Ear, Nose and Throat

What is chronic laryngitis?

Laryngitis is an inflammation of the voice box that can cause hoarseness or loss of voice. Chronic laryngitis lasts for more than 3 weeks, and causes can include other illnesses or certain lifestyle factors.

In this article, we examine chronic laryngitis and look at its symptoms, causes, and risk factors. We also cover diagnosis, treatment, and prevention.

What is chronic laryngitis?

Woman sat up coughing due to chronic laryngitis
Symptoms of chronic laryngitis can include a persistent cough, difficulty swallowing, and a sore throat.

The larynx, also known as the voice box, contains the vocal cords in the throat. The vocal cords vibrate to produce a person’s voice.

Laryngitis causes swelling and inflammation of the larynx, which affects the functioning of the larynx and can lead to voice changes, such as hoarseness. The larynx is also essential for protecting the airways, swallowing, coughing, and supporting the lungs.

Laryngitis is either acute or chronic. Acute laryngitis usually comes on rapidly and symptoms usually last around 1 week. It is generally not a serious condition and often clears up without medical treatment.

Chronic laryngitis develops more slowly, with symptoms lasting over 3 weeks. A 2013 study estimates that up to 21 percent of people will develop chronic laryngitis at some point during their lifetime.

Chronic laryngitis is a more severe condition than acute laryngitis as it can cause longer-lasting and more uncomfortable symptoms. It may also be a sign of a more serious underlying condition, such as an autoimmune disorder. However, chronic laryngitis does not cause any serious health problems itself, and symptoms rarely extend beyond the period of illness.


Symptoms

The main symptom of laryngitis is hoarseness or croakiness of voice. Other symptoms of chronic laryngitis can include:

  • excess mucus
  • a persistent cough
  • difficulty swallowing
  • the feeling of a lump in the throat
  • a sore throat
  • loss of voice
  • fever

Many of these symptoms can also occur with acute laryngitis, but they last much longer in chronic laryngitis. A hoarse voice can get worse over time and may persist after other symptoms have gone.

Some people may develop laryngitis alongside other conditions, such as the flu, a cold, or tonsillitis. This means they may also experience other symptoms, such as:

It is also possible for chronic laryngitis to injure the vocal cords over time. This can cause small growths known as polyps or nodules to develop. These growths can be uncomfortable, but they do not pose any significant health risk.


Causes

woman with acid reflux which may be an affect of bulimia on the body
Acid reflux can cause chronic laryngitis.

Laryngitis has a range of different causes.

Viral infections, such as colds and the flu, are the most common cause of acute laryngitis. Bacterial and fungal infections also cause acute laryngitis.

Causes of chronic laryngitis can include:

  • acid reflux
  • overuse of the voice, such as in singers and performers
  • infection
  • smoking
  • steroid inhaler medications
  • excessive alcohol intake
  • chronic sinusitis
  • exposure to chemicals and dust that cause irritation

In rare cases, it is possible for inflammatory conditions that affect the vocal cords, such as tuberculosis, to cause laryngitis.


Risk factors

Risk factors for developing chronic laryngitis include:

  • smoking
  • working in an environment with irritating chemicals or dust
  • working, or having a hobby, that requires prolonged or very loud talking, shouting, or singing
  • respiratory infections, such as colds or the flu

Diagnosis

A doctor will often carry out a physical examination to diagnose laryngitis. They may also ask about a person’s medical history and lifestyle to assess the risk of laryngitis. Some symptoms, such as hoarseness of voice, are usually easy to identify.

A doctor may also conduct a laryngoscopy, which involves passing a thin tube with a camera and light through a person’s mouth or nose and down into their throat. This procedure allows the doctor to inspect the inside of the throat.

To rule out more serious conditions, such as laryngeal cancer, a doctor may also recommend:

  • a biopsy, which involves taking a small sample of throat tissue during a laryngoscopy and analyzing it in a lab
  • an X-ray, CT, or MRI scan, which are imaging tests that allow a doctor to see inside of the throat
  • blood tests, which can check for signs of other conditions


Treatment

There are several treatment options for laryngitis. A person can often treat acute symptoms at home, such as by:

  • avoiding talking, singing, or unnecessary use of the voice
  • drinking plenty of fluids
  • limiting caffeine and alcohol intake
  • avoiding decongestants
  • not smoking
  • avoiding throat irritants, such as smoke, dust, and chemical fumes
  • rinsing the throat with a saline solution or over-the-counter mouthwash

Management of chronic laryngitis often depends on identifying and treating the underlying cause. For example, if the cause is acid reflux, it may be necessary to make dietary changes, such as avoiding fatty, fried, or spicy foods.

In the case of a bacterial infection, some doctors may prescribe antibiotics. However, the use of antibiotics for laryngitis is currently controversial.

A 2015 review of clinical trials involving 351 participants found that antibiotics do not appear to be effective in treating acute laryngitis. The researchers concluded that the cost, side effects, and negative consequences for antibiotic resistance outweigh the benefits of this treatment for laryngitis.

Prevention

woman shows a broken cigarette
Stopping smoking can help to prevent laryngitis.

Although it may not always be possible to prevent chronic laryngitis, some simple measures can help, such as:

  • stopping smoking and avoiding second-hand smoke
  • avoiding straining or overusing the voice
  • drinking alcohol and caffeine in moderation
  • keeping the air at home moist, such as by using a humidifier
  • avoiding inhalation of irritating chemicals or dust, such as by using protective gear
  • washing hands regularly
  • avoiding contact with people who have colds or the flu
  • getting vaccinated against related conditions, such as the flu
  • drinking plenty of fluids


Takeaway

Chronic laryngitis is an inflammation of the voice box that lasts for more than 3 weeks. People with laryngitis usually experience hoarseness of voice, but it can cause discomfort and a range of other symptoms.

Causes of laryngitis can include illnesses, such as colds or the flu, and lifestyle factors, including smoking and excessive use of the voice. Treatment involves resting the voice, avoiding substances that irritate the throat, and treating any underlying conditions.

See a doctor if symptoms are severe or do not improve after a couple of weeks.

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