Laryngitis

1. LaryngitiLaryngiti
ss
Presented by:- Presented by:-
Jay RamiJay Rami

2. ANATOMY OF THE LARYNXANATOMY OF THE LARYNX

4. •First we will see the vocal folds First we will see the vocal folds
movement during the different- movement during the different-
different speechdifferent speech

6. LaryngitisLaryngitis
•inflammation of the larynx inflammation of the larynx
or voice box, caused by or voice box, caused by
chemical or mechanical chemical or mechanical
irritation or bacterial irritation or bacterial
infection.infection.

7. EtiologyEtiology

8. •Voice abuse or misuseVoice abuse or misuse —
This means talking too much or too This means talking too much or too
loudly. It can be an ongoing problem loudly. It can be an ongoing problem
for people whose jobs depend on their for people whose jobs depend on their
voices, including singers, actors, voices, including singers, actors,
telephone operators, lawyers, telephone operators, lawyers,
teachers, referees, coaches and teachers, referees, coaches and
anyone who must shout over loud anyone who must shout over loud
noise at work (construction workers, noise at work (construction workers,
personnel in airports and train personnel in airports and train
stations, factory workers).stations, factory workers).

10. •SmokingSmoking — Cigarette smoke irritates Cigarette smoke irritates
the larynx, causing swelling and the larynx, causing swelling and
inflammation that thickens the vocal inflammation that thickens the vocal
cords. This thickening can lower the pitch cords. This thickening can lower the pitch
of the voice or make it sound raspy and of the voice or make it sound raspy and
harsh.harsh.
•Viral infection - common cause of acute Viral infection - common cause of acute
laryngitislaryngitis
•AllergiesAllergies
•Larynx cancerLarynx cancer

11. •TumorTumor
•Drinking alcohol Drinking alcohol
heavilyheavily — 
Alcohol causes a chemical irritation Alcohol causes a chemical irritation
of the larynx that produces changes of the larynx that produces changes
similar to those seen in smokers.similar to those seen in smokers.

12. •Gastro esophageal reflux Gastro esophageal reflux
disease (GERD) disease (GERD) — GERD is a GERD is a
disorder in which acidic fluids from the disorder in which acidic fluids from the
stomach flow backward (reflux) into the stomach flow backward (reflux) into the
esophagus and throat, irritating the esophagus and throat, irritating the
larynx. Because acid reflux usually is larynx. Because acid reflux usually is
worse when lying down, the hoarseness worse when lying down, the hoarseness
caused by GERD often is most noticeable caused by GERD often is most noticeable
in the morning right after awakening. in the morning right after awakening. 

13. •Work-related exposure to Work-related exposure to
irritating chemicals or dustsirritating chemicals or dusts — 
Many industrial products are suspected Many industrial products are suspected
of causing chronic laryngitis and other of causing chronic laryngitis and other
respiratory problems. The U.S. respiratory problems. The U.S.
Department of Labor monitors many of Department of Labor monitors many of
these products and provides safety these products and provides safety
guidelines for handling and exposure guidelines for handling and exposure
through the Occupational Safety and through the Occupational Safety and
Health Administration (OSHA).Health Administration (OSHA).

14. Symptoms

15. •The most common symptom is The most common symptom is
hoarseness. hoarseness.
•A low, raspy voiceA low, raspy voice
•A voice that tires easily, “breaks” or A voice that tires easily, “breaks” or
“cracks”“cracks”
•The sensation of a lump in the throat The sensation of a lump in the throat
or a dry throat.or a dry throat.
•Difficulty swallowingDifficulty swallowing
•CoughingCoughing
•Difficulty breathingDifficulty breathing

16. •A constant urge to clear the throatA constant urge to clear the throat
•Heavy mucus in the throatHeavy mucus in the throat
•Chronic cough or postnasal dripChronic cough or postnasal drip
•Discomfort during swallowingDiscomfort during swallowing

17. DiagnosisDiagnosis

18. •The most common sign of laryngitis is The most common sign of laryngitis is
hoarseness. Changes in your voice can hoarseness. Changes in your voice can
vary with the degree of infection or vary with the degree of infection or
irritation, ranging from mild hoarseness irritation, ranging from mild hoarseness
to almost total loss of your voice. to almost total loss of your voice.
•If you have chronic hoarseness, your If you have chronic hoarseness, your
doctor may want to listen to your voice doctor may want to listen to your voice
and to examine your vocal cords, and he and to examine your vocal cords, and he
or she may refer you to an ear, nose and or she may refer you to an ear, nose and
throat specialist.throat specialist.

19. •These techniques sometimes are used to help These techniques sometimes are used to help
diagnose laryngitis:diagnose laryngitis:
•LaryngoscopeLaryngoscope:-Your doctor can :-Your doctor can
visually examine your vocal cords in a visually examine your vocal cords in a
procedure called laryngoscope, by using a procedure called laryngoscope, by using a
light and a tiny mirror to look into the back light and a tiny mirror to look into the back
of your throat. Or your doctor may use of your throat. Or your doctor may use
fiber-optic laryngoscope. fiber-optic laryngoscope.
•This involves inserting a thin, flexible tube This involves inserting a thin, flexible tube
(endoscope) (endoscope) with a tiny camera and light with a tiny camera and light
through your nose or mouth and into the through your nose or mouth and into the
back of your throat. back of your throat.

20. •Then your doctor can watch the Then your doctor can watch the
motion of your vocal cords as you motion of your vocal cords as you
speak.speak.
•BiopsyBiopsy:- If your doctor sees a :- If your doctor sees a
suspicious area, he or she may do a suspicious area, he or she may do a
biopsy — taking a sample of tissue biopsy — taking a sample of tissue
for examination under a microscope.for examination under a microscope.

21. Types Types

23. Acute Acute
laryngitislaryngitis

24. DEFINITIONDEFINITION
oIt is the acute inflammation ofIt is the acute inflammation of
larynx leading to oedema of laryngeallarynx leading to oedema of laryngeal
mucosa and underlying structures.mucosa and underlying structures.
oAcute laryngitis is an inflammationAcute laryngitis is an inflammation
of the vocal fold mucosa and larynxof the vocal fold mucosa and larynx
that lasts less than 3 weeks.that lasts less than 3 weeks. 

25. ACUTE VIRAL ACUTE VIRAL
LARYNGITISLARYNGITIS
•Frequently caused by “Rhinovirus”Frequently caused by “Rhinovirus”
•Other causes:Other causes:
–ParainfluenzaParainfluenza
–respiratory syncytial virusrespiratory syncytial virus
–AdenovirusAdenovirus

26. Symptoms Symptoms

27. •Hoarseness or change in voice.Hoarseness or change in voice.
•Husky, high pitched voice.Husky, high pitched voice.
•Discomfort in throat, pain.Discomfort in throat, pain.
•Body aches. Body aches.
•Dysphagia, Dysphonea..Dysphagia, Dysphonea..
•Dry irritating paroxysmal cough.Dry irritating paroxysmal cough.
•Fever, Malaise.Fever, Malaise.

28. ETIOLOGYETIOLOGY

29. •vocal misusevocal misuse
•exposure to noxiousexposure to noxious
•infectious agents leading to upper infectious agents leading to upper
respiratory tract infections The respiratory tract infections The
infectious agents are most often viral infectious agents are most often viral
but sometimes bacterial.but sometimes bacterial.
•  
•Frank aphoniaFrank aphonia

30. Treatment Treatment

31. •Inhaling humidified air promotes Inhaling humidified air promotes
moisture of the upper airway, helping moisture of the upper airway, helping
to clear secretions and exudate.to clear secretions and exudate.
•Complete voice rest is suggested, Complete voice rest is suggested,
although this recommendation is although this recommendation is
nearly impossible to follow. nearly impossible to follow.

32. •If the patient must speak, soft If the patient must speak, soft
sighing phonation is best. Avoidance sighing phonation is best. Avoidance
of whispering is best, as whispering of whispering is best, as whispering
promotes hyper functioning of the promotes hyper functioning of the
larynx.larynx.
•Prevailing data do not support the use Prevailing data do not support the use
of antihistamines and corticosteroidsof antihistamines and corticosteroids

34. Chronic Chronic
laryngitislaryngitis

35. Definition Definition
•Chronic laryngitis is a more Chronic laryngitis is a more
persistent disorder that produces persistent disorder that produces
lingering hoarseness and other voice lingering hoarseness and other voice
changes. It usually is painless and changes. It usually is painless and
has no significant sign of infection.has no significant sign of infection.

36. ETIOLOGYETIOLOGY

37. •Vocal misuseVocal misuse
•Exposure to noxious agentsExposure to noxious agents
•Infectious agents leading to upper Infectious agents leading to upper
respiratory tract infections. The respiratory tract infections. The
infectious agents are most often viral infectious agents are most often viral
but sometimes bacterial.but sometimes bacterial.

38. INFECTIOUS:INFECTIOUS:
ViralViral
BacterialBacterial
NON INFECTIOUSNON INFECTIOUS
Inhaled fumesInhaled fumes
AllergyAllergy
Polluted atmospheric Polluted atmospheric
conditionsconditions
Vocal abuseVocal abuse
Iatrogenic traumaIatrogenic trauma

39. Differential Differential
DiagnosisDiagnosis

40. •Acute epiglottitisAcute epiglottitis
•Acute laryngotracheo bronchitis.Acute laryngotracheo bronchitis.
•Laryngeal perichondritisLaryngeal perichondritis
•Laryngeal oedemaLaryngeal oedema
•Laryngeal diphtheriaLaryngeal diphtheria
•Reinke’s oedemaReinke’s oedema

41. PAEDIATRIC PAEDIATRIC
CONCERNSCONCERNS

42. •Lacks firm cartilaginous skeleton.Lacks firm cartilaginous skeleton.
•Flabby , easily collapses.Flabby , easily collapses.
•Glottis aperture , relatively smaller.Glottis aperture , relatively smaller.
•Mucosa swells up rapidly in response Mucosa swells up rapidly in response
to slightest trauma or infection.to slightest trauma or infection.
•Stridor is the most noticeable Stridor is the most noticeable
presentation.presentation.

43. TREATMENTTREATMENT

44. SUPPORTIVESUPPORTIVE
•Voice rest.Voice rest.
•Steam inhalation.Steam inhalation.
•Cough suppressants.Cough suppressants.
•Avoid smoking and cold.Avoid smoking and cold.
•Fluid intake.Fluid intake.
•Consider short course of corticosteroidsConsider short course of corticosteroids
•voice rehabilitationvoice rehabilitation
•HumidificationHumidification

45. DEFINITIVEDEFINITIVE
• ANTIBIOTICSANTIBIOTICS
•STEROIDSSTEROIDS
•ANALGESICSANALGESICS

48. •Treatment 4 Treatment 4
hoarse voicehoarse voice

50. Voice TherapyVoice Therapy

51. •Voice therapy is an approach to Voice therapy is an approach to
treating voice disorders that involves treating voice disorders that involves
vocal and physical exercises coupled vocal and physical exercises coupled
with behavioral changes. with behavioral changes.
•The purpose of voice therapy is to The purpose of voice therapy is to
help attain the best possible voice help attain the best possible voice
and the most relief from the vocal and the most relief from the vocal
symptoms that are bothering the symptoms that are bothering the
patientpatient

52. Duration of voice Duration of voice
therapytherapy

53. The length of each individual voice therapy The length of each individual voice therapy
session usually ranges from ½ to 1 hour.session usually ranges from ½ to 1 hour.
The sessions are weekly. The sessions are weekly.
However, for some types of voice However, for some types of voice
disorders, two or more sessions per week disorders, two or more sessions per week
are best for the first few weeks, tapering are best for the first few weeks, tapering
down as the therapy progresses. down as the therapy progresses.

54. The duration of the entire voice The duration of the entire voice
therapy program is highly individual.therapy program is highly individual.
 The program can be as short as just The program can be as short as just
a few sessions, or as long as 12 a few sessions, or as long as 12
weeks or more.weeks or more.

55. The voice quality in The voice quality in
laryngitislaryngitis

57. ThankThank
youyou