Laryngitis

introduction

If you have a laryngitis (laryngitis) it is an inflammation of the larynx. A distinction is made between an acute and a chronic form. While the acute form is usually triggered by bacteria or viruses, the causes of chronic laryngitis are usually long-term stress on the vocal folds, for example through abuse of tobacco or alcohol, inhaling dry, dusty air, excessive stress on the vocal cords or receding (Reflux) of gastric juice into the esophagus. Rarely, especially when the voice is not spared, an acute inflammation can develop into a chronic one.

root cause

The acute laryngitis is usually caused by viruses, and is particularly common Parainfluenza Viruses, but also others (Influenza viruses, Adenoviruses, Rhinoviruses, Enteroviruses or RS viruses) are not uncommon.
bacteria This disease usually occurs as a so-called superinfection, which means that it is already infected Larynx sit on. In most cases, the acute form occurs as part of an upper respiratory disease such as one cold or Sinus infection, but sometimes an inflammation can arise from below, for example in one bronchitis.
Pollutants lead to the typical picture of acute inflammation less often.

Classification

Acute laryngitis is divided in terms of its exact location in relation to the glottis (glottis) again in three groups:

1. There are the supraglottic inflammation (above the glottis)
2. the glottic inflammation (in the area of ​​the glottis) and
3. the subglottic inflammation (below the glottis), often also called Pseudo croup referred to as.

Inflammation of the Supraglottis (Epiglottitis) is bacterial, takes a highly acute course and is a life-threatening emergency, but the remaining variants of laryngitis are rather harmless and heal themselves within a few days for most of those affected.

Symptoms

The classic acute laryngitis is particularly noticeable through the two main symptoms of cough and hoarseness.
The painful cough is often referred to as "barking", especially in the case of subglottic laryngitis in young children. The throat is often scratchy, so that patients describe that they feel like they have to constantly clear their throat. The hoarseness is often accompanied by a hoarse voice, which sometimes even becomes completely voiceless (Aphonia) can develop further.
It is not uncommon for laryngitis to cause swallowing difficulties and pain, which occasionally lead to children refusing to eat.
Fever occurs only in exceptional cases in those affected. Very rarely, acute laryngitis can take a serious course and compress the trachea through swelling of the soft tissues of the larynx, which then causes shortness of breath. This complication is more likely to occur in younger children.

Children can get laryngitis too. The main symptom here is the children's hoarseness.

Read more about this under Laryngitis in the child or symptoms of vocal cord inflammation

Chronic laryngitis

If the inflammation persists for three weeks or more, it is called chronic laryngitis. In principle, this is accompanied by the main symptoms of cough and hoarseness, but differs in one important point from the acute form of laryngitis.
On the one hand, the quality of the cough changes, which is now more of a dry cough and there is a permanent feeling of foreign bodies or dryness (Globe feeling) in the throat. In addition, the voice often changes, becoming a little deeper, quieter and less resilient, the compulsion to clear the throat is now also more pronounced. However, those affected suffer less pain than those with acute inflammation. If the inflammation is caused by gastric juice reflux, the symptoms often appear primarily at night. In the case of chronic inflammation, treatment and regular visits to the doctor are particularly important, as the chronically inflamed mucous membrane of the larynx can degenerate and a preliminary stage of larynx cancer develops. According to current knowledge, the risk of degeneration of chronic inflammation of the larynx is at least 10%.

Find out more about the topic here: chronic inflammation of the throat.

Cough with a larynx infection

Drier, excruciating cough, as well as a Feeling of dryness which with a Throat irritation are typical symptoms of acute laryngitis. In the case of the two special forms of laryngitis, the appearance of a cough can be helpful in the differential diagnosis. That's the way it is with one Subglottic laryngitis (Pseudo croup), i.e. inflammation below the glottis, of the rough, dull, often described as "barking" to cough characteristic. In comparison, a Epiglottitis (Supraglottic laryngitis) just rarely cough on. If then you can quiet throat clearing observe.

Read more on the topic: Larynx pain when coughing

diagnosis

The diagnosis "Laryngitis“Is initially asked based on the clinical appearance of the patient. A Laryngoscopy (a Larynxoscopywhich can be done directly or indirectly). This then provides a typical picture in the event of an inflammation Redness, swelling and possibly also Deposits of mucus or that protein Fibrin. If symptoms have been present for a long time (more than three weeks) should undergo direct laryngoscopy general anesthetic a mucosal sample (biopsy) to be examined under the microscope for any degeneration in order to rule out cancer of the larynx.

Risk of contagion

Whether an inflammation of the larynx (laryngitis) is contagious depends on the cause of the laryngitis. Acute laryngitis is triggered in a large number of cases by an infection with a virus or, more rarely, with a bacterium. In these cases the acute laryngitis is quite contagious for the environment. The acute form of laryngitis can affect different levels of the larynx (supraglottis, glottis, subglottis).

Depending on the level of the larynx affected, a different spectrum of pathogens is typical.

Supraglotic laryngitis

Supraglottic laryngitis, also known as epiglottitis, is a life-threatening inflammation of the epiglottis that is usually caused by the bacterium Haemophilus influenzae type B (Hib) in children. In the meantime, however, it only occurs rarely, as the Standing Vaccination Commission (STIKO) recommends vaccination against the causative bacterium (Haemophilus influenzae). Haemophilus influenzae type B infection may spread from person to person via droplet infection. It is especially dangerous for young, unvaccinated children. When adults develop epiglottitis, it is usually caused by other bacteria such as streptococci, staphylococci or pneumococci. Of course, an infection with these bacteria is also contagious.

Subglottic laryngitis

Subglottic laryngitis is also known as croup and in most cases is triggered by a viral infection. However, there is definitely the possibility of a bacterial infection, which is referred to as a bacterial superinfection. Such a bacterial superinfection usually occurs with the bacterium Haemophilus influenzae. Subglottic laryngitis is therefore also contagious.Viruses and bacteria that cause colds or even laryngitis are spread into the environment and transmitted in the form of tiny droplets (droplet infection), such as those produced when speaking, coughing or sneezing.

In order to avoid infection, close contact with sick people should be avoided as far as possible. In addition, overcrowded trains or waiting rooms are a frequent source of infection in winter. In addition to airborne infection, i.e. infection via the airway through inhalation of infectious droplets, the bacteria and viruses can also adhere to objects. If the respective objects are then touched with the hands and the person then touches his mouth or nose, an infection can also occur in this way. Smokers and people with already irritated mucous membranes are particularly at risk. Working in a dusty environment, smoking cigarettes or even unfavorable weather conditions are unfavorable for the mucous membranes. How long an acute laryngitis is contagious and how high the infection rate is depends on the causative agent.

Chronic laryngitis

Chronic laryngitis, on the other hand, is in most cases not contagious, as it is largely not caused by an infection with a virus or a bacterium. If chronic laryngitis is caused by one of the following causes, it is not contagious: nicotine abuse, regular exposure to dusty surroundings, excessive vocal stress and the rise of acidic stomach acid (gastroesophageal and laryngopharyngeal reflux). Of course, an infection with a pathogen can also occur in these cases and cause a possible infection.

Read more on this topic at: Laryngitis - How Contagious Is It?

therapy

The therapy of laryngitis depends primarily on the underlying cause.
First of all, of course, basic diseases have to be treated. For example, if one suffers from reflux and is adequately treated with proton pump inhibitors (e.g. omeprazole), the laryngitis often regresses as part of this therapy.

In addition, of course, any pollutants (tobacco) and bad external conditions for the larynx (dry, dusty air) should be avoided as far as possible, whether they are the cause of its inflammation or not. This also applies to irritating substances such as alcohol or hot spices.
The focus is also on protecting the voice. Those affected should speak as little as possible and, above all, avoid whispering, as this is particularly harmful due to the great tension that the vocal cords have to build up for this. The success of the healing depends to a large extent on these simple rules of behavior, which the patient should strictly adhere to in order to prevent the transition to chronic inflammation.
In the case of acute laryngitis, no specific measures are usually necessary. As a rule, one tries to alleviate the symptoms by letting the affected person get cold, moist air and possibly instructing them to inhale with essential oils.

Read more on the topic: inhalation

These inhalations can also be carried out with anti-inflammatory substances such as hydrocortisone, which also have a decongestant effect. For some sufferers, the use of expectorants also proves to be helpful. An exception is epiglottitis caused by the bacterium Haemophilus influenzae B, as this requires antibiotic therapy. Intubation and ventilation may also be necessary here due to the shortage of air that occurs. Chronic laryngitis can rarely require surgery if it does not heal, for example surgical correction of a defective nasal septum, which can improve breathing again. In some cases, voice therapy (Speech therapy) makes sense, in which "correct" speech is learned, in which the vocal folds are relieved as much as possible.

Read more on the subject at: What to do if you have a laryngitis

Medication

In the foreground of laryngitis is voice protection and a smoking ban. For a while, complete vocal rest is preferable, and whispering should be strictly avoided. Those affected find the enjoyment of warm drinks and the use of hot throat compresses pleasant. In addition, steam inhalations with the addition of chamomile or sage can also have a soothing effect on pain, tickling and dryness. It should be noted that gargling is ineffective. In the case of swollen, i.e. edematous vocal folds, inhalation of cortisone (e.g. Pulmicort-Spray®) can also help.

Symptomatic laryngitis can be treated with drugs that work in the same way as Local anesthetics and relieve the throat and pharynx from the pain with anesthesia. These drugs include Dorithricin ® or Lemocin ®, among others.

If the inflammation of the larynx is purulent, anitseptic drugs must also be used, as a bacterial infection is likely in these cases. The antiseptic hexetidine (Hexoral®Spray) can be used in the form of a dosing spray as well as systemic antibiotics from the group of tetracyclines such as supracycline.

A pronounced urge to cough can be treated symptomatically with a cough suppressant. Active substances from the group of expectorants with expectorant and liquefying properties, such as bromhexine, can also be used for coughing.

For more information, read on: Calyx medication.

Homeopathy for laryngitis

At a Laryngitis exists at not pronounced symptoms the possibility of homeopathic treatment. It should be noted, however, that in the event of serious complaints, a medical clarification is always indicated. A doctor should also be consulted in children because of the risk of epiglottitis or pseudocup. In addition to the homeopathic treatment described below, additional measures such as the Vocal calm and Nicotine abstinence The Cure.

At the beginning of the treatment is the administration of Aconite D30 possible. It makes sense to take 3 x 5 globules every 2 hours.

Show up at the larynxoscopy crimson vocal cords, so is below Belladonna D30, 3 x 5 globules every 12 hours, the drug of choice. Are the vocal cords rather pale and swollenso come Apis D6 , 3 x 5 globules daily for use.

For people who are in speaking Profession are, for example, teachers or singers can also be Echinacea mouth spray from WALA be prescribed, which is sprayed before longer vocal stress.

At prolonged laryngitis can with dominating hoarseness in the evening Phosphorus D12 (2 x 5 globules per day) can be used and if there is more hoarseness in the morning Causticum D6 (3 x 5 globules per day). At a chronic laryngitis is next to a physical treatment the gift of Sulfur D6To consider 3 x 5 globules daily as useful.

If the evening hoarseness is dominant, this can also be the case with chronic laryngitis Phosphorus D12 (2 x 5 globules per day) and for more hoarseness in the morning Causticum 6X (3 x 5 globules per day). Again, the treatment can be done with Echinacea mouth spray from WALA Provide relief. However, chronic laryngitis is usually associated with lengthy and difficult treatment. If there is no response to homeopathic therapy, a doctor should be consulted.