Acute Laryngitis vs Chronic Laryngitis: Symptoms, Differences, Diagnosis, and Treatment

The infectious form of acute laryngitis is most common and often follows an upper respiratory tract infection. To start with, it's usually viral but bacterial agents later occur. Viral agents might include:

• Parainfluenza virus

• Rhinovirus

• Coronavirus

• Respiratory Syncytial virus

• Influenza virus

• Adenovirus

HIV and coxsackievirus might be possible causes among immunocompromised people. 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. Fungal infection-related laryngitis is also common but often stays undiagnosed. This typically occurs secondary to recent antibiotic or inhaled corticosteroids use. Strains that cause fungal laryngitis are:

• Cryptococcus

• Blastomyces

• Histoplasma

• Coccidioides

• Candida

The non-infectious form of acute laryngitis is due to things like:

• Allergy

• Vocal trauma

• Use of asthma inhalers

• GERD

• Environmental pollution

• Chemical or thermal burns of your larynx

• Smoking

Symptoms of Acute Laryngitis

Acute laryngitis often causes symptoms like:

• Sore throat

• Hoarseness of the voice

• A cough

• Fever (first few days of infection)

• A need to frequently clear your throat

Symptoms often come on suddenly and become worse after a few days. After around a few weeks, with adequate treatment that includes resting your larynx and drinking plenty of water, symptoms like a hoarse voice and cough typically relieve.

While acute laryngitis typically relieves without treatment, it's essential that you see a doctor immediately if you:

• Cough up blood

• Experience swallowing problems

• Have a persistent fever of over 103 F

• Have trouble breathing

• Have respiratory problems

These symptoms could indicate epiglottis. This is a condition where the tissue covering the lid of your windpipe become inflamed. It could be life-threatening.

Diagnosis of Acute Laryngitis

Doctors often diagnose acute laryngitis by examining the throat. They'll try and identify the cause of your acute laryngitis since this will determine what the proper course of treatment should be, if needed. If your laryngitis is caused by a known underlying disorder like GERD, the treatment plan for this could be adjusted to avoid further laryngeal complications.

Your doctor might perform a laryngoscopy to examine your larynx in order for them to determine what's causing your laryngitis. They may do this indirectly or directly. When performed indirectly, it involves them shining a light into your throat and using a handheld mirror to examine your larynx. When performed directly, it involves them inserting a small tube with an attached camera into your throat through your mouth to view your larynx in detail.

Treatment of Acute Laryngitis

The best treatment for acute laryngitis includes plenty of rest, staying hydrated (externally and internally) and antibiotics if required (for bacterial infection). 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. It produces voice changes and lingering hoarseness. It's typically painless and doesn't have any significant sign of infection. It also takes longer to develop. It persists for more than three weeks. 

It could be caused by things like:

• Cigarette smoke

• Irritation from asthma inhalers

• Polluted air (i.e. gaseous chemicals)

• GERD

• Vocal misuse (i.e. prolonged vocal use at abnormal pitch or loudness)

Vocal misuse can lead to an increased adducting force of your vocal folds, followed by increased friction and contact between the contacting folds. The contact area between the folds starts swelling. 

Symptoms of Chronic Laryngitis

Vocal hoarseness is the primary symptom of chronic laryngitis. This results from vocal cord inflammation. When your vocal cords become inflamed, it can distort the sounds you make while talking, when air passes over them, leading to hoarseness of your voice.

Common chronic laryngitis symptoms include:

• Sore throat

• Voice hoarseness

• Swallowing problems

• Coughing

Diagnosis of Chronic Laryngitis

Your doctor can give you a chronic laryngitis diagnosis. You'll want to pay them a visit if you have been experiencing laryngitis symptoms that have lasted for more than 14 days. You're better off addressing your laryngitis sooner than later. The doctor will likely look at your larynx through a laryngoscopy procedure. If they find anything abnormal, they'll probably order a biopsy of the impacted area.

Treatment of Chronic Laryngitis

There are various treatments for chronic laryngitis. If you have already tried home treatments like drinking fluids, resting your voice and not smoking and your acute laryngitis has turned into chronic laryngitis, the doctor will first try and find the underlying cause. Treatment will depend on what the underlying cause is. 

For instance, if it's being caused by GERD, the doctor will have you make dietary changes like avoiding fried, spicy or fatty foods. They may prescribe GERD medication. For bacterial infection, they may prescribe antibiotics. 

Laryngitis Prevention

You can help prevent laryngitis with some general healthy practices like avoiding contact with individuals with a cold or the flu and washing your hands. If you use your voice excessively for a living (i.e. public speaking, singer), you should take frequent breaks. Consult with your Houston ENT doctor to learn about ways of reducing the potential of voice box inflammation. If you smoke, quit immediately to lower your inflammation risk. Avoid working in areas that expose you to harsh chemicals constantly. Have your stomach acid reflux treated properly and avoid excessive alcohol intake. These are some things to try to prevent laryngitis.

CONTACT HOUSTON ENT & ALLERGY SERVICES VOICE AND SWALLOWING CENTER FOR A LARYNGITIS DIAGNOSIS AND TREATMENT 

If you're experiencing signs and symptoms of acute or chronic laryngitis, contact us here at Houston ENT Clinic to set up an appointment. Visit our new Voice and Swallowing Center at our Southwest Houston ENT office and Memorial City ENT office lead by Dr. Michael Underbrink, M.D., M.B.A., F.A.C.S. . The Voice and Swallowing Center offers diagnostic and treatment services for acute and chronic laryngitis, as well as many voice, swallowing, and airway disorders.

By: Michael P Underbrink, MD