Acute laryngitis refers to acute diffuse catarrhal inflammation of the laryngeal mucosa, mainly in the vocal fold, and is one of the common acute infectious diseases of the adult respiratory tract. Acute laryngitis can occur alone or secondary to acute rhinitis and acute pharyngitis, and is part of upper respiratory tract infections or secondary to acute infectious diseases. It occurs mostly in winter and spring. Pediatric acute laryngitis has its own special risks, which are described separately.
Etiology
1. Infection is the main cause, mostly after a cold or flu, secondary to bacterial infection on the basis of viral infection. Commonly infected bacteria include Staphylococcus aureus, Streptococcus hemolyticus, S. pneumoniae, Cattamora, Bacillus influenzae, etc.
2.Harmful gases Inhalation of harmful gases and dust can cause acute inflammation of the mucous membrane of the larynx.
3.Occupational factors Such as teachers, actors and salesmen who use their voices more, are prone to develop the disease when they use their voices improperly or excessively.
4.Trauma, such as foreign body or instrument damage to the mucous membrane of the larynx.
5, too much alcohol and tobacco, cold, fatigue These factors lead to the lowering of the body’s resistance to induce acute laryngitis.
Pathology】 Initially, the laryngeal mucosa is acutely diffuse congestion, inflammatory cell infiltration, tissue edema. As inflammation continues to develop, the exudate may become purulent secretions or become pseudomembranous adhesions. If the epithelium is damaged and detached, ulcers may also form. If the inflammation is not controlled in time, there is round cell infiltration and gradual formation of fibrous degeneration. Sometimes the lesions are deep and can even reach the intramyocardial layer of the larynx, and can also spread to the trachea.
Clinical manifestations
1. Hoarseness is the main symptom, mostly sudden onset, and in mild cases, the voice quality loses its roundness and clarity, and the tone becomes low and coarse. In severe cases, the voice is hoarse, or even only whispering or completely lost voice.
2.Laryngeal pain The pain in the larynx of the patient is usually not serious, and there is also a feeling of discomfort, dryness and foreign body in the larynx.
3.Increased laryngeal secretions There is dry cough without sputum or coughing out mucopurulent secretions.
4. Systemic symptoms Often occur after a cold, generally adults have mild systemic symptoms, including nasal congestion, runny nose, sore throat, chills, fever and fatigue.
Examination
Laryngoscopic examination shows that the laryngeal mucosa is characterized by bilateral symmetry and diffuse congestion, especially the vocal folds are congested. In the early stage, the surface of the vocal folds was light red with congested capillaries, which gradually became dark red, and sometimes submucosal bleeding of the vocal folds was seen. Poor closure of the vocal folds during vocalization. The laryngeal mucosa is dry in the early stage, and later there is mucus or mucopurulent secretion attached to the surface of the vocal folds.
Diagnosis】The diagnosis of acute laryngitis can be made based on the history of cold or excessive use of voice, hoarseness and other symptoms; diffuse congestion of the laryngeal mucosa, congestion of the vocal folds but normal movement.
Treatment
1.Vocal rest Vocal rest is the main treatment measure.
2, nebulization or steam inhalation Available gentamicin and dexamethasone ultrasonic nebulization inhalation, but also in hot water with mint, compound benzoin tincture and other steam inhalation.
3.Antibiotics and glucocorticoids The disease is serious, with bacterial infection can be systemic application of antibiotics. Glucocorticosteroids can be applied for severe vocal fold swelling.
4.Chinese herbal medicine can be used for symptomatic treatment such as Chinese medicine tablets.