Acute Laryngitis

Overview of Acute Laryngitis:

Acute laryngitis is often a secondary bacterial infection triggered by infecting agents causing such illnesses as colds, measles, whooping cough or influenza. It may also result from straining the voice, drinking hot liquids or exposure to irritating gases.

Laryngitis resulting from weakened laryngeal muscles is common in singers, teachers and others who use their voice professionally. Avoidance of cigarette smoke, alcohol, inhalation of irritating fumes also resting the voice are considerations to be taken into account in assisting in the aid of laryngitis.

Nearly all major respiratory viruses have been implicated in acute viral laryngitis, for example,

• Rhinovirus,
• Influenza virus,
• Para-influenza virus,
• Adenovirus,
• Coxsackie virus,
• Corona virus,

Acute laryngitis:

It can also associate with acute bacterial respiratory infections such as those cause by group A Streptococcus or C. diphtheriae (although diphtheria has been virtually eliminated in the United States). Another bacterial pathogen thought to play a role (albeit unclear) in the pathogenesis of acute laryngitis is M. catarrhalis, which has recovered from nasopharyngeal culture in a significant percentage of cases.

Chronic laryngitis:

Chronic laryngitis of infectious etiology much less common in develop than in developing countries. Laryngitis due to Mycobacterium tuberculosis is often difficult to distinguish from laryngeal cancer, in part because of the frequent absence of signs, symptoms, and radiographic findings typical of pulmonary disease.

Histoplasma and Blastomyces may cause laryngitis, often as a complication of systemic infection. Candida species can cause laryngitis as well, often in association with thrush or esophagitis and particularly in immunosuppressed patients. Rare cases of chronic laryngitis are due to Coccidioides and Cryptococcus.[1]

• Spasmodic dysphonia.
• Reflux laryngitis.
• Chronic allergic laryngitis.
• Epiglottitis.
• Neoplasm.[5]

Risk factors for laryngitis include i.e.:

• Having a respiratory infection, such as a cold, bronchitis or sinusitis
• Exposure to irritating substances, such as cigarette smoke, excessive alcohol intake, stomach acid or workplace chemicals
• Overusing your voice, specifically by speaking too much, speaking too loudly, shouting or singing[4]

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Pathophysiology of Acute laryngitis

Acute laryngitis resolves within 2 weeks, and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. If symptoms persist beyond this timeframe it is either due to superinfection or due to a transition to chronic laryngitis.

Acute laryngitis is characterized by inflammation also congestion of the larynx in the early stages. Besides this, This can encompass the supraglottic, glottic, or subglottic larynx (or any combination thereof), depending on the inciting organism. As the healing stage begins, white blood cells arrive at the site of infection to remove the pathogens.

Phonation pressure

This process enhances vocal cord edema also affects vibration adversely, changing the amplitude, magnitude, also frequency of the normal vocal fold dynamic. As the edema progresses, the phonation threshold pressure can increase.

The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes both as a result of the changing fluid-wave dynamics of the inflamed also edematous tissue, but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics.

Sometimes edema is so marked that it becomes impossible to generate adequate phonation pressure. In such a situation, the patient may develop frank aphonia. Besides this, Such mal adaptations may result in prolonged vocal symptoms after an episode of acute laryngitis that can persist long after the inciting event has resolved. Lastly, In such situations, referral to an otolaryngologist and/or speech-language pathologist is warranted.[5]

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• Laryngitis characterize by hoarseness and also can associate with reduced vocal pitch or aphonia.
• As acute laryngitis cause predominantly by respiratory viruses, these symptoms usually occur in association with other symptoms and signs of URI, including rhinorrhea, nasal congestion, cough,also sore throat.
• Direct laryngoscopy often reveals diffuse laryngeal erythema and edema, along with vascular engorgement of the vocal folds. In addition, chronic disease (e.g., tuberculous laryngitis) often includes mucosal nodules and ulcerations visible on laryngoscopy; these lesions are sometimes mistaken for laryngeal cancer.

Appearance of Patient

• Patients are usually well-appearing.

Vital Signs

• Fever

HEENT

• Vocal fold i.e.:
  • Cysts
  • Erythema
  • Edema
• Nodules i.e.:
  • Secretions
  • Surface irregularities
• Granulomas
• Dysphagia
• Hemoptysis
• Odynophagia
• Wheezing

Neck

• Lymphadenopathy

Heart

• Heart burn[6]

Physical Examination of Throat reveals signs of inflammation redness, examine uvula and tonsils for other conditions.

• Spasmodic dysphonia
• Reflux laryngitis
• Chronic allergic laryngitis
• Epiglottitis
• Neoplasm[5]

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

Treatment  of Acute Laryngitis:

Acute laryngitis is usually treated with humidification and voice rest alone.

Antibiotics are not recommending except when group A Streptococcus is culturing, in which case penicillin is the drug of choice.

The choice of therapy for chronic laryngitis depends on the pathogen, whose identification usually requires biopsy with culture. Patients with laryngeal tuberculosis are highly contagious because of the large number of organisms that are easily aerosolized. These patients should manage in the same way as patients with active pulmonary disease.[1]

Prevention of Acute Laryngitis

1. Avoid smoking and stay away from second hand smoke. Smoke dries your throat.
2. Limit alcohol and caffeine.
3. Drink plenty of water.
4. Keep spicy foods out of your diet.
5. Include a variety of healthy foods in your diet.
6. Avoid clearing your throat.
7. Avoid upper respiratory infections.

Homeopathic Treatment of Acute laryngitis

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

Which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.

Homeopathic Medicines 

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).

BELLADONNA:

Dry throat. Esophagus feels dry, constricted. Scraping sensation. Tickling, short dry cough, < night. Larynx feels sore. Painless hoarseness. Barking cough, whooping cough. Hoarse, loss of voice. In addition, Larynx feels very painful – as if a foreign body were in it, with cough.

BROMIUM:

Throat feels raw, evening, with hoarseness. Tickling in trachea during inspiration. Hoarseness coming on from overheated. Spasmodic cough with rattling of mucous in larynx. Worse – from evening until midnight, warm damp weather. Better – from motion.

IODUM:

Laryngitis with painful roughness. Worse during cough. Child grasps throat when coughing. Dry morning cough from tickling in larynx. Hoarse.

Worse – indoors, warm, wet weather, when lying on back. [2]

MERCURIUS:

Throat, red, swollen, painful. Intensely inflamed. Swallowing painful. Pain in larynx, as if cut with knife. Aphonia (loss of voice). Cough with bloody expectoration. Salivation++. Worse – slight external pressure, evenings, also at night.

NITRIC ACID:

Hoarseness. Aphonia, with dry hacking cough specifically from tickling in larynx and pit of stomach. Soreness at lower end of sternum. Cough during sleep.

Worse – evening also night, cold climate and also hot weather. On the other hand, Better by while riding in carriage.

PHOSPHORUS:

Larynx very painful. Clergyman’s sore throat. Violent tickling in larynx while speaking. Aphonia worse evenings. Cannot talk due to pain in larynx. Hard, dry, tight, racking cough. Sputa rusty, blood coloured or purulent. Worse – cold air, laughing, talking, evening, especially lying on left side.

SENEGA:

Hoarseness, hurts to talk, loss of voice, bursting pain-in back on coughing. Catarrh of larynx. Moreover, Cough often ends in a sneeze. Voice unsteady, vocal cords partially paralysed.

Worse – walking in open air, during rest. Additionally, Better – sweat, bending head backwards.

SPONGIA TOSTA:

Cough, dry, barking, also croupy. Larynx sensitive to touch. Furthermore, Respiration short, panting, difficulty, feeling of a plug in larynx, laryngeal phthisis (wasting away).

Worse – before midnight, cold air, wind, ascending. Better – warm drink, descending, lying with head low. [2]

Some self-care methods and home treatments may relieve the symptoms of laryngitis and reduce strain on your voice i.e.: [3]

• Breathe moist air. Use a humidifier to keep the air throughout your home or office moist. In addition, Inhale steam from a bowl of hot water or a hot shower.
• Rest your voice as much as possible. Avoid talking or singing too loudly or for too long. If you need to speak before large groups, try to use a microphone or megaphone.
• Drink plenty of fluids to prevent dehydration (avoid alcohol also caffeine).
• Moisten your throat. Try sucking on lozenges, gargling with either salt water or chewing a piece of gum.
• Avoid decongestants. These medications can dry out your throat.
• At last, Avoid whispering. This puts even more strain on your voice than normal speech does.[3]

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[1] Harrisons Principles of Internal Medicine 19^th Edition.

[2] Homoeopathic Body-System Prescribing – A Practical Workbook of Sector Remedies

[3] https://www.mayoclinic.org/diseases-conditions/laryngitis/diagnosis-treatment/drc-20374267

[4]https://www.mayoclinic.org/diseases-conditions/laryngitis/symptoms-causes/syc-20374262#:~:text=Risk%20factors%20for%20laryngitis%20include,too%20loudly%2C%20shouting%20or%20singing

[5]https://www.ncbi.nlm.nih.gov/books/NBK534871/

[6]https://www.wikidoc.org/index.php/Laryngitis_physical_examination

[7]https://voicefoundation.org/health-science/voice-disorders/voice-disorders/laryngitis/diagnosis-of-laryngitis/#:~:text=Laryngitis%20is%20diagnosed%20by%20examination,%2C%20see%20Laryngoscopy%20%2FStroboscopy.)

Frequently Asked Questions

What is Acute Laryngitis?

Laryngitis is defined as any inflammatory process involving the larynx also can be caused by a variety of infectious and noninfectious processes.

Homeopathic Medicines use by Homeopathic Doctors in treatment of Acute Laryngitis?

• Belladonna
• Bromium
• Iodum
• Mercurius
• Nitric Acid
• Phosphorus
• Senega
• Spongia

What are the causes of Acute Laryngitis?

• Rhinovirus
• Influenza virus
• Para-influenza virus
• Adenovirus
• Coxsackie virus
• Corona virus

What is the symptoms of Acute Laryngitis?

• Hoarseness
• Reduced vocal pitch or aphonia.
• Rhinorrhea
• Nasal congestion
• Cough
• Sore throat.
• Mucosal nodules and ulcerations

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