Acute laryngitis is the most common cause of hoarseness and voice loss that starts suddenly. Most cases of acute laryngitis are caused by a viral infection (the cause of the common cold). In addition to symptoms of a cold or an upper respiratory tract infection (ie, fever, cough, rhinitis), the patient also experiences a hoarse voice. A hoarse voice is defined as one that has the components of breathiness and tension. Patients with laryngitis may also experience pain when speaking or swallowing, difficulty swallowing or a sore throat, difficulty breathing, a runny nose, postnasal drip, nasal congestion, a cough, fatigue, and body aches. The patient’s vocal symptoms usually last 7-10 days.
The best treatment for this condition is to stay well hydrated and to rest or reduce your voice use. Serious injury to the vocal cords can result from strenuous voice use during an episode of acute laryngitis. Since most acute laryngitis is caused by a virus, antibiotics are not effective. Bacterial infections of the larynx are much rarer and often are associated with difficulty breathing. Any problems breathing during an illness warrants an emergency evaluation at the emergency room or at the ENT specialist’s office.
Inhaling humidified air promotes moisture of the upper airway, helping to clear secretions and exudate. Therefore, the use of a cool mist humidifier is helpful and if coughing out thick mucous, a mucolytic agent like Mucinex or Robitussin may be helpful as well.
Complete voice rest is suggested, although this recommendation is nearly impossible to follow. If you must speak, soft sighing phonation is best. Avoidance of whispering is best, as whispering promotes overuse of the inflamed vocal cords.
One contributory factor that can worsen laryngitis and at times cause it is acid reflux. Acid reflux affecting the throat is also called silent reflux or laryngopharyngeal reflux.
Laryngitis that lasts longer than three weeks is known as chronic laryngitis. This type of laryngitis is generally caused by exposure to irritants over time. Chronic laryngitis can cause vocal cord strain and injuries or growths on the vocal cord (polyps or nodules). These injuries can be caused by:
- Inhaled irritants, such as chemical fumes, allergens or smoke
- Acid reflux, also called gastroesophageal reflux disease (GERD)
- Chronic sinusitis
- Excessive alcohol use
- Habitual overuse of your voice (such as with singers or cheerleaders)
- Less common causes of chronic laryngitis include:
- Bacterial or fungal infections
- Infections with certain parasites