I will be editing the treatment and prognosis sections of the laryngitis article.
Treatment
editTreatment is often supportive in nature, and depends on the severity and type of laryngitis (acute or chronic).[1] General measures to relieve symptoms of laryngitis include behaviour modification, hydration and humidification.[1]
Vocal hygiene (care of the voice) is very important to relieve symptoms of laryngitis. Vocal hygiene involves measures such as: [1]
- Resting the voice
- Drinking sufficient amounts of water
- Reducing caffeine and alcohol intake
- Stopping smoking
- Limiting throat clearing
Voice hygiene programs are given by speech-language pathologists. These programs typically include the following components:[1]
- Addressing amount and type of voice use
- Reducing behaviours that are damaging to the vocal folds
- Increasing hydration
- Adjusting lifestyle (for example, limiting caffeine and managing medical conditions)
Treatment of Acute Laryngitis
editIn general, acute laryngitis treatment is involves vocal hygiene, painkillers (analgesics), humidification[2] and antibiotics. [1]
Viral Laryngitis
editThe suggested treatment for viral laryngitis involves vocal rest, painkillers (analgesics), and mucolytics for frequent coughing.[3] Home remedies such as tea and honey may also be helpful. [3] Antibiotics are not used for treatment of viral laryngitis.[3][4]
Bacterial Laryngitis
editAntibiotics may be prescribed for bacterial laryngitis, especially when symptoms of upper respiratory infection are present.[3] However, the use of antibiotics is highly debated for acute laryngitis. This relates to issues of effectiveness, side effects, cost, and possibility of antibiotic resistance patterns. Overall, antibiotics do not appear to be very effective in the treatment of acute laryngitis.[2]
In severe cases of bacterial laryngitis, such as supraglottis or epiglottis, there is a higher risk of the airway becoming blocked.[3] An urgent referral should be made to manage the airway[1]. Treatment may involve humidification, corticosteroids, intravenous antibiotics, and nebulised adrenaline.[3]
Fungal Laryngitis
editFungal laryngitis can be treated with oral antifungal tablets and antifungal solutions. [1][3] These are typically used for up to three weeks and treatment may need to be repeated if the fungal infection returns.[3]
Phonotrauma
editLaryngitis caused by excessive use or misuse of the voice can be managed though vocal hygiene measures.
Treatment of Chronic Laryngitis
editLaryngopharyngeal Reflux
editLaryngopharyngeal reflux treatment primarily involves behavioural management and medication.[3][1] Behavioural management involves aspects such as:
- Wearing loose clothing
- Eating smaller, more frequent meals
- Avoiding certain foods (e.g. caffeine, alcohol, spicy foods)[3]
Anti-reflux medications may be prescribed for patients with signs of chronic laryngitis and hoarse voice.[5] If anti-reflux treatment does not result in a decrease of symptoms, other possible causes should be examined.[1] Over-the-counter medications for neutralizing acids (antacids) and acid suppressants (H-2 blockers) may be used.[3] Antacids are often short-acting and may not be sufficient for treatment.[3] Proton pump inhibitors are an effective type of medication.[3] These should only be prescribed for a set period of time, after which the symptoms should be reviewed.[1] Proton pump inhibitors do not work for everyone. A physical reflux barrier (e.g. Gaviscon Liquid) may be more appropriate for some.[1] Antisecretory medications can have several side-effects.[1]
When appropriate, anti-reflux surgery may benefit some individuals.[1]
Inflammatory
editWhen treating allergic laryngitis, topical nasal steroids and immunotherapy have been found to be effective for allergic rhinitis.[3] Antihistamines may also be helpful, but can create a dryness in the larynx.[3] Inhaled steroids that are used for a long period can lead to problems with the larynx and voice.[3]
Autoimmune
editMucous membrane pemphigoid may be managed with medication (cyclophosphamide and prednisolone).[1]
Granulomatous
editSarcoidosis is typically treated with systemic corticosteroids. Less frequently used treatments include intralesional injections or laser resection.[1]
Prognosis
editAcute Laryngitis
editAcute Laryngitis may persist, but will typically resolve on its own within two weeks.[1] Recovery is likely to be quick if the patient follows the treatment plan.[6] In viral laryngitis, symptoms can persist for an extended amount of time, even when upper respiratory tract inflammation has been resolved. [4]
Chronic Laryngitis
editLaryngitis that continues for more than three weeks is considered chronic. [1] If laryngeal symptoms last for more than three weeks, a referral should be made for further examination, including direct laryngoscopy.[1] The prognosis for chronic laryngitis varies depending on the cause of the laryngitis.[6]
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http://bestpractice.bmj.com/best-practice/monograph/423/treatment/step-by-step.html
- ^ a b c d e f g h i j k l m n o p q r Wood, John M.; Athanasiadis, Theodore; Allen, Jacqui (2014-10-09). "Laryngitis". BMJ. 349: g5827. doi:10.1136/bmj.g5827. ISSN 1756-1833.
- ^ a b Reveiz, Ludovic; Cardona, Andrés Felipe (2015-05-23). Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd. doi:10.1002/14651858.cd004783.pub5. ISBN 14651858.
{{cite book}}: Check|isbn=value: length (help) - ^ a b c d e f g h i j k l m n o p Colton, Raymond H.; Casper, Janina K.; Leonard, Rebecca (2011). Understanding Voice Problems (4th ed.). Baltimore, MD: Lippincott Williams & Wilkins. pp. 308–309. ISBN 978-1-60913-874-5.
- ^ a b Dominguez, L. M.; Simpson, C. B. (December 2015). "Viral laryngitis". Current Opinion in Otolaryngology & Head and Neck Surgery. 23 (6): 454-458.
- ^ Schwartz, Seth R.; Cohen, Seth M.; Dailey, Seth H.; Rosenfeld, Richard M.; Deutsch, Ellen S.; Gillespie, M. Boyd; Granieri, Evelyn; Hapner, Edie R.; Kimball, C. Eve (2009-09-01). "Clinical Practice Guideline Hoarseness (Dysphonia)". Otolaryngology -- Head and Neck Surgery. 141 (3 suppl): S1–S31. doi:10.1016/j.otohns.2009.06.744. ISSN 0194-5998.
- ^ a b Jonas, Nico (2007). "Laryngitis Management". Journal of Modern Pharmacy. 14 (5): 44.