Is Laryngitis Painful?
The term laryngitis describes the inflammation of the larynx and a variety of different causes that result in the presentation of common symptoms. Laryngitis can be acute or chronic, infectious or inflammatory, an isolated disorder, or part of a systemic disease, and often includes symptoms such as hoarseness or dysphonia.
Commonly, laryngitis is related to an infection of the upper respiratory tract and can have an important impact on physical health, quality of life and even psychological well-being and occupation if the symptoms persist.
Laryngitis includes a set of non-specific laryngeal signs and symptoms that may also be caused by other diseases. Consequently, the diagnosis can be difficult and requires correlation with the clinical history, the physical examination and, if necessary, with the specialized evaluation, including visualization of the larynx and stroboscopy.
What Is The Larynx?
The larynx is a complex organ that is important for the protection of the respiratory tract and the maintenance of safe swallowing and positive pressure in the pulmonary system. It participates in the act of coughing, making efforts and swallowing, and has immunological and even hormonal functions. The disease related to changes in the larynx can affect some or all of these functions.
The term laryngitis is descriptive and refers to the inflammation of the larynx. It is usually used to describe acute infectious laryngitis, one of the most common diseases of the larynx. However, a multitude of other causes of inflammation of the larynx present with similar signs and symptoms.
Typically, laryngitis includes dysphonia, loss of air mass (excessive loss of air through the glottis that did not close completely resulting in a choked voice), and pain or discomfort in the anterior part of the neck. It may include other symptoms such as cough, throat clearing, pharyngeal globus (feeling of a lump in the throat), fever, myalgia and dysphagia.
What Are The Causes Of Acute Laryngitis?
Acute laryngitis is commonly caused by an infection (viral, bacterial or fungal), inflammation or trauma and edema of the larynx that impairs the vibration of the vocal cords, with consequent inflammation and symptoms. It may involve any area within the larynx, including the supraglottis (epiglottis, arytenoids and the folds of the false vocal cords), the glottis (the true vocal cords), and the subglottic regions.
The larynx can be affected directly by the inhaled material or by hematogenous spread, infectious secretions, or as a consequence of irritation for example in contact trauma, cough. Symptoms may persist, but are usually self-limiting with duration of less than two weeks. In general practice, the treatment is generally supportive, with voice rest, adequate hydration, and mucolytics.
Viruses are the most common cause of acute laryngitis, most often rhinovirus, adenovirus, influenza, parainfluenza and other viruses should be considered, especially in patients who have an affected immune system (e.g., herpes species, human immunodeficiency virus, Coxsackie). Rarely, serious infections such as herpes simplex can lead to erosion of the larynx and necrosis.
Bacteria are also a major cause of acute laryngitis, and the distinction between viral and bacterial infections can be difficult. Both can coexist, the viral disease allows opportunistic bacterial superinfection to occur. The production of pseudomembranes or serous molds, purulence, marked erythema is often suggestive of bacterial disease. Historically diphtheria was associated with a pathognomonic gray membranous laryngitis that could cause airway obstruction. With vaccination this is rarely seen today.
The viral disease may manifest as blisters, particularly herpes zoster, and may be associated with nerve paralysis involving the lower cranial nerves. Likewise, erythema and pain disproportionate to the appearances of the mucosa may be representative of the viral disease.
The symptoms that the patient suffering from laryngitis may present depend exclusively of the etiological factor. In general, these include dysphonia, dry cough, fever, malaise, and throat itching and even pain originated by the inflammation or trauma and edema of the larynx that impairs the vibration of the vocal cords.
- “Laryngitis: Overview.” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/laryngitis/symptoms-causes/syc-20374262
- “Laryngitis.” Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21372-laryngitis
- “Laryngitis.” NHS Inform. https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/laryngitis