Laryngitis

Laryngitis and nursing management of patient with laryngitis

1. LARYNGITIS
Ms. SAHELI C
LECTURER
IACN

2. ANATOMY OF THELARYNX

4. LARYNGITIS
Inflammationand swelling of themucous
membrane lining the larynx or voice box, which
is located in the upper part of the respiratory
tract; caused bychemical or mechanical
irritation or bacterial infectioncalled as
laryngitis.

5. RISK FACTORS
Havingarespiratoryinfectionsuchasacold,flu,
bronchitis,sinusitis,pneumonia.
Exposuretoirritantssuchascigarettesmoke,stomach
acid(reflux/heartburn).
Exposuretoirritantsdistributedbyairconditioning
systemssuchasmold,pollenandpollutants,workplace
chemicals/dust.
Extremelycoldweather.
Excessalcoholconsumption.

6. ETIOLOGY

7. ❑This means talking too much or too loudly.
❑It canbeanongoing problem for people whose jobs
depend on their voices, including singers, actors,
telephone operators, lawyers, teachers, referees,
coaches and anyone who must shout over loud noise at
work (construction workers, personnel in airports and
train stations, factoryworkers).
1) VOICEABUSEORMISUSE:

9. 2)SMOKING
Cigarette smokeirritatesthe larynx, causing swelling
and inflammation that thickens the vocal cords. This
thickening can lower the pitch of the voice or make it
sound raspy and harsh.
❑Viral infection -common cause of acutelaryngitis
❑Allergies
❑Larynxcancer
❑Tumour

10. 3) ALCOHOLCONSUMPTION:
Alcohol causes a chemical irritation of the
larynx that produces changes similar to
those seen insmokers.

11. 3) GASTRO ESOPHAGEAL REFLUX
DISEASE:
❑GERDisadisorderinwhichacidicfluidsfromthe
stomachflowbackward(reflux)intotheoesophagusand
throat,irritatingthelarynx.
❑Becauseacidrefluxusuallyisworsewhenlyingdown,
thehoarsenesscausedbyGERDoftenismostnoticeable
inthemorningrightafterawakening.

12. 4) WORK RELATED EXPOSURE TO
IRRITATING CHEMICALS OR DUSTS :
Many industrial products are suspected of causing chronic
laryngitis and other respiratory problems.
The U.S. Department of Labour monitors many of these
products and provides safety guidelines for handling and
exposure through the Occupational Safety and Health
Administration(OSHA).

13. TYPES OF LARYNGITIS
Laryngitis is categorized as :
1.Acute laryngitis.
2.Chronic laryngitis

14. ACUTE
LARYNGITIS

15. DEFINITION
❑It is the acute inflammation of larynx which lasts less
than a few days and leads to oedema of laryngeal
mucosa and underlyingstructures.
❑Most cases of acute laryngitis are temporary and
improve after the underlying cause gets better.

16. ETIOLOGY
❑Frequently caused by“Rhinovirus”
❑Othercausative organism:
–Para influenza virus.
–respiratory syncytialvirus
–Adenovirus
–Measles and mumps
–Bacterial infection such as diphtheria –this is rare.

17. ❑vocal misuse, vocal strain caused by yelling or
overusing of the voice.
❑exposure tonoxious
❑Viral infections such as those that cause a cold.
❑Frank aphonia

18. CHRONIC LARYNGITIS

19. •Laryngitis that lasts more than 3 weeks is known as
chronic laryngitis.
•Chronic laryngitis is a more persistent disorder that
produces lingering hoarseness and other voice
changes.
•It usually is painless and has no significant sign of
infection.
DEFINITION

20. •Vocalmisuse
•Exposure to noxiousagents
•Infectious agents leading to upper respiratory tract
infections. The infectious agents are most often viral
but sometimesbacterial.
•Inhaled irritants such as chemical fumes, allergens or
smoking.
•Acid reflux, also gastro esophagealreflux disease
(GERD)
ETIOLOGY

21. Chronic sinusitis, bronchitis.
Excessive alcohol use.
Habitual overuse of the voice such as with singers or
cheerleaders.
Smoking.
# Less common cause of chronic laryngitis include:
Infections such as tuberculosis, Syphilis or a fungal
infection.
Infections with certain parasites.
Cancer.
Vocal cord paralysis, which can result from injury,
stroke or a lung tumoror other conditions.

22. PATHOPHYSIOLOGY

24. SYMPTOMS

25. The most common symptom is-
•Hoarseness.
•A low, raspyvoice, voice loss.
•Tickling sensation and rawness in throat.
•A voice that tires easily, “breaks” or “cracks”
•The sensation of alump inthethroat or a drythroat, sore throat
•Difficultyswallowing
•Cold or flu like symptoms.
•Fever
•Swollen lymph nodes in the neck.

26. •A constant urge to clear thethroat
•Heavy mucus in the throat
•Chronic cough or postnasaldrip
•Dysphagia.
•Coughing
•Difficultyin breathing: Children face the added risk of encountering
breathing difficulty, because the opening of a child’s larynx is narrow
to begin with, and inflammation restricts the air passages even
further.
•Feeling of fullness in the throat or neck.

27. DIAGNOSIS

28. Diagnosis is based upon a combination of the
complete history and physical exam.
If symptoms are severe, particularly in children,
the doctor may order an X-ray of the neck and
chest.
Sometimes in children rarely in adults, the doctor
may order blood work such as complete blood
count (CBC)
These techniques are sometimes used to help
diagnose laryngitis.

29. LARYNGOSCOPY:
Doctorcanvisually examine vocal cords in a procedure called
laryngoscopy, by using a light and a tiny mirror to look into
the back of your throat.
Or doctor may use fiber-opticlaryngoscopy.
This involves inserting a thin, flexible tube (endoscope)with a
tiny camera and light through nose or mouth and into the
back of throat.
Then doctor can watch the motion of vocal cords as the person
speak.

30. BIOPSY
If doctor sees a suspicious area, doctor may do a
biopsy-taking a sample of tissue for
examination under a microscope.

31. TREATMENT

32. Sometimes laryngitis may be more serious. Several symptoms
should cause the symptoms to see a doctor:
High fever with a sore throat.
Coughing up yellow or green phlegm
Coughing up blood.
Unable to take liquids
A history of breathing problems.
Symptoms that last for 2-3 weeks despite resting the voice.
Child are different than adults because they are more likely to
become infected with certain microbes.

33. If a child just has a hoarse voice with or without other
symptoms of a virus such as low grade fever less than 100.5˚
F, runny nose, muscle aches, cough or nasal congestion then
the treatment is the same as for an adult.
If the child has a fever, a sore throat, won’t eat or think or has
a decreased number of wet diapers (indicating less than
adequate drinking), however should take the child to see a
doctor.

34. •Voicerest.
•Steaminhalation.
•Avoid smoking andcold.
•Fluidintake.
•voicerehabilitation
•Humidification
•Increase intake of fluids.
•Reduction of high impact stress to the vocal cords
caused by loud, frequent and high pitched voicing is
recommended
SUPPORTIVE THERAPY

35. MEDICAL MANAGEMENT
Anti-fungal or antibiotics–for bacterial or fungal infection.
Short course of steroids eg. Prednisone, prednisoloneor
dexamethasonemay be used to decrease the inflammation
and shorten the course of symptoms.
H2 blocker such as Zantac or Prilosecfor a period of 4-6
weeks in case of gastroesophagealreflux.
Analgesic-egAcetaminophen, ibuprofen
Coughsuppressants.

36. NURSING MANAGEMNET
1.To prevent dryness or irritation to the vocal cords.
❑Do not smoke and avoid passive smoking-Smoke dries throat
and irritates vocal cords.
❑Drink plenty of water-Fluid help keep the mucus in the throat
thin and easy to clear.
❑Advice patient to avoid cleaning the throat-This does more
harm than good, because it causes an abnormal vibration of the
vocal cords and can increase swelling and causes the throat to
secrete more mucus and feel more irritated.
❑Avoid upper respiratory infections. Make sure annual flu shot
as per the recommendation of the doctor.
❑Wash hands more often and avoid contact with people who have
upper respiratory infections such as colds.

37. 2) The following steps may relieve the symptoms of
laryngitis and reduce strain on voice.
Use a humidifier: Keep the air throughout the moist
home. Try a cool mist humidifier. Avoid air conditioning.
Drink plenty of fluids to prevent dehydration.
Avoid alcohol and caffeine.
Give your voice a break.
Rest the voice when and as much as possible.
Inhale steam or breath moist air.
Breath in steam from a bowl of hot water or a hot
shower.

39. PREVENTION
Wash hands before touching face.
Hemophilusinfluenza vaccine for children to
prevent the possibility of life threatening
bacterial infection.
Prevention of overuse of voice.

40. HOME REMEDIES FOR
LARYNGITIS
Avoid shouting
Do not whisper
Breathe through the nose
Steam inhalation
Using a humidifier
Drink lots of water
Drink lemon and honey mixture
Moisten throat
Say no to decongestant
Avoid throat cleaning
Avoid smoking.