Laryngitis
Acute laryngitis is a very common cause of hoarseness. It is a self-resolving illness that typically lasts 3 to 4 weeks. The larynx (often referred to as our voice box) is the tissue that uses airflow to produce and control sounds. When it becomes inflamed due to infection or overuse (vocal strain), the larynx produces a different sound. It’s important to identify which type of laryngitis you have to determine treatment and rule out infection.
The Main Causes of Laryngitis
- Vocal strain: Do you recall a significant event that led to vocal strain, such as a concert or other exposure to sustained loud noise that forced you to speak loudly? Events like this can cause vocal strain, as can prolonged and heated arguments. If you are unable to recall any such event, you are likely dealing with an infection.
- Infection: Patients who have hoarseness along with runny nose, cough, and a sore throat likely have a viral or bacterial infection of their vocal cords. Most often, the infection is viral. However, some bacterial organisms can cause laryngitis. In general, it is easy to tell the difference between these two causes.
What if My Laryngitis Lasts Longer than 4 Weeks?
If your hoarseness lasts longer than four weeks, you are considered to have chronic laryngitis. After this length of time, your laryngitis is unlikely to be a simple viral or bacterial infection or vocal strain. It’s time to consider the following causes:
Irritants:
- Laryngopharyngeal reflux
- Muscle tension dysphonia
- Benign vocal fold lesions
Nerve damage:
- Laryngeal cancer
- Voice disorders
- Vocal fold paralysis
How Do You Heal Laryngitis?
Laryngitis treatment depends on its cause. For most causes, treatment involves voice rest. But occasionally, it requires voice therapy, medications, or sometimes surgery.
We often recommend voice rest for acute laryngitis with significant swelling. There are two voice resting plans we recommend. The extreme voice resting plan will accelerate recovery, but is often not ideal for social and work obligations. The moderate voice resting plan allows the person to function in most work and social environments, but recovery will be longer. Below are details of both voice resting plans:
Extreme voice resting plan:
When you speak, people should not be able to hear you unless they are two feet away. Only use your voice for the following amount of times throughout the entire day:
- Day 1: No more than 5 minutes
- Day 2: No more than 10 minutes
- Day 3: No more than 15 minutes
- Day 4: No more than 30 minutes
- Day 5: No more than 40 minutes
- Day 6: No more than 60 minutes
- Day 7: No more than 120 minutes
The moderate voice resting plan:
When you speak, people should not be able to hear you unless they are three to four feet away. Only use your voice for the following amount of times throughout the entire day:
- Day 1: No more than 5 minutes
- Day 2: No more than 15 minutes
- Day 3: No more than 30 minutes
- Day 4: No more than 60 minutes
- Day 5: No more than 120 minutes
Note: While whispering is thought to be using a “softer voice,” it is in fact more taxing on the vocal cords. If you are voice resting, do not whisper. Instead, speak in a low volume. Additionally, for both plans, do not play musical instruments (especially wind instruments), lift weights, strain in the bathroom, or perform any other action that builds pressure behind your vocal cords.
Do I Need to See The Doctor For My Laryngitis?
Most cases of voice hoarseness will resolve on their own without the need to see a doctor. If your voice is not improving after 7-10 days or if you have been experiencing unexplained weight loss, fevers, and chills, or night sweats, then it’s time to see the doctor. In some of these cases, the doctor will need to prescribe you antibiotics, anti-inflammatories, will start a trial course of anti-GERD medications, and will occasionally try a course of steroids. Although steroids appear to have limited benefit in these situations. If after these measures you continue to experience voice hoarseness, then it is time to be referred to an ENT (Ear, Nose, Throat) doctor. A visit to the ENT doctor will likely result in a laryngoscope so the doctor can visualize and biopsy the vocal cords to see if there is evidence of chronic inflammation, vocal chord scarring, vocal cord paralysis, benign vocal cord lesion, or the worst-case scenario laryngeal cancer.