Laryngitis medical therapy
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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]
Overview
Patients with viral laryngitis are treated with supportive therapy, whereas patients with laryngitis due to infectious causes other than viral infections are treated with antimicrobial therapy. Medical therapy for laryngitis due to gastroesophageal reflux includes acid suppression therapy such as either omeprazole or ranitidine . Surgery is usually reserved for patients with persistent laryngitis due to vocal cord nodules.
Medical Therapy
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 cord nodules, a structural change resulting in persistent hoarseness or loss of voice.
If laryngitis is due to a viral cause:
- 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]
- Nasal breathing is very important so as not to dry the throat.
- 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:
- 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 is a result of vocal cord nodules:
- 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.
Antibiotic Therapy
- Antibiotic use is not associated with significant improvement of objective symptoms[2][3][4] and is not indicated in the treatment of acute laryngitis.[5]
References
- ↑ Mayoclinic.com. 2006. Laryngitis: Self care
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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
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