OVERVIEW

What does the larynx look like?

The larynx is located in the midline of the front part of the neck. It is a tubular organ composed of cartilage, muscles, fibrous tissue, and mucous membranes.

What are the functions of the larynx?

The larynx connects upward to the oral cavity and downward to the trachea, making it a "critical passage." The vocal cords are its most important structure. The glottis between the vocal cords can be seen as a gate at the beginning of the airway. If this area becomes blocked, breathing will be affected, ranging from mild symptoms like shortness of breath, wheezing, or difficulty breathing to severe cases of suffocation. This condition is called "laryngeal obstruction."

Therefore, the larynx serves as both a vocal organ and the entryway of the respiratory tract. Its most important functions include breathing, vocalization, participation in swallowing, and a protective role.

What is laryngitis?

Broadly speaking, any inflammation of the larynx can be called "laryngitis." Commonly discussed types include acute laryngitis and chronic laryngitis, with the latter further classified into chronic simple laryngitis, hypertrophic laryngitis, and atrophic laryngitis. Pediatric laryngitis is discussed separately under the topic of "acute laryngitis in children."

The main treatment principles for laryngitis involve removing irritants and using nebulized medications as appropriate. With active treatment, recovery is generally achievable, and patients can expect a good quality of life.

SYMPTOMS

What are the symptoms of laryngitis?

• Hoarseness: The primary symptom of both acute and chronic laryngitis is hoarseness.

• Sore throat: Patients with acute laryngitis often experience a sore throat due to significant inflammation and redness, which worsens when speaking. Chronic laryngitis usually causes mild throat pain. Both types may also cause discomfort such as a foreign body sensation or dryness.

• Cough and phlegm: Acute laryngitis often involves a dry cough initially, which worsens at night. Later, thick mucus may develop but is difficult to expel. Chronic laryngitis typically presents with a dry cough to relieve throat discomfort.

• Wheezing and breathing difficulties: Severe cases, particularly in children with acute laryngitis, may experience wheezing or breathing difficulties, though this is rare in adults or chronic cases.

• Systemic symptoms: Fever, chills, fatigue, and loss of appetite may occur, though these are less common and milder in adults and more pronounced in children.

What is the difference between acute and chronic laryngitis?

• The most notable difference is that acute laryngitis is "sudden onset, quick recovery, and patients seek prompt treatment." It often develops abruptly, leaving patients unable to speak upon waking, but resolves within days to a week. Patients usually seek medical help immediately. Chronic laryngitis, however, is "gradual, recurrent, and patients often neglect it." Initially, symptoms like occasional coughing or hoarseness after drinking may resolve with rest, but they recur more frequently and last longer over time, becoming persistent despite treatment. Chronic cases last for months or even years, and patients often delay seeking care.

• Severe acute laryngitis may cause breathy speech or complete voice loss, while chronic laryngitis rarely leads to voice loss.

• Acute laryngitis often involves thick, sticky mucus, whereas chronic laryngitis usually presents with a dry cough.

• Acute laryngitis frequently causes throat pain, especially when speaking or coughing, while chronic laryngitis typically involves a persistent foreign body sensation rather than significant pain.

Why does a laryngitis patient's voice temporarily improve after coughing or throat clearing?

Mucus stuck on the vocal cords can worsen hoarseness. Coughing or clearing the throat removes this mucus, temporarily improving the voice.

Can laryngitis be life-threatening?

Most cases are not life-threatening. However, severe acute laryngitis with significant vocal cord swelling can obstruct the airway, potentially leading to suffocation. Children are more prone to breathing difficulties, so pediatric cases require close monitoring.

Why does laryngitis affect breathing?

Severe inflammation can cause significant swelling of the vocal cords, narrowing the airway and leading to symptoms like shortness of breath or wheezing. In extreme cases, it may cause life-threatening suffocation, particularly in acute laryngitis.

Why does a laryngitis patient no longer have hoarseness but still feel throat discomfort or pain?

Laryngitis often coexists with pharyngitis. Even after the laryngitis resolves, lingering pharyngitis can cause symptoms like throat pain, a foreign body sensation, or burning.

Can children get laryngitis? How does pediatric laryngitis differ from adult cases?

Children can develop laryngitis, usually acute rather than chronic. Pediatric acute laryngitis is more common in winter and spring, peaking in January and February, and is more prevalent in infants and toddlers. While less common than in adults, it carries a higher risk of breathing difficulties.

• Causes: Often follows viral infections like acute rhinitis or pharyngitis, sometimes with secondary bacterial infection.

• Symptoms: Rapid onset with systemic symptoms like fever. Early signs include spasmodic "barking" coughs, hoarse crying or speech, and severe cases may involve breathing difficulties.

• Treatment: Focuses on relieving airway obstruction with antibiotics, steroids to reduce swelling, and, in severe cases, tracheotomy. Additional treatments include nebulized medication, oxygen therapy, and minimizing agitation or crying.

CAUSES

What Causes Laryngitis?

• Infection: The primary cause of acute laryngitis is infection, often occurring after a cold or flu. Bacterial infections may follow viral infections. Factors like cold exposure and fatigue, which lower the body's resistance, can also trigger acute laryngitis.

• Inflammation in Adjacent Areas: Chronic laryngitis is often caused by inflammation in nearby areas (such as rhinitis, sinusitis, chronic pharyngitis, or chronic tonsillitis) or irritation from purulent secretions (e.g., nasal discharge, pus from tooth sockets flowing into the throat, or purulent phlegm coughed up from the throat). Additionally, chronic laryngitis may result from mouth breathing due to nasal congestion.

• Irritation from Harmful Gases or Dust: Long-term exposure to irritants like smog, sulfur dioxide, chlorine, or dust; excessive smoking or alcohol consumption; and overuse or improper use of the voice (common in teachers, actors, or salespeople) are shared causes of both acute and chronic laryngitis.

Is Laryngitis Contagious? Does It Require Isolation?

Laryngitis is not classified as a contagious disease. However, acute laryngitis patients, often infected with viruses followed by bacterial infections, may carry significant bacteria. Close contact with individuals with low immunity could lead to infection, but isolation is unnecessary.

DIAGNOSIS

Are laryngitis and pharyngitis the same disease? What is the relationship between them?

From an anatomical perspective, the pharynx and larynx are two distinct anatomical regions. Generally speaking, the pharynx is located above the larynx, but they also overlap and are closely interconnected, sometimes making it difficult to separate them. Therefore, they are often referred to collectively as the "throat."

What we commonly refer to as "throat inflammation" more often indicates pharyngitis. Strictly speaking, it is not the same disease as laryngitis, but the two frequently influence each other and coexist: pharyngitis can lead to laryngitis, and laryngitis often presents with symptoms of pharyngitis.

If a doctor has already diagnosed laryngitis, why are further tests needed? Can't medication be prescribed directly?

The most common test for laryngitis is laryngoscopy. The primary purpose of this examination is not only to assess the severity of the inflammation but, more importantly, to determine whether the airway is unobstructed and whether there is a potential risk of laryngeal obstruction. For example, it checks for growths in the larynx, such as polyps, vocal cord nodules, or even cancer, whether the vocal cords are immobile, as well as the degree of swelling in the larynx and the size of the glottis.

TREATMENT

What department should laryngitis patients visit?

ENT (Ear, Nose, and Throat) or Respiratory Medicine. Children with laryngitis should go to Pediatrics. In emergencies or severe breathing difficulties, visit the Emergency Department.

Why do laryngitis patients need hospitalization?

Most laryngitis patients do not require hospitalization. However, if a doctor identifies laryngeal obstruction or a high risk of it occurring shortly, immediate hospitalization is necessary to ensure patient safety and provide timely treatment for breathing difficulties.

How is laryngitis treated?

• Voice rest: Avoid speaking or speak minimally.

• Addressing the cause: Quit smoking and alcohol; avoid harmful gas or dust exposure; correct improper vocal techniques; treat infections in the nose, throat, or lower respiratory tract (e.g., rhinitis, sinusitis, pharyngitis, bronchitis).

• Local treatment: Antibiotic and steroid nebulization for bacterial infections.

• Medication: Antibiotics or steroids for severe acute laryngitis.

• Physical therapy: Ultrashort wave or infrared therapy to reduce inflammation and swelling.

Is there a cure for laryngitis?

The most effective "cure" for laryngitis is voice rest—speak as little as possible, ideally not at all.

What medications are used for laryngitis?

For bacterial infections, local nebulized antibiotics and steroids are primary treatments. Severe acute cases with fever or chills may require oral or intravenous antibiotics/steroids. Immediate IV steroids are needed if breathing difficulties arise.

What is nebulization for laryngitis patients?

Nebulization delivers medication (usually liquid) as a mist via a device. Patients inhale it deeply through the mouth, allowing the drug to coat the throat. Common medications include anti-inflammatory, decongestant, or expectorant agents. Typically done 1–2 times daily for 3–6 days.

Does laryngitis require surgery?

Usually not. Medication, voice rest, and physical therapy suffice.

Why do some laryngitis patients need surgery?

Surgery (tracheotomy) is urgent if laryngeal obstruction severely impairs breathing. It’s a temporary measure to restore airflow, not a cure for laryngitis.

What is a tracheotomy for laryngitis?

A tracheotomy creates an opening in the neck’s trachea to bypass upper airway blockages (e.g., laryngeal obstruction). It’s a lifesaving procedure for severe respiratory distress. It may also be used for coma patients, severe trauma, or prolonged ventilator use.

Is the tracheotomy hole permanent?

No. Once the obstruction or need resolves, the tube is removed. The hole heals naturally within days.

Can laryngitis be cured?

• Acute laryngitis: Most recover fully with prompt treatment. Recurrence or poor vocal habits may lead to chronic laryngitis.

• Chronic laryngitis: Often curable with treatment and proper voice use. Hypertrophic or atrophic types may heal slower.

How long does laryngitis take to heal?

Acute cases improve in 7–10 days; chronic cases may take weeks or months.

What are the complications of untreated laryngitis?

Chronic hoarseness, vocal fatigue, inability to hit high notes, throat dryness, or a persistent foreign-body sensation.

Why isn’t medication alone effective for some laryngitis patients?

Voice rest, proper vocal techniques, and eliminating irritants (smoke, dust, infections) are crucial. Without addressing these, medications alone won’t fully resolve laryngitis.

What is vocal training for laryngitis? How does it help?

Guided by specialists, patients learn correct vocal techniques to replace harmful habits. Essential for occupational voice users (teachers, performers, salespeople) with strain-induced laryngitis.

DIET & LIFESTYLE

What should laryngitis patients pay attention to in their diet?

The diet should be light, and spicy and irritating foods should be avoided.

Can laryngitis patients go to work? Do they need to rest at home?

Apart from needing vocal rest, laryngitis patients do not require excessive physical rest. Unless the work involves exposure to large amounts of harmful gases, dust, smoke, or other irritants, or requires a lot of talking, loud speaking, or singing, they can continue with normal work and study.

PREVENTION

How to Prevent Laryngitis?

• Exercise regularly, maintain a balanced diet, and follow a regular sleep schedule to boost immunity and avoid viral or bacterial infections.

• If you suffer from rhinitis, sinusitis, chronic pharyngitis, or chronic tonsillitis, seek active treatment to prevent infections from spreading to the larynx.

• Wear a mask when necessary to minimize inhalation of harmful gases (such as smog, sulfur dioxide, chlorine, etc.) and dust. Limit outdoor activities in heavily polluted conditions.

• Quit smoking and drinking.