speaking when possible. They are instructed to speak softly, but to avoid whispering, which further strains the voice.[1]
  • Throat clearing is not advised. The act of clearing one's throat may aggravate the laryngitis.
  • Humidifiers and warm showers can also help alleviate some symptoms.
  • Steroids may be prescribed to help accelerate the healing if significant inflammation is present.

Gastroesophageal reflux laryngitis

Bacterial laryngitis

  • The patient may be prescribed a course of antibiotics however, there is little evidence to demonstrates the efficacy of oral antibiotics for laryngitis.

Antibiotic Therapy

  • Antibiotic use is not associated with significant improvement of objective symptoms[2][3][4][5] and is not a first-line therapy for the treatment of acute laryngitis.[6]
  • Fusafungine, a locally acting antibiotic, has been shown to increase the number of asymptomatic patients by the fifth day of disease.[7]

References

  1. ↑ Laryngitis. Mayo Clinic (2015). http://www.mayoclinic.org/diseases-conditions/laryngitis/basics/lifestyle-home-remedies/con-20021565 Accessed on November 2, 2016
  2. ↑ Reveiz, L.; Cardona, AF.; Ospina, EG. (2005). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev (1): CD004783. doi:10.1002/14651858.CD004783.pub2. PMID 15674965.
  3. ↑ Reveiz, L.; Cardona, AF.; Ospina, EG. (2007). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev (2): CD004783. doi:10.1002/14651858.CD004783.pub3. PMID 17443555.
  4. ↑ Reveiz, L.; Cardona, AF. (2013). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev. 3: CD004783. doi:10.1002/14651858.CD004783.pub4. PMID 23543536.
  5. ↑ Reveiz L, Cardona AF (2015). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev (5): CD004783. doi:10.1002/14651858.CD004783.pub5. PMID 26002823.
  6. ↑ Schwartz, SR.; Cohen, SM.; Dailey, SH.; Rosenfeld, RM.; Deutsch, ES.; Gillespie, MB.; Granieri, E.; Hapner, ER.; Kimball, CE. (2009). "Clinical practice guideline: hoarseness (dysphonia)". Otolaryngol Head Neck Surg. 141 (3 Suppl 2): S1–S31. doi:10.1016/j.otohns.2009.06.744. PMID 19729111. Unknown parameter |month= ignored (help)
  7. ↑ Lund VJ, Grouin JM, Eccles R, Bouter C, Chabolle F (2004). "Efficacy of fusafungine in acute rhinopharyngitis: a pooled analysis". Rhinology. 42 (4): 207–12. PMID 15626253.
Retrieved from "https://www.wikidoc.org/index.php?title=Laryngitis_medical_therapy&oldid=1640104"