CHRONIC LARYNGITIS

Aetiology of Chronic Laryngitis:

I. Endogenous:

1) Constitutional.

2) Metabolic.

3) Diabetes, hypothyroidism.

4) Vit A deficiency.

II. Physical:

1) Chronic voice abuse.

2) Chronic cough.

III. Chemical:

1) Smoking.

2) Alcohol.

3) Infective.

Symptoms:

Signs:

Vocal cord edges lose their pearly shine and appear red and congested with dilated blood vessels on the superior surface.
Cord movements appear asynchronous and flabby on phonation.
Thick mucus seen on the cords.
In advanced untreated cases, mucosa exhibits polypoidal changes.

Pathophysiology:

Dilated vessels are seen on superior surface of vocal cords.
Movements are flabby and sluggish. Interstitial oedema and inflammatory exudates are present.
If no treatment is taken, polypoidal deformities develop on true and false cords with fibrosis and hyalinization of cords.

Treatment: Apart from treating the parent causative factor for Chronic Laryngitis the following management should be done:

Stop smoking and alcohol.
Plenty of fluids to keep the vocal cords moist and thin secretions.
Voice rest.
Speech therapy /Voice Therapy.
Avoid whispering as it puts more strain on the vocal cords.
Avoid decongestants, as they cause dryness in oral cavity and throat.
Steam inhalation.
Control of Laryngo-pharyngeal reflux by giving proton pump inhibitors.
Expectorants to reduce cough.
Well humidified atmosphere.
If there is keratosis of vocal cord, microlaryngoscopy done and stripping of the vocal cords done by cold steel instruments, laser or radiofrequency .

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