How Long Does Laryngitis Last on Average?
Laryngitis is defined as an inflammation of the laryngeal mucosa. This can be acute when the symptomatology is established in a short period of time, which can vary from hours to days. In case the symptoms last for more than three weeks we are talking about chronic laryngitis.
Acute laryngitis in children and adults are considered as separate entities. This is for several reasons: in children, the airway area is smaller and the arytenoids are larger.
Arytenoids cartilages are a pair of small three-sided pyramids which form part of the larynx, to which the vocal folds (vocal cords) are attached. The affectation is going to be subglottic, therefore the airway compromise occurs more frequently and the predominant symptomatology is dyspnea. In the adult the subglottic affection is less frequent, the inflammation has rather a glottic and supraglottic tropism with what the predominant symptomatology in this case is dysphonia. The evolution of laryngitis is faster in children than in adults. With respect to epidemiology, no exact references of prevalence have been found. There are a multitude of etiological factors and clinical forms, being a self-limiting process in its great majority, no significant morbidity and mortality data have been presented. There is, however, a multitude of predisposing factors closely related to the development of laryngitis such as: smoking, alcohol, vocal overexertion, gastroesophageal reflux, environmental factors (pollution, irritating vapors, abrupt changes in temperature, etc).
The clinical presentation is often part of an acute inflammatory process of the upper respiratory tract manifested by one or more of the following symptoms: dysphonia (loss of normal ringing of the voice due to functional or organic disorder), odynophagia (sore throat produced at swallowing fluids), otalgia reflex (pain in the ear), dyspnea (respiratory distress) in varying degrees. Symptoms may vary according to the cause. The evolution is usually benign, although occasionally obstruction of the airway may occur; in these cases, they are usually infectious, with adult epiglottitis predominating within the group.
The diagnosis is mainly clinical, evidenced by an indirect laryngoscopy or a flexible nasofibroscopy that reveals the presence of inflammatory signs in the laryngeal mucosa, especially in the vocal cords. These are visualized as congested or red in their entirety, with filaments of mucus between the strings due to hypersecretion of the mucous membrane; doctors can find edema (an abnormal infiltration and excess accumulation of serous fluid) of the ventricular bands. If airway patency is questionable, as suggested by stridor, tachycardia and tachypnea, visualization of the larynx will be performed with extreme caution.
Depending on its etiology, acute laryngitis can be classified according to whether it is infectious or noninfectious. Those of infectious cause are the most frequent and within them, the viral ones are the protagonists; although they can also be bacterial. Non-infectious causes include various etiologies, among which are allergic and inhalatory.
Evolution of Acute Laryngitis
In most cases, laryngitis is cured without sequelae in 8 to 15 days. A control by indirect laryngoscopy verifies the return to normality of the laryngeal mucosa. The dysphonia must have disappeared.
Recurrences appear in case of persistence of predisposing factors (toxic, weather conditions, infectious foci, and vocal efforts). These factors favor the chronicity of the process. Surveillance is necessary, especially in smokers in whom dysphonia and recurrent laryngitis should make doctors suspect an adjacent neoplastic process.
Complications or unfavorable evolutions are linked to predisposition (malnutrition, immunosuppression, latent cardiorespiratory insufficiency or others), or to the virulence of the causative agents.
Laryngitis of bacterial origin can be resistant to medical treatment and evolve causing ulceration of the laryngeal mucosa, epiglottitis, perichondritis, and even laryngeal abscess. These severe cases may require aggressive therapeutic measures (intubation, parenteral antibiotic therapy, hyperbaric oxygen therapy in a hospital center).
This condition may also appear in addition to symptoms such as dry cough, pain and throat itching, congestion, fever and malaise. It is important to note that laryngitis can be acute or chronic depending on its duration, while the first can last only a few days, the chronic can persist for more than three weeks.