Laryngitis

Definition

Laryngitis is caused by inflammation of the larynx, often resulting in a temporary loss of voice.

Description

When air is breathed in, it passes through the nose and the nasopharynx or through the mouth and the oropharynx. These are both connected to the larynx, a tube made of cartilage. The vocal cords, responsible for setting up the vibrations necessary for speech, are located within the larynx.

The air continues down the larynx to the trachea. The trachea then splits into two branches, the left and right bronchi (bronchial tubes). These bronchi branch into smaller air tubes that run within the lungs, leading to the small air sacs of the lungs (alveoli).

Either food, liquid, or air may be taken in through the mouth. While air goes into the larynx and the respiratory system, food and liquid are directed into the tube leading to the stomach, the esophagus. Because food or liquid in the bronchial tubes or lungs could cause a blockage or lead to an infection, the airway must be protected. The epiglottis is a leaf-like piece of cartilage extending upwards from the larynx. The epiglottis can close down over the larynx when someone is eating or drinking, preventing these substances from entering the airway.

In laryngitis, the tissues below the level of the epiglottis are swollen and inflamed. This causes swelling around the area of the vocal cords and they can't vibrate normally. Hoarse sounds or loss of voice are characteristic of laryngitis. Laryngitis is a very common problem, and often occurs during an upper respiratory tract infection (cold).

Causes & symptoms

Laryngitis is primarily caused by overuse of the voice, a condition faced by people ranging from teachers to performers. Other causes of laryngitis include:

• strain on the larynx from talking or singing for long periods
• shouting or cheering for an extended time
• allergies
• colds or cough
• smoking
• alcohol consumption
• atmospheric conditions like dust in the air
• anxiety
• underactive thyroid
• growths on the larynx

However, the primary medical cause of laryngitis is a viral infection. The same viruses that cause the majority of simple colds are responsible for laryngitis. In extremely rare cases, more harmful bacteria or the bacteria that causes tuberculosis (TB) may cause laryngitis. In people with faulty immune systems (like AIDS patients), infections with fungi may be responsible for laryngitis.

Symptoms usually begin with a cold. The person may have a sore, scratchy throat, as well as a fever , runny nose, aches, and fatigue . Difficulty swallowing sometimes occurs, and the patient may have a ticklish cough or wheeze. Most characteristically, the patient suffers voice loss or the voice will sound strained, hoarse, and raspy.

In extremely rare cases, the swelling of the larynx may cause symptoms of airway obstruction. This is more common in infants because the diameter of their airways is so small. In that case, the baby may have a greatly increased respiratory rate and exhibit loud, high-pitched sounds with breathing (called stridor).

Diagnosis

Laryngitis is easily recognizable. People realize they can't speak or that their voices are hoarse. In most cases, they know the cause. Laryngitis could be the next phase of the flu or the result of cheering too energetically during a football game. In addition to being an easily recognizable condition, laryngitis is a self-limiting condition that goes away on its own. In most cases, laryngitis can be treated at home.

However, a doctor should be consulted if the laryngitis occurs for no apparent reason or if hoarseness lasts for more than two weeks. A doctor may diagnose another condition such as an underactive thyroid. Symptoms of underactive thyroid include tiredness, constipation , aches, and dry skin.

Diagnosis is usually made by learning the history of a cold that is followed by hoarseness. The throat usually appears red and somewhat swollen. Listening to the chest, neck, and back with a stethoscope (an instrument used to hear heart and lungs sounds) may reveal some harsh wheezing sounds when the person breathes.

With chronic laryngitis, TB may be suspected. Using an instrument called a laryngoscope, a doctor can examine the airway for redness, swelling, small bumps of tissue called nodules, and irritated pits in the tissue called ulcerations. Special skin testing (TB testing) will reveal if the person has been exposed to TB.

Treatment

Alternative treatments for laryngitis include various herbal therapies, as well reflexology , homeopathy, relaxation , and exercise. Resting the voice is especially important, as is consulting a doctor or practitioner if symptoms last for more than two weeks.

Practitioners who treat laryngitis include naturopathic doctors and ayurvedic doctors. Naturopathic medicine focuses on whole body health care; the ayurvedic practitioner concentrates on maintaining balance between the body and the world.

Acupuncture or accupressure, elements of traditional Chinese medicine (TCM), may provide some relief. A TCM practitioner may prescribe Throat Inflammation Pills, which are also known as Laryngitis Pills. The pill is an over-the-counter Chinese formula. The usual dosage for adults is 10 pills taken three times daily. This is a short-term treatment and should be stopped after three days.

An ayurvedic practitioner could prescribe an infusion of mint, ginger , or cloves, as well as a milk decoction or licorice root powder.

Herbal remedies

Numerous herbals can be used to treat laryngitis. Herbal lozenges and throat sprays can provide immediate relief to a raw throat. Herbs that are effective for laryngitis include thyme, horehound , cardamom, plantain, cinnamon, and eucalyptus . Commercial cough medicines that are effective include herbs such as anise, fennel , and peppermint . A person can gargle with warm salt water and slippery elm bark, wild cherry, and mallow.

Echinacea tincture taken in water is recommended to boost the immune system. The tincture consists of 10 drops (1/8 teaspoon or 5/8 ml) of the herb in a glass of water. This mixture is taken frequently, or 5 ml three to four times a day. Antiviral herbs such as usnea, lomatium , and ligusticum may help speed recovery.

Poke should be taken as a last resort. It's a strong herb that should be taken only in small amounts and under the direction of a healthcare professional. However, there are many other herbs that can be purchased as packaged cold and throat remedies or used to prepare home treatments.

HYDROTHERAPY. A person can use a vaporizer for relief by inhaling steam. A natural version of the vaporizer is a boiling pot of water with herbs or essential oils added. The amount of these ingredients varies. A small handful of sage or eucalyptus leaves may be added to the water. When using essential oils, 1-2 teaspoons (4.5-10 g) of an oil such as sage, eucalyptus, lavender , benzoin, frankincense, thyme, or sandalwood are added. The pot is removed from the stove and the ingredients are allowed to steep. The person places a towel over the head for a tent-like effect, leans over the pot, and breathes in steam through the mouth.

HERBAL TEAS. Commercial products like horehound tea will provide relief. For brewing tea at home, 1 cup (250 ml) of boiling water is poured over 1-2 teaspoons (4.5-10 g) of an herb. The tea is steeped for about 10 minutes and then strained. Generally, up to 3 cups of tea may be drunk daily.

Helpful herbs for teas include capsicum (cayenne), which is used to treat conditions caused by a cold or flu. Capsicum tea might be a painful treatment if inflammation is severe. Ginger root helps with chest congestion. Other useful herbs include cardamom, eucalyptus, spearmint, rosemary , sweet Annie, nutmeg , lavender, bee balm, peppermint, tansy, mallows, and mullein .

GARGLES. A home gargle is prepared like herbal tea. One cup (250 ml) of boiling water is poured over 1-2 teaspoons (4.5-10 g) of an herb. This mixture is steeped for about 10 minutes and then strained. The solution is gargled for about 10 seconds, and repeated every three to four hours. Herbs recommended for gargling include coltsfoot , garden raspberry , golden seal, mullein, plantain , red sage, yarrow , licorice, and slippery elm .

Other home remedies

A range of other home remedies will bring relief to laryngitis and its symptoms. These include:

• Drinking more liquids and eating raw fruit and vegetables.
• Eating certain foods. Candied ginger, honey, lemon, and pineapple juice are soothing. Spicy foods with ingredients like garlic, cayenne pepper, horseradish, mustard, or ginger are helpful.
• Using vitamins. They can also help the immune system. The recommended dosages are 1,000-3,000 mg of vitamin C and 10,000-20,000 I.U. of vitamin A (beta carotene).
• Using a compress. A compress is a form of hydrotherapy that starts by placing a warm washcloth on the neck. Next, a long cotton cloth is soaked in cold water. After the cloth is wrung out, it is wrapped around the neck. Then a long piece of wool flannel such as a scarf is wrapped around the wet cloth. The flannel is secured with a safety pin and remains in place for at least 30 minutes. The compress can be worn overnight.
• Relaxing and exercising. Since anxiety can cause laryngitis, both relaxation techniques and physical exercise can reduce stress.
• Breathing deeply. Deep breaths and breathing exercises can make the respiratory system stronger.

Reflexology

Reflexology is a healing method that involves the manipulation of certain parts of the body to bring about balance. For laryngitis, the reflexology focus is on the throat, lung, chest, lymphatic system, and diaphragm points on both feet. Also recommended is manipulation of all points on the sides and bottoms of the toes.

Homeopathy

Homeopathy is a healing method that is based on the theory that "like cures like." The potency of a homeopathic remedy is indicated by an "x." This indicates the number of times that one part of a remedy was diluted in nine parts of a dilutant. Distilled water is the preferred dilutant. The potency of a remedy can also be expressed as "c," the number of times one part of the remedy was diluted in 99 parts of a dilutant.

Homeopathic remedies for laryngitis include:

• Aconite (6x or 12x). It's taken every two hours at the very start of a cold or when the voice is lost and the person has a dry cough. If there is no improvement after four or five hours, another remedy such as spongia tosta is taken.
• Spongia tosta (12x). It's taken four times daily for laryngitis combined with a dry throat.
• Arnica (6x or 12x). It's taken hourly when loss of voice is caused by overuse or trauma.

Allopathic treatment

Treatment of a simple, viral laryngitis relieves the symptoms. Gargling with warm salt water, using pain relievers such as acetaminophen, using a vaporizer to create moist air, and resting will help the illness resolve within a week. Over-the-counter remedies such as throat sprays and lozenges may provide relief.

For an infant who is clearly struggling for air, a doctor may put in an artificial airway for a short period of time. This is very rarely needed.

When a doctor is consulted, antibiotics may be prescribed. The person with an underactive thyroid could be prescribed a thyroid hormone supplement. An individual with tubercular laryngitis is treated with a combination of medications used to treat classic TB. For people with fungal laryngitis, a variety of antifungal medications are available.

Expected results

The prognosis for people with laryngitis is excellent because it is a self-limiting condition. Recovery is complete, usually within a week. In the meantime, alternative remedies can provide relief.

Prevention

Prevention of laryngitis is the same as for any upper respiratory infection. People should wash their hands frequently and thoroughly, and should avoid contact with people who might be sick. However, even with relatively good hygiene practices, most people will get about five to six colds per year. It is unpredictable which of these may lead to laryngitis.

Resting the voice is important, particularly for people like teachers, politicians, or actors who talk for long periods. Not speaking for a time is one way to rest the voice. Before giving a lengthy speech or attending an exciting championship game, herbal remedies can be used preventively to soothe the larynx. If anxiety provokes laryngitis, a person should practice a relaxation technique or exercise to reduce stress .

In all cases, smoking should be avoided. Since alcohol can irritate the throat, consumption may need to be limited.

Resources

BOOKS

Albright, Peter. The Complete Book of Complementary Therapies. Allentown, PA: People's Medical Society, 1997.

Duke, James A. The Green Pharmacy. Emmaus, PA: Rodale Press, Inc., 1997.

Fauci, Anthony S., et al., eds. Harrison's Principles of Internal Medicine. New York: McGraw-Hill, 1998.

Gottlieb, Bill. New Choices in Natural Healing. Emmaus, PA: Rodale Press, Inc., 1995.

Keville, Kathi. Herbs for Health and Healing. Emmaus, PA: Rodale Press, Inc., 1996.

Medical Economics Company. PDR for Herbal Medicines. Montvale, N.J: 1998.

Stoffman, Phyllis. The Family Guide to Preventing and Treating 100 Infectious Diseases. New York: John Wiley and Sons, Inc., 1995.

Time-Life Books Editors. The Alternative Advisor. Alexandria, VA: Time-Life Books, 1997.

Tyler, Varro, and Steven Foster. Tyler's Honest Herbal. Binghamton, NY: The Haworth Herbal Press, 1999.

ORGANIZATIONS

American Botanical Council. P.O. Box 201660, Austin, TX, 78720. (512) 331-8868. http://www.herbalgram.org

Herb Research Foundation. 1007 Pearl St., Suite 200, Boulder, CO 80302. (303) 449-2265. http://www.herbs.org.

OTHER

Holistic OnLine. http://www.holisticonline.com.

MotherNature.com Health Encyclopedia. http://www.mothernature.com/ency.

Liz Swain

Laryngitis

Definition

Laryngitis is caused by inflammation of the larynx, resulting in hoarseness of the voice.

Description

When air is breathed in (inspired), it passes through the nose and the nasopharynx or through the mouth and the oropharynx. These are both connected to the larynx, a tube made of cartilage. The vocal cords, responsible for setting up the vibrations necessary for speech, are located within the larynx. The air continues down the larynx to the trachea. The trachea then splits into two branches, the left and right bronchi (bronchial tubes). These bronchi branch into smaller air tubes which run within the lungs, leading to the small air sacs of the lungs (alveoli).

Either food, liquid, or air may be taken in through the mouth. While air goes into the larynx and the respiratory system, food and liquid are directed into the tube leading to the stomach, the esophagus. Because food or liquid in the bronchial tubes or lungs could cause a blockage or lead to an infection, the airway must be protected. The epiglottis is a leaf-like piece of cartilage extending upwards from the larynx. The epiglottis can close down over the larynx when someone is eating or drinking, preventing these substances from entering the airway.

In laryngitis, the tissues below the level of the epiglottis are swollen and inflamed. This causes swelling around the area of the vocal cords, so that they cannot vibrate normally. A hoarse sound to the voice is very characteristic of laryngitis. Laryngitis is a very common problem, and often occurs during the course of an upper respiratory tract infection (cold).

Causes and symptoms

Laryngitis is caused almost 100% of the time by a virus. The same viruses which cause the majority of simple upper respiratory infections (colds, etc.) are responsible for laryngitis. These include parainfluenzae virus, influenza virus, respiratory syncytial virus, rhinovirus, coronavirus, and echovirus. Extremely rarely, bacteria such as Group A streptococcus, M. catarrhalis, or that which causes tuberculosis may cause laryngitis. In people with faulty immune systems (particular due to acquired immunodeficiency syndrome, or AIDS ), infections with fungi may be responsible for laryngitis.

Symptoms usually begin along with, or following, symptoms of a cold. A sore, scratchy throat, fever, runny nose, achiness, and fatigue may all occur. Difficulty swallowing sometimes occurs with streptococcal infections. The patient may cough and wheeze. Most characteristically, the patient's voice will sound strained, hoarse, and raspy.

In extremely rare cases, the swelling of the larynx may cause symptoms of airway obstruction. This is more common in infants, because the diameter of their airways is so small. In that case, the baby may have a greatly increased respiratory rate, and exhibit loud high-pitched sounds with breathing (called stridor ).

Diagnosis

Diagnosis is usually made by learning the history of a cold followed by hoarseness. The throat usually appears red and somewhat swollen. Listening to the chest and back with a stethoscope may reveal some harsh wheezing sounds with inspiration (breathing in).

In long-standing (chronic laryngitis), tuberculosis may be suspected. Using a scope called a laryngoscope, examination of the airway will show redness, swelling, small bumps of tissue called nodules, and irritated pits in the tissue called ulcerations. Special skin testing (TB testing) will reveal that the individual has been exposed to the bacteria causing TB.

Treatment

Treatment of a simple, viral laryngitis simply addresses the symptoms. Gargling with warm salt water, pain relievers such as acetaminophen, the use of vaporizers to create moist air, and rest will help the illness resolve within a week.

In an infant who is clearly struggling for air, it may be necessary to put in an artificial airway for a short period of time. This is very rarely needed.

An individual with tubercular laryngitis is treated with a combination of medications used to treat classic TB. In people with fungal laryngitis, a variety of antifungal medications are available.

Alternative treatment

Alternative treatments include aromatherapy inhalations made with benzoin, lavender, frankincense, thyme, and sandalwood. Decoctions (extracts made by boiling an herb in water) or infusions (extracts made by steeping an herb in boiling water) can be made with red sage (Salvia officinalis var. rubra ) and yarrow (Achillea millefolium ) or with licorice (Glycyrrhiza glabra ). These are used for gargling, and are said to reduce pain. Echinacea (Echinacea spp.) tincture taken in water every hour for 48 hours is recommended to boost the immune system. Antiviral herbs, including usnea (Usnea spp.), lomatium (Lomatium dissectum ), and ligusticum (Ligusticum porteri ), may help hasten recovery from laryngitis. Homeopathic remedies are recommended based on the patient's symptoms. Some people may get relief from placing cold compresses on the throat.

Prognosis

Prognosis for laryngitis is excellent. Recovery is complete, and usually occurs within a week's time.

Prevention

Prevention of laryngitis is the same as for any upper respiratory infections. The only way to even attempt to prevent such illnesses is by good handwashing, and by avoiding situations where one might come in contact with people who might be sick. However, even with relatively good hygiene practices, most people will get about five to six colds per year. It is unpredictable which of these may lead to laryngitis.

Resources

ORGANIZATIONS

American Academy of Otolaryngology-Head and Neck Surgery, Inc. One Prince St., Alexandria VA 22314-3357. (703) 836-4444. 〈http://www.entnet.org〉.

KEY TERMS

Epiglottis— A leaf-like piece of cartilage extending upwards from the larynx, which can close like a lid over the trachea to prevent the airway from receiving any food or liquid being swallowed.

Larynx— The part of the airway lying between the pharynx and the trachea.

Nasopharynx— The part of the airway into which the nose leads.

Oropharynx— The part of the airway into which the mouth leads.

Trachea— The part of the airway which leads into the bronchial tubes.

Laryngitis

Why Do People Get Laryngitis?

What Are the Signs and Symptoms of Laryngitis?

How Is Laryngitis Diagnosed and Treated?

Preventing Laryngitis

Resources

Laryngitis (lair-in-JY-tis) is an inflammation of the vocal cords that causes hoarseness or a temporary loss of voice.

KEYWORDS

for searching the Internet and other reference sources

Hoarseness

Larynx

Loss of voice

Respiratory infections

Vocal cords

Voice disorders

The vocal cords are the two bands of muscle found inside the larynx (LAIR-inks), or voice box, located between the base of the tongue and the top of the trachea*. As they let air into and out of the lungs, the vocal cords are relaxed. When a person talks, however, the vocal cords tighten as air passes through them, causing the cords to vibrate and thereby produce sound.

*trachea

(TRAY-kee-uh) is the windpipe, the firm, tubular structure that carries air from the throat to the lungs.

People who lose their voice after cheering too much at a hockey game or who begin to sound hoarse or raspy when they have a bad cold probably have laryngitis. Laryngitis refers to inflammation or irritation of the vocal cords. Inflammation causes swelling, which prevents the vocal cords from working properly, and the sounds they produce can seem strange or be hard to hear. Although laryngitis can make it difficult to communicate, it is rarely serious.

Why Do People Get Laryngitis?

Almost everyone gets laryngitis at some point, whether it is a low raspy whisper or a complete loss of voice. Overusing the voice, such as yelling, speaking too loudly or for too long, and even singing, can lead to laryngitis. People who use their voice constantly, such as radio announcers, politicians, and singers, get laryngitis more often than other people do. The larynx is located along the respiratory tract*, which is why respiratory infections such as the flu (influenza) and the common cold can easily spread to the voice box and cause laryngitis. People who have allergies or who develop polyps* on the vocal cords may also experience laryngitis. Smoking, heavy drinking, inhaling harmful fumes, and acid reflux* all irritate and inflame the vocal cords and can result in long-term or chronic laryngitis.

*respiratory tract

includes the nose, mouth, throat, and lungs. It is the pathway through which air and gases are transported down into the lungs and back out of the body.

*polyps

(PAH-lips) are bumps or growths, usually on the lining or surface of a body part (such as the nose or intestine). Their size can range from tiny to large enough to cause pain or obstruction. They may be harmless, but they also may be cancerous.

*acid reflux

is a condition in which stomach acid flows upward into the esophagus, often causing a burning sensation (so-called “heartburn”) in the upper abdomen or chest.

What Are the Signs and Symptoms of Laryngitis?

The most obvious symptoms of laryngitis are a hoarse or low voice, the inability to speak above a whisper, a raw feeling or sensation of having a lump in the throat, difficulty swallowing, and the need to clear the throat often. When laryngitis is caused by an infection such as the flu, a person may also experience sneezing, coughing, runny nose, headache, and fever.

Hand Washing 101

Hand washing is one of the best ways to prevent the respiratory infections that lead to laryngitis. What is the best way to wash hands? Rubbing the hands together, front and back, with warm, soapy water for at least 15 to 30 seconds is much better at preventing the spread of germs than just a quick rinse.

Severe laryngitis can sometimes lead to breathing problems, especially in young children. Anyone with laryngitis who develops difficulty breathing or high fever or who is not getting better after a few days needs medical care.

How Is Laryngitis Diagnosed and Treated?

A doctor will ask about a person’s symptoms and voice use to help determine whether laryngitis is the result of a respiratory infection or some other cause. In some cases, a doctor might take a close look at the vocal cords by holding a small mirror at the back of the throat. To get an even better view, a doctor might use a tiny camera on a long, thin tube that goes through the mouth or nose. This method allows the doctor to watch the vocal cords in action.

How a doctor treats laryngitis depends on what is causing it. If the cause is a viral infection, antibiotics will not help and the laryngitis will go away on its own. The doctor may recommend certain medicines to help relieve symptoms. Other tips that can help a person to feel better sooner are:

• resting the voice for several days (this means barely even a whisper) to help the vocal cords heal
• using a humidifier at home or sitting in the bathroom while a steamy shower is running; both put moisture into the air that can help to soothe an inflamed larynx
• drinking plenty of liquids
• getting lots of rest
• avoiding smoking or drinking alcohol

Laryngitis usually disappears after a few days, but it can last much longer and happen more often in people who are smokers or heavy drinkers or who use their voices for hours at a time in their jobs. It may take weeks of voice rest before their voices return to normal. Such long-term hoarseness might cause complications that require speech therapy to help prevent further damage. If growths have formed on the vocal cords over time, surgery may be needed.

Preventing Laryngitis

Laryngitis is not contagious, but colds, flu, and other infections that cause it are. Doing what is possible to avoid these infections (such as frequent hand washing) decreases a person’s chances of getting laryngitis.

Following these prevention basics can help maintain a healthy voice for life:

• not shouting or talking too loudly for too long
• staying away from cigarette smoke, which irritates the entire respiratory system
• keeping vocal cords from getting dry by drinking enough water every day

See also

Bronchitis, Infectious

Resources

Websites

KidsHealth.org. KidsHealth is a website created by the medical experts of the Nemours Foundation and is devoted to issues of children’s health. It contains articles on a variety of health topics, including laryngitis.

http://www.KidsHealth.org

The National Center for Voice and Speech website offers self-help for better vocal health.

http://www.ncvs.org/lifelong/strategies.html

LARYNGITIS

DEFINITION

Laryngitis (pronounced lar-uhn-JIE-tiss) is an inflammation of the larynx, resulting in hoarseness of the voice.

DESCRIPTION

The larynx is the upper portion of the trachea (pronounced TRAY-keeuh), or windpipe. When a person breathes in, air passes into the nose or mouth. It then travels down the trachea into the lungs. The larynx also contains the vocal cords, used in making sounds. When air passes over the vocal cords, it causes them to vibrate. That vibration produces sound.

In laryngitis, the lower part of the larynx, including the vocal cords, is swollen and inflamed. The vocal cords can still vibrate, but not in their normal manner. The sound produced is husky. Laryngitis is a very common problem. It often occurs during an upper respiratory (breathing) tract infection, such as a common cold (see common cold entry).

Laryngitis: Words to Know

Larynx:

The part of the airway between the pharynx and trachea.

Trachea:

The part of the airway that leads into the bronchial tubes in the lungs.

CAUSES

In the vast majority of cases, laryngitis is caused by a virus. The virus is often the same one that causes a common cold or influenza (the flu; see influenza entry). In very rare cases, the disease is caused by a bacterium, such as the one that also causes tuberculosis (see tuberculosis entry). In people with weakened immune systems, such as those with AIDS (see AIDS entry), laryngitis can be caused by a fungus.

SYMPTOMS

The symptoms of laryngitis are similar to those of the common cold. They include a sore, scratchy throat; fever; runny nose; achiness; and tiredness. A person may have trouble swallowing and may experience coughing and wheezing. The most characteristic symptom of laryngitis, however, is a hoarse and raspy voice.

In very rare cases, swelling of the larynx can cause constriction (shrinking or blockage) of the airways. This problem is usually serious only in young children, whose airways are small.

DIAGNOSIS

A common clue used to diagnose laryngitis is the recent occurrence of a cold or the flu followed by hoarseness. The throat usually appears red and somewhat swollen. The doctor will usually listen to the patient's chest and back with a stethoscope. A harsh, wheezing sound is an indication of laryngitis.

Chronic (persistent) laryngitis may suggest the presence of tuberculosis. In such a case, a doctor can use an instrument known as a laryngoscope (pronounced luh-RING-guh-skope) to look directly into the patient's airway. The presence of redness, swelling, nodules (small lumps), and sores indicates the possibility of tuberculosis.

TREATMENT

Since laryngitis is usually caused by a virus, there is no cure for the disease. Treatment is aimed at relieving its symptoms. Gargling with warm salt water, taking pain relievers, using a moist air vaporizer, and getting plenty of rest are usually the best practices to follow.

When laryngitis is more serious, which is rare, it needs special treatment. For example, an infant who has trouble breathing may temporarily require an artificial airway. A person with tubercular laryngitis requires the combination of medications used to treat tuberculosis itself.

Alternative Treatment

One kind of alternative treatment is aromatherapy. In aromatherapy, the patient breathes fumes of special mixtures with soothing properties. For laryngitis, these mixtures may contain lavender, frankincense, thyme, or sandalwood. Special solutions for gargling can be made with a variety of herbs, including sage, yarrow, or licorice.

Some practitioners recommend the use of echinacea (pronounced eki-NAY-see-uh) to strengthen the immune system. Herbs believed to kill viruses, such as usnea (pronounced US-nee-uh), have also been suggested. Homeopathic remedies are recommended based on the patient's symptoms. Some people may get relief by placing cold compresses (pads) on the throat.

PROGNOSIS

Prognosis for laryngitis is excellent. Recovery is complete and usually occurs within a week.

PREVENTION

Most people get at least one cold or other upper respiratory tract infection a year. About the only way to avoid these infections is to wash one's hands well and often and to avoid contact with people who have colds. The same rules hold true for laryngitis. By avoiding colds and similar infections, the chances of developing laryngitis are greatly reduced.

FOR MORE INFORMATION

Books

Stoffman, Phyllis. The Family Guide to Preventing and Treating 100 Infectious Diseases. New York: John Wiley & Sons, 1995.

Organizations

American Academy of Otolaryngology-Head and Neck Surgery, Inc. On Prince Street, Alexandria, VA 22314-3357. (703) 836-444.

Laryngitis

Laryngitis is an inflammation of the larynx. Located at the upper end of the trachea, or windpipe, the larynx contains the vocal chords that are used to form sounds. Because the larynx plays such an important role in speech, it is sometimes called the voice box. When the larynx becomes inflamed in laryngitis, it swells and reddens. The major symptom of laryngitis is hoarseness. Other symptoms include cough, a sore throat, and noisy breathing. Since laryngitis is so common—many people do not even see a medical doctor—the statistics on its overall frequency is difficult to calculate. However, it is known that laryngitis is most common in people from 18 to 40 years of age. It is less common, but still occurs, in infants, people from 3 to 18 years of age, and those over 40 years of age.

Laryngitis can be caused by infections of the upper respiratory tract, and is either acute or chronic. Acute infectious laryngitis strikes quickly and lasts a short time. The laryngitis that accompanies the common cold, the flu, or a bacterial infection as in strep throat, are all examples of acute laryngitis. Chronic infectious laryngitis is more serious and long lasting. Chronic infectious laryngitis can result from infection by the tuberculosis bacterium or by various yeasts or other fungi.

Although it is relatively rare, one form of acute infectious laryngitis can be fatal. The cause of this deadly laryngitis is a bacterium called Haemophilius influensae. In this infection, the larynx and the tissues surrounding it swell to such a degree that the windpipe becomes blocked. If untreated, the affected person can suffocate. This infection is extremely dangerous because the symptoms progress quickly, especially in children. A child with a cold or flu that leads to laryngitis should be watched carefully for signs of obstructed breathing.

Laryngitis can result from causes other than infections. Raising the voice for long periods of time has been known to cause laryngitis. Smoking has been linked to chronic laryngitis. A condition called gastrointestinal reflux can also lead to chronic laryngitis. In this condition, stomach acid is forced upward, refluxed, into the esophagus or food tube. If this acid is forced high enough, it can spill over into the windpipe, which can irritate the larynx and eventually cause laryngitis. Doctors treat this kind of laryngitis with antacids that neutralize the stomach acid.

Most people will experience a bout of acute laryngitis over a lifetime. Whether brought on by a cold or flu or simply talking too much, the cure is the same: rest the voice and drink plenty of fluids. Gargling with warm saltwater can also be soothing. Sprays that numb the throat are not recommended because they tend to dry out delicate tissues. Pain relievers, such as acetaminophen, also help, along with the use of vaporizers to create moist air

Alternative treatments include decoctions (extracts made by boiling an herb in water) or infusions (extracts made by steeping an herb in boiling water) can be made with red sage and yarrow or with licorice. These are used for gargling, and are said to reduce pain. Echinacea tincture taken in water every hour for 48 hours is recommended to boost the immune system. Antiviral herbs, including lomatium and ligusticum, may help hasten recovery from laryngitis. Some people may get relief from placing cold compresses on the throat. Most patients recover from laryngitis within a week.

A person can prevent laryngitis in the same way as any common cold, by washing hands often, avoiding touching the face and nose as much as possible, and by disinfecting household surfaces commonly touched by others such as door handles and telephone receivers. However, even with relatively good hygiene practices, most people will get about five to six colds per year, which makes it likely that a person may occasionally get laryngitis.