Acute Laryngitis: Causes, Features, Treatment

Acute laryngitis may be infectious or non-infectious.
Aetiology
The infectious type is more common and usually follows
upper respiratory infection. To begin with, it is viral in ori gin
but soon bacterial invasion takes place with Strept.
pneumoniae, H. influenzae and haemolytic streptococci or
Staph. aureus. Exanthematous fevers like measles, chickenpox
and whooping cough are also associated with laryngitis,
The non-infectious type is due to vocal abuse, allergy,
thermal or chemical burns to larynx due to inhalation or
ingestion of various substances, or laryngeal trauma such
as endotracheal intubation.
Clinical Features
Symptoms are usually abrupt in onset and consist of:
1. Hoarseness which may lead to complete loss of voice.
2. Discomfort or pain in throat, particularly after talking.
3. Dry, irritating cough which is usually worse at night.
4. General symptoms of head, cold, rawness or dryness
of throat, malaise and fever if laryngitis has followed
viral infection of upper respiratory tract.
Signs: Laryngeal appearances vary with severity of disease. In early
stages, there is erythema and oedema of epiglottis,
aryepiglottic folds, arytenoids and ventricular bands, but
the vocal cords appear white and near normal and stand
out in contrast to surrounding mucosa, betraying the
degree of hoarseness patient has. Later, hyperaemia and
swelling increase. Vocal cords also become red and swollen.
Subglottic region also gets involved. Sticky secretions are
seen between the cords and interarytenoid region. In case
of vocal abuse, submucosal haemorrhages may be seen in
the vocal cords.
Treatment
1. Vocal rest. This is the most important single factor.
Use of voice during acute laryngitis may lead to
incomplete or delayed recovery.
. 2, Avoidance of smoking and alcohol.
3. Steam inhalations with Tr. Benzoin Co, oil of eucalyptus
or pine are soothing and loosen viscid secretions.
4. Cough sedative. To suppress troublesome irritating
cough.
5. Antibiotics. When there is secondary infection with
fever and toxaemia or purulent expectoration.
6. Analgesics. To relieve local pain and discomfort.
7. Steroids. Useful in laryngitis following thermal or
chemical burns.

Acute membranous laryngitis. This condition is
similar to acute membranous tonsillitis and is caused by
pyogenic non-specific organisms. It may begin in the larynx
or may be an extension from the pharynx. It should
be differentiated from laryngeal diphtheria.