Chronic laryngitis (CL) is chronic laryngeal inflammation with an annual incidence of about 4 cases per population of 1000 [1]. The most common cause of CL is laryngopharyngeal reflux but other causes include vocal abuse (singing, teaching), smoking, excessive alcohol and caffeine intake, bacterial and fungal infections as well as occupations like glass blowing [2] [3] [4].

Patients usually present with waxing and waning dysphonia, globus (foreign body) sensation in the throat, pain in the throat, constant urge to clear the throat, and dry cough. Symptoms of dysphonia include reduced volume, hoarseness, raw sensation, inability to modulate the voice and vocal fatigue.The symptoms depend on the severity of the inflammation. In severe infections, patients may have a fever, laryngeal edema, dyspnea and even stridor. Chronic laryngeal mucosal injury secondary to gastroduodenal reflux (GERD) of acidic contents has been implicated as a cause of CL in almost 50% of the patients [5]. Clinical features of CL associated with GERD are called laryngopharyngeal reflux (LPR) as the main region affected is the laryngopharynx [6] [7].

• Inflammation

  Chronic laryngitis (CL) is chronic laryngeal inflammation with an annual incidence of about 4 cases per population of 1000. [symptoma.com]

  PREOBRAZHENSKII laryngitis [‚lar·ən′jīd·əs] (medicine) Inflammation of the larynx. laryngitis inflammation of the larynx [encyclopedia2.thefreedictionary.com]

  […] by Sue Pondrom • September 3, 2010 Nonetheless, “chronic laryngitis is inflammation of the larynx; it is not commonly misdiagnosed,” Dr. Sataloff said. [enttoday.org]

  Talk to your doctor about other ways you can reduce the possibility of inflammation. You should avoid working in locations that constantly expose you to harsh chemicals. People who smoke should quit immediately to lower their risk of inflammation. [healthline.com]

  By having a good comfort level in your throat you will be able to prevent your voice or throat from straining and therefore can prevent inflammation. [onlymyhealth.com]

• Pain

  When phonation, and cough - sharp pain in my throat. With the defeat of the top departments of the larynx there podergivani, severe pain when swallowing. Often develops stenosis of the larynx (see Langostinos ). [medicalency.com]

  […] upon arising in the morning As the physical activity increases the sound improves The next morning the hoarseness returns Over long periods of time there is fatigue of the voice and sound cannot be emitted for an extended period Throat discomfort and pain [americandragon.com]

  It started with excess gas and burping and stomach pain and then the. and stuffy nose, sinus congestion and pain, sore throat, ear pain, difficulty in swallowing, loss of smell or taste. the blisters is clear and watery, the blisters look like ovalshaped [elmemesser.eu]

  Dysphonia, globus sensation, and pain were the most common symptoms. Population surveys could be used to define undiagnosed disease and the overall prevalence of CL. [ncbi.nlm.nih.gov]

  This procedure is not painful, although doctors can numb the throat using an anesthetic spray if necessary. [ada.com]

• Swelling

  When laryngoscopy is marked swelling and edema of the mucous membrane, in places visible inflamed follicles and small raids similarly follicular and lacunar tonsillitis (see). [medicalency.com]

  Call your child’s doctor if your child has symptoms of vocal cord swelling accompanied by any of the following: a barking cough fever difficulty breathing difficulty swallowing These may be signs of croup, which causes swelling of the area around the [healthline.com]

  With reflux, there is swelling of the inner lining of the larynx and redness of the arytenoids. If a pseudomembrane is present, diphtheria is suspected. [merckmanuals.com]

  Usually, the laryngitis (redness and swelling) will resolve when the irritants are removed from contact with the larynx. [voicefoundation.org]

  Swelling in the voice box, also known as the larynx, causes laryngitis. This organ is in your upper neck just beyond the back of your throat. An infection, such as a cold, the flu, or bronchitis, may spur the swelling. [webmd.com]

• Fever

  Tonsillitis in adults is a very painful condition associated with fever and swollen glands. symptoms of a cold – sneezing sore throat runny nose even a low-grade fever. Then canker flared and aphthous symptoms followed. [elmemesser.eu]

  Clinical Manifestations Severe chills May have mild fever No sweat Aversion to Cold Cold extremities Cold sensation on back Pale face Extreme fatigue Muscle aching T: Pale with scallop C: White P: Deep, weak and thready Treatment Principle Warm Yang Expel [americandragon.com]

  The more commonly encountered bacterial organisms are: Moraxella catarrhalis H.influenzae Streptococcus pneumoniae Exanthematous fevers such as chickenpox, measles and whooping cough are also linked with acute laryngitis. [houstonent.com]

  Lancefield's GABS can cause rheumatic fever, Sydenham's chorea, glomerulonephritis and scarlet fever. Streptococcal infection may cause a flare-up of guttate psoriasis. Enlarged and chronically infected tonsils interfere with children's sleep[11]. [patient.info]

  If the child has a fever, a sore throat, won't eat or drink, or has a decreased number of wet diapers (indicating less than adequate drinking) you should take the child to see a doctor. [emedicinehealth.com]

• Fatigue

  Clinical Manifestations Chronic simple laryngitis : Episodic hoarseness which is most prevalent upon arising in the morning As the physical activity increases the sound improves The next morning the hoarseness returns Over long periods of time there is fatigue [americandragon.com]

  The main complaints - hoarseness, fatigue voice. In atrophic laryngitis, in addition,dryness in the throat. [medicalency.com]

  Other symptoms include laryngeal fatigue (tired voice) and non-productive coughing and throat clearing. [provoicecenter.com]

  Vocal fatigue 3. Chronic throat irritation 4. Dry hacking cough Signs: 1. Vocal cord edges loose their pearly shine and appear red and congested with dilated blood vessels on the superior surface. 2. [specialist-ent.com]

  Sinus congestion Chest congestion Shortness of breath Wheezing Fatigue Body aches or chills Chest discomfort from coughing Here's a snapshot of the symptoms that distinguish acute bronchitis from chronic bronchitis, followed by more detailed information [verywellhealth.com]

• Hoarseness

  The main complaints - hoarseness, fatigue voice. In atrophic laryngitis, in addition,dryness in the throat. [medicalency.com]

  Throat discomfort and pain upon emitting sounds There is often a habit of clearing ones throat but no evident sputum is coughed up The hoarseness is more evident when attempting to make a high pitched sound A long history of hoarseness and aphonia Hoarseness [americandragon.com]

  Symptoms of Chronic Laryngitis Vocal hoarseness is the primary symptom of chronic laryngitis. This results from vocal cord inflammation. [houstonent.com]

  The main symptom of laryngitis is hoarseness or croakiness of voice. [medicalnewstoday.com]

• Cough

  Clinical Manifestations Cough with little yellow sputum Spitting saliva Wheezing Shortness of breath Dry, uncomfortable sensation in throat Hiccups Dry mouth Coughing up difficult-to-expectorate Phlegm Nausea Hoarseness Thirst Asthma Flushed face Five [americandragon.com]

  A patient can contract laryngitis after a cold, prolonged cough, or respiratory disease. Coughing, in particular, can cause irritation of the larynx because it agitates the vocal cords by bringing them together. [virginiaent.com]

  It might benefit you to take a cough suppressant if you're also experiencing coughing since prolonged coughing could cause long-term damage to your vocal fold tissue. What is Chronic Laryngitis? Chronic laryngitis is persistent. [houstonent.com]

  […] a frequent cause of cough. [arquivosdeorl.org.br]

• Sore Throat

  A GP with a list of 2,000 can expect to see around 120 cases of sore throat a year with considerable seasonal variation - see the separate Sore Throat article[1]. [patient.info]

  This, like affections of the throat and nares, usually begins with a severe cold, and is always attended by hoarseness. It is more frequently a mere extension of Catarrh or sore-throat than an original disease. [nytimes.com]

  Acute laryngitis typically is a brief illness producing hoarseness and a sore throat. In most cases, an upper respiratory tract infection causes it. [health.harvard.edu]

  Pharyngitis Other names Acute sore throat Viral pharyngitis resulting in visible redness. [en.wikipedia.org]

• Pharyngitis

  Treatment with pantoprazole reduced the frequency and severity of gastroesophagopharyngeal acid reflux in patients with chronic pharyngitis and laryngitis. [ncbi.nlm.nih.gov]

  What are pharyngitis and tonsillitis? Pharyngitis and tonsillitis are infections that cause inflammation. If the tonsils are affected, it is called tonsillitis. If the throat is affected, it is called pharyngitis. [hopkinsmedicine.org]

  Pharyngitis Other names Acute sore throat Viral pharyngitis resulting in visible redness. [en.wikipedia.org]

  Oral, pharyngeal and upper esophageal sphincter motility disordersReview Gastroesophageal reflux and asthmaGastroesophageal reflux and chronic cough Gastroesophageal reflux disease > and asthmaOverview Oral, pharyngeal and upper esophageal sphincter [nature.com]

• Chronic Cough

  Post-nasal drip (PND) Chronic cough is a regular clinical situation. [arquivosdeorl.org.br]

  What is Aetiology of Chronic Laryngitis? Endogenous 1) Constitutional 2) Metabolic 3) Diabetes, hypothyroidism 4) Vit A deficiency II. Physical 1) Chronic voice abuse 2) Chronic cough III. [specialist-ent.com]

  […] antireflux therapy, and patients with pulmonary manifestations such as chronic cough. [nature.com]

  The most typical symptoms/complaints associated with vocal chronic laryngitis may include: Vocal fatigue The sensation of a lump in the throat or a dry throat A need to clear the throat excessively Excessive mucous in the throat A chronic cough Discomfort [entwellbeing.com.au]

  Guggul can be given in large doses several times daily for laryngitis, bronchitis, pneumonia and whooping cough. The gargles of guggul can be used for acute and chronic nasal congestion, chronic laryngitis, chronic bronchitis and tuberculosis. [drvikram.com]

• Dysphagia

  Learn More About Topic css id: Dysphagia Dysphagia means that you can’t swallow well. Many factors may cause dysphagia, and most are temporary and non-life-threatening. [entnet.org]

  The most common symptoms were dysphonia (53%), pain/soreness (45%), globus sensation (40%), cough (33%), excessive throat clearing (28%), and dysphagia (32%). An otolaryngologist saw 93% of the cases. [ncbi.nlm.nih.gov]

  Symptoms included hoarseness (8/12), dysphagia (6/12), and hemoptysis (1/12). There was poor correlation between oral lesions and esophageal or laryngeal involvement. [pediatrics.aappublications.org]

  Fever, malaise, dysphagia, and throat pain may occur in more severe infections. Laryngeal edema, although rare, may cause stridor and dyspnea. [merckmanuals.com]

  In patients with infectious mononucleosis (glandular fever) requiring hospital admission, corticosteroids may have a role when pain and swelling threaten the airway or where there is very severe dysphagia[2]. [patient.info]

• Dysphagia

  Learn More About Topic css id: Dysphagia Dysphagia means that you can’t swallow well. Many factors may cause dysphagia, and most are temporary and non-life-threatening. [entnet.org]

  The most common symptoms were dysphonia (53%), pain/soreness (45%), globus sensation (40%), cough (33%), excessive throat clearing (28%), and dysphagia (32%). An otolaryngologist saw 93% of the cases. [ncbi.nlm.nih.gov]

  Symptoms included hoarseness (8/12), dysphagia (6/12), and hemoptysis (1/12). There was poor correlation between oral lesions and esophageal or laryngeal involvement. [pediatrics.aappublications.org]

  Fever, malaise, dysphagia, and throat pain may occur in more severe infections. Laryngeal edema, although rare, may cause stridor and dyspnea. [merckmanuals.com]

  In patients with infectious mononucleosis (glandular fever) requiring hospital admission, corticosteroids may have a role when pain and swelling threaten the airway or where there is very severe dysphagia[2]. [patient.info]

• Odynophagia

  Chronic laryngitis typically produces symptoms of frequent throat-clearing, soreness, decreased voice quality with use, nonproductive cough, globus sensation, and odynophagia. [scholars.northwestern.edu]

  On 2 nd day, patient complained of severe dysphagia and odynophagia and was referred for otolaryngological examination. Ear, nose, and throat (ENT) examination revealed: Oral cavity- NAD. [laryngologyandvoice.org]

  Dysphagia (difficulty swallowing) or odynophagia (pain on swallowing). Signs of serious systemic illness. Differential diagnosis See also the separate article Hoarseness. Acute laryngitis Early chronic laryngitis. Spasmodic dysphonia. [patient.info]

  […] hoarseness.[1][15] The symptoms in this form of laryngitis are usually present for less than one week, however they can persist for 3-4 weeks.[1] This form of laryngitis might also be accompanied by upper respiratory tract symptoms such as: sore throat, odynophagia [en.wikipedia.org]

• Hiccup

  Clinical Manifestations Cough with little yellow sputum Spitting saliva Wheezing Shortness of breath Dry, uncomfortable sensation in throat Hiccups Dry mouth Coughing up difficult-to-expectorate Phlegm Nausea Hoarseness Thirst Asthma Flushed face Five [americandragon.com]

• Ulcer

  The vocal cords share in the alteration, while erosion of the mucous membrane, with occasional ulceration, is a rare condition. Symptoms . [henriettes-herb.com]

  […] code together. acute laryngitis ( ICD-10-CM Diagnosis Code J04.0 Acute laryngitis 2016 2017 2018 2019 Billable/Specific Code Applicable To Edematous laryngitis (acute) Laryngitis (acute) NOS Subglottic laryngitis (acute) Suppurative laryngitis (acute) Ulcerative [icd10data.com]

  Ulceration and granuloma formation were less common, but also responded to antireflux treatment. [ncbi.nlm.nih.gov]

  The resin is used in the form of a lotion for corneal ulcers and as a gargle in chronic tonsillitis, pharyngitis, chronic laryngitis and ulcerated throat. [drvikram.com]

  Oropharynx-0.5 × 0.5 cm sized multiple ulcerative lesions covered with slough were present over uvula, soft palate, anterior and posterior tonsillar pillars, and posterior pharyngeal wall. [laryngologyandvoice.org]

• Neck Swelling

  When to call your healthcare provider If a sore throat is severe and includes trouble swallowing, drooling, or neck swelling, see a healthcare provider right away. [hopkinsmedicine.org]

• Headache

  […] is also regarded as safe to use during pregnancy for pain relief and/or headaches. buy zyban cough syrup online stomach septic tonsilitus high sore notes throat can sing pain;headache dizziness inging in your ears; vision changes; loss of interest in [elmemesser.eu]

  Chronic laryngitis may increase body temperature, headaches. How to cure chronic laryngitis? Treatment of chronic laryngitis is carried out comprehensively. [medicalcentr.com]

  This means they may also experience other symptoms, such as: swollen glands fatigue headaches cold or flu-like symptoms It is also possible for chronic laryngitis to injure the vocal cords over time. [medicalnewstoday.com]

The diagnosis of CL is based on clinical evaluation and patient history. It is vital for the otolaryngologist to inquire about the patient's occupation, allergies, vocal abuse and infections (tuberculosis). During the physical examination, an indirect, as well as, flexible nasopharyngolaryngoscopy is performed in all patients presenting with dysphonia lasting longer than 3 weeks. LPR can be diagnosed on the basis of the presenting symptoms and the appearance of laryngeal edema and arytenoid erythema on laryngoscopy [8]. In addition, thick, sticky mucus may be noticed in the piriform sinuses and valleculae. A video-stroboscopy provides information about vocal fold anatomy, vibratory pattern and can help to differentiate between a sulcus vocalis from mucosal stiffness. If infective etiology is suspected then a complete blood cell count, erythrocyte sedimentation rate with sputum cultures and sensitivities for bacteria, fungi, and viruses should be ordered. Serology for autoimmune disorders like sarcoidosis should also be considered. Skin allergy testing is recommended if an allergic etiology is suspected. Barium swallow, manometry and 24 hour pH monitoring are recommended for the diagnosis of GERD.
Although plain X-ray neck has no role in the diagnosis of CL, plain X-ray chest may help to detect pulmonary tuberculosis or sarcoidosis as the cause of CL. Computed tomographic scan and magnetic resonance scan are not routinely performed but may help to detect soft tissue changes, structural laryngeal changes, as well as, tumors.
Microlaryngoscopy under general anesthesia to visualize the larynx with a microscope may be necessary to detect tiny lesions and obtain tissue for biopsy, as well as for staining and cultures. The histological examination may reveal pachydermia (in long-term smoker's CL), amyloidosis, granulomatous lesions as well as malignancies. Lipoid proteinosis with hyaline deposits can mimic chronic laryngitis [9] on histology.

• Polyps

  Patients with vocal fold polyp served as control cases. SETTING: Tertiary care university hospital. PATIENTS: Eighteen consecutive patients were enrolled in the study. Thirteen of them had chronic laryngitis, and 5 had vocal fold polyps. [ncbi.nlm.nih.gov]

  Surgery Cases where one’s chronic laryngitis has led to vocal cord polyps or vocal cords that are loose or paralyzed are considered to be more serious. [healthline.com]

  Patients with vocal fold polyp served as control cases. Setting Tertiary care university hospital. Patients Eighteen consecutive patients were enrolled in the study. Thirteen of them had chronic laryngitis, and 5 had vocal fold polyps. [jamanetwork.com]

  Vocal cords can become strained and develop growths, such as polyps or nodules. [medicalnewstoday.com]

  If not treatment is taken, Laryngeal polyps develop on true and false cords with fibrosis and hyalinization of cords. What is the treatment of chronic laryngitis? 1. Stop smoking and alcohol 2. Plenty of fluids to thin secretion 3. Voice rest 4. [specialist-ent.com]

All patients received treatment with pantoprazole 80 mg daily for 8 weeks. One week after the end treatment, patients had a second ENT examination and a 24-hour pH monitoring using dual-channel probe. We included 33 patients (11 men, 22 women). [ncbi.nlm.nih.gov]

Treatment of Chronic Laryngitis There are various treatments for chronic laryngitis. [houstonent.com]

Clinical Manifestations Severe chills May have mild fever No sweat Aversion to Cold Cold extremities Cold sensation on back Pale face Extreme fatigue Muscle aching T: Pale with scallop C: White P: Deep, weak and thready Treatment Principle Warm Yang Expel [americandragon.com]

The prognosis in confirmed laryngitis is not favorable, as but few have the patience necessary to persist in the use of remedies until a cure is effected. [henriettes-herb.com]

Before anti-tubercular drug use, in the 1950’s, it was a common and frequently fatal disease but it’s clinical features, age group involved and prognosis has changed over the last few decades. [scopemed.org]

However, any underlying conditions or infections may have to be treated accordingly Generally, the prognosis is excellent with suitable treatment; acute cases are normally self-limiting and last a couple of weeks, while chronic conditions may take longer [dovemed.com]

Rarely, in severe infections such as those with herpes viruses, laryngeal erosion and necrosis may occur. [ 1 ] Prognosis In acute laryngitis, the prognosis is usually excellent. [patient.info]

Less frequently used treatments include intralesional injections or laser resection.[1] Prognosis[edit] Acute[edit] Acute laryngitis may persist, but will typically resolve on its own within two weeks.[1] Recovery is likely to be quick if the patient [en.wikipedia.org]

Skin allergy testing is recommended if an allergic etiology is suspected. Barium swallow, manometry and 24 hour pH monitoring are recommended for the diagnosis of GERD. [symptoma.com]

These findings show a possible role of H. pylori infection in the etiology of chronic laryngitis in certain patients and can be important for clinical diagnosis and treatment. [ncbi.nlm.nih.gov]

Amitriptyline is commonly used for mental/mood problems, but is also prescribed to treat chronic laryngitis because some investigators suggest a neuropathic etiology for idiopathic chronic laryngitis. [clinicaltrials.gov]

[…] secretion in chronic laryngitis. ( 11081617 ) Ebenfelt A....Finizia C. 2000 34 Diagnosis and management of chronic laryngitis associated with reflux. ( 10718463 ) Hanson D.G....Jiang J.J. 2000 35 A possible role of helicobacter pylori infection in the etiology [malacards.org]

Further epidemiological and experimental studies are necessary to clarify the impact of obesity on this condition. © 2015 S. Karger GmbH, Freiburg. [ncbi.nlm.nih.gov]

Epidemiology. 12:200–208. pmid:11246581 View Article PubMed/NCBI Google Scholar 24. [journals.plos.org]

Key words Laryngitis insulin resistance epidemiology Republic of Korea This is a preview of subscription content, log in to check access. References 1. Hammer HF. [link.springer.com]

The Epidemiologic Survey Committee of the Korean Otolaryngologic Society prepared a CL diagnostic protocol. The laryngologic questionnaire asked whether the participants have had problems with their voice. [karger.com]

Pathophysiology : Dilated vessels are seen on superior surface of vocal cords. Movements are flabby and sluggish. Interstitial oedema and inflammatory exudates are present. [specialist-ent.com]

This suggests that differences in pathophysiology between LPR and GERD patients are part of the basis for the contrasting symptomology. [nature.com]

World journal of gastrointestinal pathophysiology. 2010;1:91–96. CrossRef PubMed PubMedCentral Google Scholar 21. El-Serag HB, Graham DY, Satia JA, Rabeneck L. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. [link.springer.com]

Our data question the uniform presence of dilated intercellular space in patients with GERD and suggest a possible graded distal oesophageal variation of this pathophysiologic marker. [onlinelibrary.wiley.com]

LPR without heartburn: A pathophysiological and conceptual dilemma The exact mechanism for LPR is unclear. [racgp.org.au]

By having a good comfort level in your throat you will be able to prevent your voice or throat from straining and therefore can prevent inflammation. [onlymyhealth.com]

These are some things to try to prevent laryngitis. [houstonent.com]

Therefore, symptoms of 96% of patients responded to treatment aimed at preventing reflux of gastric acid. The remaining patients with refractory symptoms had a partial response or no response or chose fundoplication. [ncbi.nlm.nih.gov]

The doctor will probably recommend the standard prevention guidelines and may refer the patient to a speech-language pathologist for voice therapy. [drvikram.com]

1. Stein DJ, Noordzij JP. Incidence of chronic laryngitis. Ann Otol Rhinol Laryngol. 2013;122:771-774.
2. Baletic N, Jakovljevic B, Marmut Z, Petrovic Z, Paunovic K. Chronic laryngitis in glassblowers. Ind Health. 2005;43:302-307.
3. Chen H, Thornley P. Laryngeal tuberculosis: a case of a non-healing laryngeal lesion. Australas Med J. 2012;5:175-177.
4. Allen CT, Merati AL. Acute and chronic laryngitis; in Flint PW, Haughey BH, Lund VJ, Niparko JK, Robbins KT, Thomas JR, Lesperance MM (eds). Cummings Otolaryngology Head & Neck Surgery. Philadelphia, Mosby Elsevier, 2015, pp 928-935.
5. Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991;101:1-78.
6. Koufman JA. Laryngopharyngeal reflux is different from classic gastroesophageal reflux disease. Ear Nose Throat J. 2002;81:7-9.
7. Koufman JA, Aviv JE, Casiano RR, Shaw GY. Laryngopharyngeal reflux: position statement of the Committee on Speech, Voice, and Swallowing Disorders of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngol Head neck Surg. 2002 Jul;127 910: 32- 5
8. Farrokhi F, Vaezi MF. Laryngeal disorders in patients with gastroesophageal reflux disease. Minerva Gastroenterol Dietol. 2007;53:181-187.
9. Oz F, Kalekoglu N, Karakullukçu B, Oztürk O, Oz B. Lipoid proteinosis of the larynx. J Laryngol Otol. 2002 Sep; 116(9):736-9