Tuesday, March 11, 2008

LARYNGITIS

DEFINITION

Ø an inflammation of your voice box (larynx)

due to overuse, irritation or infection.

Ø The larynx is a framework of cartilage,

muscles and mucous membranes that forms

the entrance of the windpipe (trachea). Inside

the larynx are the vocal cords — two folds of

mucous membrane covering muscle and

cartilage.

Ø The vocal cords become inflamed or irritated.

They swell, causing distortion of the sounds

produced by air passing over them. As a

result, the voice sounds hoarse.

Ø In some cases of laryngitis, the voice can

become so faint as to be undetectable.

Ø The vocal cords become inflamed or irritated.

They swell, causing distortion of the sounds

produced by air passing over them. As a

result, the voice sounds hoarse.

Ø In some cases of laryngitis, the voice can

become so faint as to be undetectable.

Acid reflux, also known as gastroesophageal reflux disease, can cause chronic laryngitis.

Persistent laryngitis in the absence of an infection or other cause could be a sign of cancer.

SIGNS AND SYMPTOMS

hoarseness and loss of voice

a raw throat, a dry cough, a tickling

sensation in the back of the throat, and a

constant need to clear the throat

ETIOLOGY

Acute laryngitis is usually caused by an upper respiratory tract infection. The infection may be localized to the larynx (voice box), or it may be part of a wider respiratory tract infection such as a cold or flu.

Most cases of laryngitis are caused by viral infections, but bacterial infections such as bronchitis and pneumonia can also result in inflammation of the vocal cords.

SIGNS and SYMPTOMS

hoarseness and loss of voice

a raw throat, a dry cough, a tickling sensation in the back of the throat, and a constant need to clear the throat

symptoms may include pain, fever, difficulty swallowing, and general malaise

The severity of inflammation determines the severity of symptoms. Severe swelling of the vocal cords may cause difficulty breathing.

PROGNOSIS

Most cases of laryngitis resolve within a few days to a week. Acute laryngitis almost invariably resolves after the infection or other transient cause is cleared. Although chronic inflammation can lead to permanent changes in the vocal cords, most people with chronic laryngitis recover completely when the underlying cause is eliminated. Chronic laryngitis caused by nerve damage or cancer, however, usually does not fully resolve.

ASSESSMENT FINDINGS

Many times you can be thoroughly evaluated with only a complete history and physical exam.

The doctor will pay particular attention to your ears, nose, throat, and neck.

If symptoms are severe, particularly in children, the doctor may order an x-ray of your neck or chest.

The doctor may also choose to look at your throat with a small, lighted scope.

This thin scope is inserted through your nose after numbing the nose and nostrils. The procedure only takes a few minutes and may yield valuable information.

Sometimes in children, rarely in adults, the doctor may order blood work such as a complete blood cell count.

TREATMENT MODALITIES

After a careful exam the doctor will decide on a course of treatment.

o Most of the time, the doctor will recommend the home care actions and may prescribe a steroid injection or prescription.

o If the doctor is concerned about a bacterial infection causing the laryngitis, then he or she will prescribe a course of antibiotics.

o Sometimes, the doctor may choose to observe in the office or the emergency department for a short period of time in order to be sure it is not getting worse quickly.

If you have any signs of respiratory distress or think your airway could swell and close, then you will be admitted to the hospital.

o In some emergency situations, more commonly in children than adults, the danger of your throat swelling shut exists.

o It may be necessary to place a breathing tube into the throat in order to breathe.

o The patient will be placed on a machine to breathe called a ventilator.

o In this situation, he/she will receive IV antibiotics and likely steroids.

METHODS of PREVENTION

Wash hands often especially before touching your face.

For children, it is important that they receive the Haemophilus influenzae vaccine in order to protect them from this possibly life-threatening bacterial infection.

Do not overuse your voice.

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