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Laryngitis (cont.)

What is the treatment for laryngitis?

As with any other structure in the body that gets inflamed, rest is the key to recovery. For laryngitis, that means limiting the amount of talking. If talking is required, one should avoid whispering and instead talk in a regular voice, regardless of how it sounds. Whispering requires the vocal cords to be stretched tightly and requires more work by the surrounding muscles.

  • The treatment for viral laryngitis is supportive: plenty of fluids, humidified air, acetaminophen or ibuprofen for pain, and the investment of time for recovery.

  • For patients with significant laryngitis, a short course of steroids (prednisone, prednisolone, or dexamethasone) may be used to decrease the inflammation and shorten the course of symptoms. Dexamethasone as a single dose given orally (Decadron, DexPak) or by intramuscular injection (Adrenocot, CPC-Cort-D, Decadron Phosphate, Decaject-10, Solurex) may be used to treat croup.

  • The treatment of chromic laryngitis will be determined by the cause of the inflammation or loss of function. Discontinuation of smoking and alcohol use will always have a positive effect.

What are the complications of laryngitis?

For those patients in which vocal cord paralysis is the cause of hoarseness, aspiration pneumonia may be a concern. Particles of food, fluid, and saliva may be inhaled into the lungs during the swallowing process, since the muscles of the larynx may fail to close and protect the upper airway.

Similarly, repeated episodes of gastroesophageal reflux may cause small amounts of acid to get past the inflamed larynx and enter the lung, causing pneumonia.

Prior to the advent of Haemophilus influenza immunization, epiglottitis due to this infection was always considered as a possible alternative diagnosis for children with croup. This was a true emergency because the epiglottis could massively swell, blocking air from entering the larynx and lungs. X-rays of the neck may be taken to visualize the epiglottis and look for swelling. The diagnosis was often confirmed in the operating room where the otolaryngologist and anesthesiologist would use laryngoscopy to look at the epiglottis and vocal cords and decide whether to insert a breathing tube in the child's airway to prevent the airway from swelling shut. Fortunately, because of immunization, this disease is rarely seen.



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Laryngitis

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