Laryngitis - clinical syndrome lesions of the larynx caused by inflammatory changes in the mucous membrane due to the development of viral or bacterial etiology or other reasons, manifested in acute or chronic forms. Development is promoted by hypothermia, breathing through the mouth, dusty air, overstrain of the larynx, smoking and drinking alcohol.
The course of the disease depends on a number of conditions (age, body resistance, adequacy of therapy, etc.). How to treat laryngitis, what are the symptoms and first signs in adults, as well as the main methods of prevention - we will talk in more detail in this article.
What is laryngitis?
Laryngitis is a disease respiratory system, in which the mucous membrane of the larynx is affected. In adults, the disease is accompanied by a change in voice, up to its complete loss, coughing, and breathing problems. It can occur independently or be a continuation of inflammation of the mucous membranes of the pharynx, nasopharynx or nasal cavity in cases of acute respiratory diseases.
The fact is that when we talk, our vocal cords begin to vibrate, which is why sound appears. But with this disease, the vocal cords swell and completely lose this unique property. At the same time, the airways also narrow, it becomes a little difficult to breathe; another characteristic of the disease may be the so-called barking cough.
It is important to realize in time that silence is golden in the literal sense of the word. It’s better to talk in a whisper for a few days than to suffer for many weeks later.
Types of disease
There are two forms of laryngitis: acute, which lasts only a few days, and chronic, which lasts for weeks or months.
Acute laryngitis
Acute laryngitis relatively rarely develops as an independent disease. Usually it is a symptom of ARVI (influenza, adenoviral infection, parainfluenza), in which inflammatory process The mucous membrane of the nose and pharynx, and sometimes the lower respiratory tract (bronchi, lungs) is also involved. Acute laryngitis can result from excessive strain on the vocal cords, such as shouting, greeting, singing, or giving speeches.
Chronic laryngitis in adults
The chronic form results from acute manifestation in the absence of treatment or becomes the result of infection from chronic sources of the pathogen (inflammatory diseases in the nasopharynx). It is often diagnosed in smokers, since tobacco smoke negatively affects the condition of the epithelial layer and leads to its depletion, as a result of which the mucous membrane becomes susceptible to the effects of negative factors.
The outcome of chronic laryngitis in adults depends on its form. For hypertrophic and atrophic chronic laryngitis full recovery doesn't come. Prevention is aimed at eliminating causative factors.
Sometimes due to similarity clinical picture this pathology is confused with, however, how to treat laryngitis in an adult and what to do with pharyngitis are very different. Therefore, before being diagnosed by a doctor accurate diagnosis You should not take any medications.
Also distinguished:
- Catarrhal laryngitis– the patient has a sore throat, hoarseness, a feeling of rawness in the throat, an intermittent cough, dry and poorly expressed. The course is favorable and easy. Characteristic symptoms of laryngitis in adults: most often patients complain of dysphonia, hoarseness, soreness, rawness and dryness in the throat with normal or low-grade fever. Sometimes a dry cough occurs, which is subsequently accompanied by expectoration of sputum.
- Atrophic type of laryngitis characterized by a decrease in the thickness of the mucous membrane. Given this feature, coughs often include discharge with traces of blood. Characteristic sign- the formation of yellow-green or dirty brown crusts on the mucous membrane is a distinctive feature.
- Allergic laryngitis occurs in a patient with an allergic reaction (allergic rhinitis, pharyngitis and others).
- Hypertrophic laryngitis, unlike atrophic laryngitis, is characterized by thickening of the laryngeal mucosa. Excessively thickened areas of the larynx, in the form of whitish or transparent elevations, can become so large that they interfere with the closure of the vocal cords.
- In case of diphtheria form the development of the disease occurs due to the spread of infection into the larynx from the tonsils. The mucous membrane becomes covered with a white membrane, which can detach and cause blockage of the airways at the level of the vocal cords. A similar membrane can also form during streptococcal infection.
Causes of occurrence in adults
The causative agents of laryngitis are divided into two groups:
- viruses (influenza virus, parainfluenza, and others);
- bacteria (the causative agent of scarlet fever, diphtheria, whooping cough, streptococci, staphylococci, mycobacteria, treponema and others).
The main causes of laryngitis:
- General and local hypothermia, eating irritating food (usually very cold), cold drinking, mouth breathing, excessive vocal stress (long, loud conversation, singing, screaming) - all this leads to disruption of local defense systems, damage to the cellular structures of the mucous membrane and the development of inflammatory process. In the future, infection may occur.
- Contacts with patients with whooping cough, influenza or other acute respiratory viral infections. Incubation period laryngitis of infectious origin can last from several hours to several days, depending on the pathogen.
- Spread of infections from the paranasal sinuses, oral cavity and other nearby areas.
- Inhalation of various irritants - contaminated with dust, soot, chemicals air.
- Constant or one-time strong tension of the vocal cords - prolonged loud conversation, as well as screaming, especially in the case of unfavorable conditions indicated in the previous paragraph.
- Damage to the surface of the mucous membrane of the larynx - surgical intervention, mechanical (fish bone, attempt to swallow poorly chewed food, crackers).
- Alcohol abuse, smoking.
- Laryngitis can develop if gastric contents enter the larynx (). This condition can develop in case of weakness of the esophageal sphincters, which normally prevent gastric contents from entering the esophagus, pharynx, and larynx.
Symptoms of laryngitis
Signs of inflammation of the larynx in adults can be suspected independently. The following symptoms may indicate the development of laryngitis:
- The appearance of a dry cough;
- Hoarseness of voice;
- Sore and sore throat;
- Severe pain when swallowing;
- General malaise;
- Increase in body temperature;
- Increased amount in the blood.
Laryngitis in adults usually lasts from several days to 2 weeks. Usually, after 2-3 days, body temperature normalizes and overall health improves. Then the voice is restored and gradually the dry cough turns into a wet one and stops.
Throat in the photo with laryngitis
In the first seven to ten days, the disease has an acute course. If the inflammatory process lasts longer, then doctors diagnose chronic laryngitis.
| Symptoms and signs in adults | |
| Acute laryngitis |
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| Chronic laryngitis | Characteristic, frequently recurring symptoms of the chronic form:
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Complications
The most common complication of laryngitis is tonsillitis. Often in acute phase there is a danger of developing laryngeal edema and the occurrence of false croup. In this condition, the person begins to choke, the skin turns pale, and the nasolabial triangle becomes blue. If a person in this condition is not given immediate assistance, he may die.
Chronic laryngitis can also lead to complications such as:
- benign tumor formation in the larynx;
- proliferation of polyps, formation of cysts or granulomas;
- development of laryngeal cancer;
- laryngeal stenosis;
- impaired mobility of the larynx.
Diagnostics
Determination of symptoms and treatment of laryngitis in adults should be under the supervision of a physician.
During the diagnostic process, the doctor initially examines the medical history, conducts a physical examination and interviews the patient about the nature of the onset and development of the disease. A thorough examination of the sound of the voice, as well as the vocal cords, helps to select the right approach to treating the disease.
In addition to a general medical examination, the doctor may also additional methods studies, especially for chronic laryngitis or prolonged acute:
- laryngoscopy;
- blood analysis;
- fluorography of a difficult cell;
- bacteriological examination of swabs, smears from the larynx, etc.
To a person who does not have medical education, you can diagnose laryngitis yourself, but the likelihood of an error is very high. Although pathology has characteristic symptoms, but in some cases it can take on a “blurred” flow. Some signs may be completely absent.
You should contact an otolaryngologist if:
- Your symptoms do not improve within 2 weeks;
- You have sudden severe pain (especially radiating to the ear), difficulty swallowing, or coughing up blood;
- Suspect another disease;
- There is a suspicion that laryngitis may become chronic.
Treatment of laryngitis in adults
How to quickly cure laryngitis in adults at home? Treatment of laryngitis involves following a gentle regimen (the patient requires rest) and eliminating factors that can increase inflammation (quitting smoking, spicy, cold and hot foods).
General treatment plan:
- elimination of possible causes - reducing stress on the larynx and vocal cords (silence);
- exclusion of foods that irritate the mucous membrane - carbonated drinks, salty, spicy foods;
- complete cessation of smoking, drinking alcoholic beverages, including beer and alcoholic cocktails;
- plenty of warm drinks - teas, infusions, decoctions, milk, jelly, juices.
If laryngitis has developed, treatment in adults can be carried out by prescribing the following: medicines local and systemic therapy:
- external medications for basic treatment: aerosols - Camphomen, Ingalipt, Tera-Flu; lozenges and absorbable tablets - Isla, Strepsils, Neo-Angin;
- providing expectoration: Mucaltin, Prospan, Gedelix, Eucabal, Gerbion;
- medications that can alleviate cough: Cofex, Sinekod;
- antiallergic drugs (antihistamines): Zodak, Suprastin;
- antibacterial antibiotic: Bioparox spray;
- targeted antibiotics: Ampicillin, Amoxicillin, Oxacillin and cephalosporins;
- antiviral drugs: Fusafungin, Fenspiride;
- improvement immune defense and strengthening the body - compositions based on radiola, aralia, pantocrine, eleutherococcus.
Drugs antibacterial action(antibiotics) are prescribed for laryngitis only if the bacterial nature of the pathology is confirmed. To do this, a bacterial culture is performed and the causative agent of the infection is identified. If this is not done, treatment may be ineffective due to the lack of sensitivity of some strains of bacteria to certain types antibiotics.
The use of physiotherapeutic methods of treatment gives good results. The following procedures may be prescribed to adult patients:
- electrophoresis with novocaine;
- microwave therapy;
How to treat acute laryngitis?
In adults, treatment of laryngitis acute form should first of all be aimed at eliminating the problem that provoked the disease.
- Used locally antibacterial drugs in the form of lozenges, aerosols, sprays, such as Strepsils, Hexoral, Tantum Verde, etc.
- At severe pain in the throat, NSAIDs are prescribed - non-steroidal anti-inflammatory drugs: Nimesil, Nise, Nurofen. They effectively eliminate all symptoms associated with inflammation - pain, voice disturbance, etc.
- To stimulate the activity of metabolic processes and increase the activity of the immune system, adaptogens are prescribed (tinctures of Eleutherococcus, pantocrine, ginseng, rosea radiola).
- An excellent remedy for laryngitis is lubricating the throat with Lugol's solution. This remedy helps protect the mucous membrane of the larynx from the effects of pathogenic flora. On the 3-4th day of illness, you can replace lubrication with Lugol's solution with sea buckthorn oil. This substance promotes rapid restoration of the mucous membrane.
To ensure complete rest of the larynx, a person It is not recommended to talk for about a week. If this is not possible, you need to speak as quietly and softly as possible.
Until the mucous membrane of the larynx is restored, the doctor must prescribe a strict diet, during which only gentle food should be consumed. However, it should not be too cold or hot.
An exact list of medications and recommendations for their use, as well as the advisability of inhalations, is given to the patient by the attending physician. Subject to compliance with the prescribed therapy, the patient returns to a normal state within 10 days.
How to treat chronic laryngitis in adults?
It is almost impossible to completely get rid of the chronic form of laryngitis, but it is possible to achieve remission and reduce its manifestations to a minimum. It is worth noting that with a particularly pronounced inflammatory process and the development of complications, hospital treatment may be required. In the treatment of exacerbations of chronic laryngitis Special attention worth spending time on therapy chronic infections contributing to this aggravation.
Its course for too long can disrupt vocal function and completely change the patient’s voice. And people suffering from chronic laryngitis are at risk for laryngeal cancer. Therefore, this disease must be treated comprehensively and until complete recovery.
For adults, laryngitis therapy will consist of the following procedures:
- Taking medications and vitamins;
- Alkaline and antibiotic inhalations;
- Physiotherapy;
- Traditional medicine methods.
Non-drug methods are of great importance in the treatment of chronic inflammation of the larynx:
- to give up smoking;
- voice rest;
- gentle nutrition (warm, soft, neutral-tasting food, exclusion of spicy, hot and cold foods, carbonated drinks);
- drinking plenty of fluids(alkaline mineral water(“Naftusya”, Borjomi), warm milk with honey);
- prevention of hypothermia;
- ventilate the room in which the patient lives for 10 minutes every hour;
- adequate microclimate (temperature and humidity) in the room.
Inhalations
Inhalation is effective for laryngitis. It is better if it is an ultrasonic inhaler, and the patient will breathe with infusion medicinal herb, for example chamomile.
Inhalation therapy can be using steam inhalations with herbs (chamomile, oregano, sage and others), potato steam, alkaline inhalations. This can be inhalation using a nebulizer (with mineral water or medications prescribed by a doctor). Inhalations are carried out from 3 to 7 times a day.
But know that steam inhalations cannot be carried out in the following cases:
- at elevated temperatures,
- with purulent processes in the nasopharynx,
- intolerance to drugs used for inhalation,
- adults with exacerbation bronchial asthma and other breathing disorders,
- tendency to nosebleeds,
Nutrition
Correct therapy means A complex approach To treat the disease, drug treatment cannot be used exclusively. It is important to follow a certain diet. For laryngitis, adults are strictly prohibited from consuming:
- all alcoholic drinks;
- sparkling water;
- seeds, nuts;
- garlic, pepper, mustard, onion, horseradish;
- seasonings, spices, herbs.
Food should be liquid or pureed, not too hot and not cold. It is advisable to exclude fried and fatty foods, and steam meat and fish.
Vegetable oils, which can be dropped a few drops into the nose or lubricated with them in the throat, will help in the fight against inflammation and irritation of the larynx. Fresh fruits, vegetables, juices will be brought great benefit in the treatment of laryngitis, but they should be eaten in the form of purees.
Drinking for laryngitis should be warm (not hot) and quite plentiful. All products should be taken in small sips. Borjomi, milk and sage will help cope with the disease.
Folk remedies
Before using folk remedies for laryngitis, it is recommended to consult with your doctor.
- At the first manifestations of laryngitis, it is advisable to drink more warm drinks. Tea should be decaffeinated, as caffeine has a dehydrating effect.
- Two teaspoons calamus pour a glass of boiling water, leave for 5 hours, use for gargling. 3 teaspoons of chopped onion peels are poured into 0.5 liters of water, let it boil and leave for 4 hours, filter and use for gargling.
- Ideal for treating laryngitis at home gargling with blueberry decoctions, beet juice and solution apple cider vinegar homemade. With false croup, the child is shown hot foot baths(procedure duration – 3-5 minutes).
- Gogol-mogol. To prepare, beat two yolks with a tablespoon of sugar, then add a tablespoon of melted butter and mix thoroughly. It is believed that using this remedy for 4-5 days twice a day helps restore your voice.
- For laryngitis, adults are recommended to use next recipe: 3 finely chopped carrots are boiled in 1 liter of milk until tender; the broth can be rinsed and taken orally.
- Add protein from 100 ml of vegetable oil chicken egg, to stir thoroughly. Drink in small sips throughout the day.
- Vitamin teas from linden, rowan, black elderberry which you can drink twice a day. Frozen viburnum is irreplaceable, which is also added to tea or eaten in its pure form.
- Another good folk remedy - tea with ginger and honey- the root is grated on a fine grater and added to tea, about 2 teaspoons of freshly grated ginger per 200 ml of boiling water, we eat honey, but only as a taste, do not add it to boiling water.
During treatment, and especially at home, It's important to listen to your body! If you feel significant discomfort and worsening laryngitis symptoms, it is better not to tempt fate and change the treatment method to a more proven one.
Prevention of laryngitis
Prevention of laryngitis in adults involves preventing factors leading to the development of the disease.
- Remember that even some drugs can cause drying of the mucous membrane, so read the instructions before drinking.
- Timely treatment of colds and chronic bacterial outbreaks.
- If an acute respiratory infection or acute respiratory viral infection occurs, adherence to the regime (home regimen, warm plenty of fluids, sparing the voice - speak quietly or whisper, do not be nervous, do not walk, avoid physical activity).
- Fight against bad habits (smoking, alcohol).
- Don't also forget about simple things, such as wet cleaning of premises: dust is the primary thing that can irritate absolutely any mucous membrane.
- Sports activities.
Laryngitis is not a serious disease, but advanced cases sometimes require surgical intervention. To prevent this, it must be treated promptly and completely. To do this, we recommend that you contact an otolaryngologist at the first sign.
Chronic laryngitis treatment requires labor-intensive and painstaking treatment. Therefore, to avoid it, you need to monitor your health. As you know, any chronic illness preceded by its initial stage. If laryngitis is not treated in time, then chronic laryngitis appears over time.
Laryngitis is viral disease the larynx, more precisely, its mucous membrane, and vocal cords. The patient feels stinging dryness, irritation, and sore throat. Over time it appears severe itching. The resulting hoarseness leads to partial, and possibly complete, loss of voice. Symptoms of laryngitis also include a barking cough.
What causes chronic laryngitis?
It was previously noted that when laryngitis occurs, the mucous membrane of the throat becomes inflamed. For what reasons does this happen? There may be several reasons for this:
- frequent relapses of the disease;
- professional costs (singers, teachers);
- smoking;
- excessive alcohol consumption;
- presence of nasopharyngeal diseases, diabetes mellitus, allergies, heart or lungs.
Taken together or individually, all these reasons lead to damage to the mucous membrane due to narrowing of the glottis.
Next, a swollen condition of the larynx appears, damaging the vocal cords. These painful symptoms may cause pharyngitis, tonsillitis or rhinitis. In case of upper respiratory tract disease, a diagnosis of chronic laryngitis is made.
The main cause of the disease in adults is smoking. According to statistics, for example, in our country, smoking is 65% among men and 50% among women.
Types of chronic laryngitis
There are three types of this disease:
- catarrhal chronic;
- atrophic chronic;
- hyperplastic chronic.
With catarrhal chronic laryngitis, the manifestations of the disease are not very pronounced compared to acute ones. There is a slight tickling sensation in the throat, a weak cough accompanied by the release of mucus. This mucus prevents the vocal cords from closing, resulting in a hoarse voice. The mucous membrane of the larynx has a gray-red color and spreads either throughout its entire part or in a certain area. The vessels of the larynx dilate.
As the disease worsens, symptoms intensify. To determine the diagnosis, a laryngoscopy is performed in a hospital facility. The patient has a cough, dryness in the larynx, decreased performance, weakness, and most importantly, discharge in the form of blood and sputum. This means that the disease has developed into chronic atrophic laryngitis. Atrophy occurs in both the larynx and nasopharynx. Frequently releasing lumps in the throat increase the inflammatory process. Trying to cough them up, the sick person causes a stronger cough, worsening the situation. After the accumulation of a large number of traffic jams, hoarseness increases, breathing becomes difficult, and the voice changes.
Hyperplastic chronic laryngitis is similar in symptoms to chronic catarrhal. Only the voice has greater hoarseness, because the vocal cords are greatly thickened. Sometimes, as the disease worsens, calloused areas appear under the ligaments, causing pain. Without treatment it can turn into cancer. This disease mainly affects children and singers who do not take care of their voice.
When laryngitis worsens, to reduce the load on the ligaments, you need to talk in a whisper. To avoid drying out the mucous membranes, breathing should be through the nose.
Prevention of chronic laryngitis
Treatment of chronic laryngitis should be carried out in clean, ventilated areas. During illness, you should not be in a building where there is evaporation from caustic chemicals: paint, varnish, etc. Inhalation of these chemicals will aggravate the situation.
It is necessary to exclude certain foods from your diet. It includes hot-salty, sour dishes, all kinds of seasonings and spices. All these products delay the healing process, as they have a negative effect on the throat.
Before going outside, it is recommended to stay indoors for 15 minutes: cold air can cause illness in people who intensively strain their voice.
An important condition for the prevention of laryngitis treatment is maintaining air humidity at the required level. To do this, you should not forget about ventilating the room and regularly performing wet cleaning.
To strengthen the immune system, all doctors prescribe systematic hardening of the body. This method gives excellent results, especially in children. But first you need to consult your pediatrician. After all, in young children laryngitis can cause various complications. After examining a small patient, the doctor will discover the cause of the inflammation. He is the one who will select a hardening system for your child. It is important to avoid hypothermia. Parents should not forget that the child must wash his hands, use wet wipes, i.e., maintain personal hygiene.
And adults need to give up bad habits. They are the ones who delay the course of treatment, and sometimes prevent a complete recovery.
How to treat chronic laryngitis?
Depending on the type of disease, the attending physician prescribes a course of treatment. Patients diagnosed with atrophic and catarrhal chronic laryngitis are cured better and faster. In this case, using inhalations of oils and alkalis, you can relieve pain in the larynx and its inflammation. Aerosol antibiotics are also used in the treatment of chronic laryngitis. For severe coughs, the doctor prescribes warm drinks with alkalis and cough medicines, supplementing the treatment with physiotherapeutic procedures.
It is advisable to talk less, especially in cold air.
Indoors, you need to talk calmly, without straining your vocal cords, as usual.
A special discussion concerns hyperplastic chronic laryngitis, the treatment of which should be carried out under the strict supervision of a doctor. It is dangerous as it can cause cancer.
Most often, men over 40 years old suffer from this disease. At long-term treatment antibiotics, certain enzymes and astringents are prescribed.
If medications do not help, then surgery is performed.
Treatment of chronic laryngitis with folk remedies
Many people have heard about treating diseases with folk remedies. Laryngitis did not escape this either. Applying traditional medicine, you can improve your condition by gargling using various solutions (saline, alkaline). Medicinal sucking lollipops also help. This remedy relieves pain well.
Very favorable on sore throat Lemon and honey work. Lemon juice helps produce acidic saliva to fight infection. For this purpose, the squeezed juice is consumed repeatedly during the day, 1 tbsp. spoon. Add a teaspoon of honey and wash it down with warm tea. Instead of lemon juice, it is good to use cranberry juice.
A popular method of treating laryngitis is inhalation. Covering your head with a warm cloth and bending over the pan, you need to inhale the moist hot steam. Herbal decoctions or potatoes are great for getting rid of this disease. Herbs used include plantain, raspberry, and sage.
Warm beer can be used to treat adults. It is drunk in small sips, preheated. It is believed that it can be used to restore your voice. This remedy is popular among singers and artists. And although alcohol is not recommended for laryngitis, it is used in small doses as a folk remedy. Here's another recipe. A drop of cognac is added to eggnog to relieve a sore throat. Patients should eat no more than one serving daily.
If chronic laryngitis is treated with various warming compresses, then the disease it will go faster. For these purposes, you can use warm vegetable oil, badger fat, interior lard.
In each case, the use of folk remedies is an additional technique in the treatment of chronic laryngitis. It is taken as a basis drug treatment, which is carried out by an ENT doctor or TB specialist.
Chronic laryngitis is a sluggish infectious inflammation of the larynx with a long course and periodic relapses. The disease rarely develops in isolation and is more often diagnosed against the background of chronic inflammation upper sections respiratory tract - nasal cavity, paranasal sinuses, throat, etc. Sometimes damage to the larynx is observed in the case of the spread of an ascending infection due to pneumonia, bronchitis or tuberculosis.
Hoarseness and discomfort in the throat - typical signs inflammation of the laryngeal mucosa. Damage to the ENT organs can be caused by overheating, hypothermia, mechanical damage mucous membranes, inhalation of polluted or dusty air. Due to the active development of pathogenic agents in the respiratory tract, an allergic reaction occurs and, accordingly, severe swelling fabrics. Subsequently, this can lead to difficulty breathing and stenosing laryngotracheitis, which often causes attacks of suffocation.
general description
What is chronic laryngitis? Laryngitis is an inflammation of the mucous membranes of the larynx, which in 97% of cases is preceded by infectious diseases- influenza, ARVI, scarlet fever, tonsillitis, tracheobronchitis, pneumonia, etc. If inflammation is not stopped in time during the acute course of the disease, over time laryngitis will develop into chronic form.
It should be noted that chronic laryngitis is an occupational disease that often occurs among teachers, lecturers, singers, theater actors, television and radio presenters. One of the basic rules that must be followed when treating the disease is complete vocal rest. It is known that even when speaking in a whisper, the vocal cords experience considerable stress. This can negatively affect the dynamics of recovery and generally lead to chronicity of the inflammatory process.
Inadequate therapy or inaction leads to the spread of infection along the respiratory tract. In patients with indolent laryngitis, laryngotracheitis can subsequently be diagnosed, which affects the mucous membranes of not only the larynx, but also the trachea. Greatest danger for humans it is the so-called stenosing laryngotracheitis. With the disease, there is a strong narrowing of the lumen of the respiratory tract, which ultimately leads to attacks of suffocation and asphyxia.
Advanced laryngitis can cause false croup, in which breathing completely stops.
Causes of chronic laryngitis
Why does chronic laryngitis appear? Sluggish inflammation of the larynx is formed against the background of frequently recurring acute laryngitis. Insufficient or inadequate treatment can also cause chronic inflammation in the ENT organs.
The key reason for the development of pathology is the activation of opportunistic microorganisms. Decreased immune defense, frequent colds, hypothermia, drinking cold drinks can provoke the proliferation of pathogenic agents - fungi, viruses, protozoa, microbes, etc. Chronic inflammation of the larynx is more often diagnosed in men who more women exposed to household and professional hazards.
In the mechanism of disease development, descending (adenoiditis, periodontitis, rhinosinusitis) and ascending (bronchiectasis, bronchitis, pneumonia) infections play a very important role. Sluggish inflammation of the ENT organs most often occurs against the background respiratory infections- scarlet fever, measles, tonsillitis, flu, pharyngitis, etc. Damage to the laryngeal mucosa, which is represented by ciliated epithelium and lymphoid tissues, entails a decrease in local immunity. As a result, the body fails to cope with the onslaught of opportunistic viruses and microbes, resulting in inflammation.
Provoking factors
Exogenous and endogenous provoking factors play an important role in infectious lesions of the larynx. Before starting treatment for a disease, it is necessary to eliminate the immediate cause of its occurrence. Chronic laryngitis can be provoked by:
It has been clinically proven that people with a hereditary predisposition and pathological narrowness of the respiratory tract in the larynx are more susceptible to laryngitis.
In addition, colds and infectious diseases are more common in people prone to irritation and depressive state. Psychosomatic reasons The development of chronic laryngitis has not been fully studied, but one thing is clear - the disease “loves” those who hush up their grievances.
Clinical picture
How to diagnose the disease? It is worth noting that the symptoms of chronic laryngitis depend on the form of the disease and the characteristics of the pathological processes in the larynx. As a rule, patients complain of deterioration in voice quality, decreased timbre, and the appearance of hoarseness. TO general manifestations sluggish inflammation of the larynx can be attributed to:
- rapid voice fatigue;
- dryness and rawness in the throat;
- “scratching” in the larynx when speaking;
- sensation of a lump in the Adam's apple area;
- decreased voice strength;
- labored breathing;
- coughing in the morning;
- hoarseness.
Swelling of the mucous membranes can lead to the development respiratory failure and the occurrence of cyanosis, i.e. bluish color of lips and skin. Despite the fact that the symptoms of the disease are relatively mild, constant inflammation of the soft tissues can lead to complications in the future. Therefore, upon detection pathological manifestations It is still advisable to undergo an examination by an ENT doctor or therapist.
In otolaryngology, it is customary to distinguish several forms of sluggish laryngitis. Depending on the nature of the inflammatory reactions, clinical manifestations diseases may differ slightly. According to generally accepted classification, chronic laryngitis can be:
- catarrhal - superficial inflammation of the laryngeal mucosa with fairly frequent exacerbations; the symptoms are not much different from the manifestations of acute laryngitis - fever (up to 37.5 ° C), moderate sore throat, increased submandibular lymph nodes, dry cough;
- atrophic - thinning of the walls of the larynx with the subsequent formation of dry crusts on the surface of the mucosa; more common in older people and men working in hazardous industries;
- hypertrophic - diffuse (widespread) or limited compaction of the laryngeal mucosa in the area of the vocal cords; narrowing of the lumen of the respiratory tract makes breathing difficult, as a result of which there is oxygen starvation and, as a result, dizziness, lethargy, lack of appetite, etc.
Hypertrophic (hyperplastic) laryngitis is a precancerous pathology that can develop into a malignant tumor.
To recognize a specific type of disease, you should familiarize yourself with the features and typical manifestations of each form of chronic laryngitis. However, it should be noted that even if the disease is correctly diagnosed, treatment can only be prescribed by a specialist. Inadequate therapy is the key reason for the deterioration of the patient’s well-being and the development of complications. Some of them have to be eliminated through surgery.
Catarrhal laryngitis
Catarrhal chronic laryngitis - the least dangerous form a disease that does not cause pathological changes in the tissues of the larynx. During endoscopic examination of the hypopharynx, some expansion is noted blood vessels, loosening of the mucous membrane and changing its color. The surface of the larynx becomes grayish-red with small spots throughout the surface of the mucosa.
Due to inflammation, the goblet cells in the larynx, which secrete mucus, begin to function intensively. Hypersecretion of mucus causes irritation and coughing with little sputum production. Over time, tissue swelling leads to changes in the elasticity of the vocal cords, so patients’ voices “sag” and hoarseness appears. In case of exacerbation of inflammation, the cough intensifies and becomes constant. To eliminate pathological processes in the larynx and speed up recovery, the following types of drugs are used:
- antibacterial agents of the penicillin and macrolide series to destroy pathogenic microbes;
- mucolytic (expectorant) medications to remove excess mucus from the respiratory tract;
- antiseptic lozenges for resorption, which inhibit the activity of infectious agents in the ENT organs;
- anti-inflammatory and disinfecting rinse solutions that restore the integrity of tissues in the larynx;
- immunostimulants that increase general and specific immunity.
IN outpatient setting An otolaryngologist performs electrophoresis and UHF therapy, which accelerates the healing process of the mucous membranes. As a rule, relief occurs within 3-4 days after using complex therapy.
Hypertrophic laryngitis
With hypertrophic laryngitis, the symptoms of inflammation are most pronounced. This is the most dangerous form respiratory disease, in which hyperplasia (increase in size) of the mucous membranes is observed. The thickening of the walls of the larynx leads to a strong narrowing of the lumen in the respiratory tract, so patients may experience a lack of oxygen. Depending on the degree of tissue hyperplasia, diffuse (spread) and limited laryngitis are distinguished. In turn, the limited form of the disease is divided into:
- monochondritis - inflammatory processes occur predominantly in vocal cords only on one side of the larynx;
- Reinke's edema is a polypoid growth of the mucous membrane, in which there is a strong narrowing of the lumen of the respiratory tract;
- hyperplasia of the false vocal cords - severe compaction of the soft tissues directly above the vocal cords;
- “singing nodules” are round, dense neoplasms on the vocal cords, which are most often found in people of “vocal” professions;
- areas of pachydermia - replacement of ciliated epithelial cells with integumentary epithelial cells, i.e. flat epithelium.
To prevent the development of malignant tumors, when treating the hypertrophic form of laryngitis, potent decongestants and anti-inflammatory drugs are used - corticosteroids and antihistamines. Physiotherapeutic procedures often include laser therapy, cryodestruction and radiotherapy.
Atrophic laryngitis
Atrophic laryngitis is more often diagnosed in people working in hazardous industries. Inhalation of volatile chemicals leads to disturbances in the functioning of the mucous membranes of the larynx, as a result of which its walls become very thin. Viscous mucous accumulations form on its surface, which dry out over time and form crusts. The development of atrophic laryngitis is signaled by:
- sore throat;
- periodic cough;
- dry mouth;
- tingling in the throat when swallowing;
- sensation of a foreign object in the throat.
Over time, dense crusts begin to separate from the walls of the larynx, resulting in the formation of ulcers that can bleed. Therefore, when coughing up sputum, blood may be found in the mucus. To eliminate inflammatory processes, inhalations are used, in which wound-healing preparations with trypsin are used as solutions. The proteometric enzyme accelerates cellular metabolism, due to which the mucous membrane of the larynx is restored faster.
To prevent exacerbation of chronic laryngitis, it is necessary to treat colds, rhinitis and dental pathologies(gingivitis, periodontitis). In addition, you should strengthen your immune system by taking vitamin-mineral complexes and foods with plenty of useful substances. In case of inflammation of the throat, it is recommended to strictly observe vocal rest for 3-4 days. During treatment of the disease, you need to stop drinking alcohol and smoking, which negatively affects the condition of the vocal cords.
The persistence of the inflammatory process in the laryngeal mucosa for more than 20 days leads to chronicity of the disease. This is facilitated by late detection of laryngitis and its incorrect treatment. Early diagnosis of the disease is especially important for people with voice-speech professions (teacher, actor or vocalist). Treatment of chronic laryngitis should be carried out taking into account the form of the disease, concomitant diseases and availability allergic reactions at the patient. notice, that chronic inflammation can lead to malignant tissue degeneration and the development of cancer.
Causes
The transition from an acute form of the disease to a chronic form may be due to the following factors:
- frequent colds due to weakened immunity;
- the presence of long-term foci of infection in the oral cavity (caries, gingivitis) or oropharynx (tonsillitis);
- gastrointestinal diseases, one of the symptoms of which is heartburn. It appears due to the entry of stomach contents into the esophagus and damage to the mucous membrane by hydrochloric acid. Such diseases include gastroesophageal reflux disease and hernias;
- air pollution with dust particles or chemicals that, when inhaled, irritate the mucous membrane of the throat;
- tendency to allergies, frequent contact with allergens;
- heavy loads on the voice-forming apparatus;
- occupational hazards (work in the mining, paint and varnish, flour-grinding industries). This group of reasons also includes professions related to constant voltage vocal cords (vocalists, speakers);
- smoking;
- low level of immune defense due to severe somatic pathology (diabetes, tuberculosis, HIV).
Symptoms and diagnostic methods
Chronic laryngitis can be suspected based on:
- hoarseness;
- changes in voice timbre;
- dryness, soreness, and the sensation of a foreign lump in the oropharynx;
- cough. It can be an infrequent cough or in the form of an attack.
During the period of remission, the listed clinical symptoms are much less pronounced compared to exacerbation. As symptoms increase, low-grade fever, weakness, and decreased appetite may appear.
To cure chronic inflammation of the larynx, you need to see a doctor for diagnosis. It includes:
Chronic inflammation can occur in several forms:
- catarrhal It is characterized by swelling of the vocal folds, hyperemia and slight thickening of the mucosa. During phonation, the gap is not able to close completely;
- hypertrophic. This form may occur in a limited or diffuse form. The mucous membrane is swollen, and “singer’s nodules” may be observed on the vocal folds. Clinically, the form manifests itself as aphonia;
- atrophic. It is characterized by severe dryness, thinning of the mucous membrane, the surface of which is covered with viscous mucus and dry crusts. The patient is bothered by a strong cough, which may cough up crusts with blood streaks. The appearance of blood indicates damage to the blood vessels by the atrophic process.
Treatment tactics
How to treat chronic laryngitis? We emphasize that it will not be possible to completely get rid of the pathology, but it is quite possible to slow down its progression. To reduce the severity clinical signs and improve the quality of life, it is recommended to follow the following rules:
- quitting smoking, strict control over the amount of alcohol consumed and the frequency of its intake;
- voice rest;
- gentle nutrition (meals should be at a comfortable temperature, not irritate the mucous membrane of the oropharynx and be beneficial; therefore, spices, pickles, and carbonated drinks are prohibited);
- plenty of warm drinks (milk with soda added, still mineral water, tea with honey);
- prevention of hypothermia and contact with drafts;
- regular ventilation of the room and wet cleaning;
- usage protective equipment in hazardous work or changing jobs.
An integral part of therapy is the treatment of somatic pathology, as well as the rehabilitation of bacterial foci. Depending on the inflammatory form therapeutic tactics may have a number of differences.
Treatment of laryngitis of various forms
A good therapeutic effect is observed with catarrhal form. From medications may be assigned:
Irrigation of the laryngeal mucosa with drugs is carried out in conditions medical institution. Additionally, physiotherapeutic procedures are prescribed, for example, electrophoresis, UHF, and DDT.
When atrophic processes predominate, treatment of chronic laryngitis involves the use of medications prescribed for catarrhal form. The only feature is inhalation with proteolytic enzymes, for example Trypsin.
As for the hypertrophic form, treatment tactics are determined based on diagnostic results and clinical symptoms. In addition to conservative tactics, the doctor may recommend surgical intervention. The operation is performed under local anesthesia using special instruments and a microscope. This makes it possible to remove hypertrophied areas of the mucosa.
Removal of singing nodules from the surface of the vocal folds can be carried out using the coblation method, which involves the impact of a beam of cold plasma on the nodular formations.
Compliance with the rules of rehabilitation in the postoperative period plays an important role in treatment. The patient must strictly follow medical recommendations:
- It is forbidden to eat for the first 3 hours after surgery;
- you should not cough so as not to enlarge the postoperative wound;
- physical activity should be limited for a week;
- a gentle diet and vocal rest are required in the first week after surgery;
- Smoking is prohibited.
You can fight chronic inflammation of the larynx folk ways however, without forgetting drug therapy. Thanks to healing properties herbs provide mild anti-inflammatory 
And antimicrobial effect, regenerative processes are stimulated and healing is accelerated.
To gargle, you can use infusions and decoctions of chamomile, sage, oak bark or calendula. Here are a few recipes that can be used for chronic laryngitis:
- 10 g of chamomile, cinquefoil and calendula should be poured with 470 ml of boiling water and left to infuse for 10 minutes. As soon as the temperature of the steam drops, you can begin inhalation or gargling;
- Soda-saline solution for rinsing the oropharynx. To prepare it, you need to dissolve 5 g of ingredients in warm water volume 240 ml, add 2 drops of iodine;
- honey can be simply sucked or taken in combination with lemon juice;
- 5 garlic cloves should be chopped, pour 230 ml of milk, boil for several minutes and filter. Take 15 ml three times a day;
- can be used for inhalation essential oils(fir, chamomile, eucalyptus). Just add 5 drops of oil to hot water volume 460 ml.
An incorrect treatment approach can lead to complete loss of voice, paresis of ligaments, as well as the formation of fibroids, cysts or contact ulcers.You should not rely solely on the help of folk remedies, because chronic inflammation is quite difficult to cure.
Chronic laryngitis is an inflammation of the mucous membrane of the larynx, usually combined with chronic pharyngitis.
Causes of chronic laryngitis
Appearance inflammatory reaction on the mucous membrane of the larynx are caused by some reasons: persistent laryngitis, occurring in acute form, chronic inflammatory diseases trachea, bronchi, lungs, sinusitis, vasomotor rhinitis, strong and prolonged tension of the vocal cords, smoking (in 100% of smokers the larynx is affected - smoker's laryngitis), drinking alcoholic beverages. Also, chronic laryngitis can be caused by inhalation of dust particles, harmful gases and other harmful factors. Passive smoking (presence in a smoky room) is also quite harmful. All this leads not only to damage to the mucous membrane, but also affects the neuromuscular apparatus of the laryngopharynx.
As a result, a defense reaction immediately appears, which is expressed in a narrowing of the glottis. This is also expressed by coughing, and swelling of the larynx is possible. The function responsible for voice formation is damaged. Chronic inflammation (rhinitis, tonsillitis, pharyngitis, etc.) to which the upper Airways, may influence the occurrence of chronic laryngitis.
Types and symptoms of chronic laryngitis
- Catarrhal
- Hyperplastic
- Atrophic
For catarrhal laryngitis in the chronic form, the symptoms are not as pronounced as they are characteristic of the acute form of laryngitis. Mainly, this is a tickling sensation in the throat, a cough, which is accompanied by the release of mucus. There is a change in the voice, which can be clear, but gradually becomes hoarse from long conversations. Quite often, the voice becomes hoarse in the evening. Coughing occurs infrequently, in most cases with inflammation back wall. Much more often the cough is mild. During laryngoscopy, hyperemia is observed. Hyperemia of the larynx is not too active than during the acute form of laryngitis. The mucous membrane of the larynx takes on a gray-red color. These symptoms are noted both over the entire surface and localized. Quite often, dilated vessels can be seen on the surface of the mucous membrane.
All symptoms appear evenly on one and the other side of the mucous membrane of the larynx. Patients who suffer from chronic laryngitis try to compensate for the strength of their voice by forcing it, which leads to more irritation. During observation of catarrhal manifestations, neuritis and myositis are observed. The chronic form of laryngitis can occur with complications and periods of acute symptoms.
Signs hyperplastic laryngitis in the chronic form, the same symptoms can be called as with catarrhal laryngitis; the color of the mucous membrane of the larynx can become blue-red, or gray-red. With hyperplastic laryngitis, the voice may become hoarse. With hyperplastic laryngitis, the vocal cords become thicker and resemble red ridges.
In some cases, the mucous membrane of the ligaments, rather than the areas under the ligaments, is susceptible to hyperplasia. Patients who do not take care of their voice by strengthening it, including children who are not able to control this process, may encounter the problem of the formation of calluses on the vocal cords. They appear at the intersection of the middle and anterior parts of the ligaments. For the first time, these formations were identified in people who sing. In honor of this, the name singing knots was coined.
Hyperplastic laryngitis, which has become chronic, is classified as a precancerous disease. As a result, patients who have been diagnosed with hyperplastic laryngitis should be treated on an outpatient basis. Periodic monitoring and clinical observation are used.
For atrophic chronic laryngitis atrophy in the larynx occurs along with the processes of atrophy in the pharynx and nasal cavity. With this form of laryngitis, patients experience the following symptoms: cough, dry throat, weakness, low ability to work. You can observe a viscous secretion in the larynx, which can dry out and create crusts. It becomes difficult to cough up. The patient tries to cough up more mucous secretions and crusts, as a result of which the cough intensifies, which can negatively affect the inflammatory process in the larynx. Possible bleeding and phlegm.
Treatment of chronic laryngitis
Treatment for this disease involves complex use medicinal and physiotherapeutic agents that have both local and general effects on the body.
Local treatment involves infusion of various medicines, as well as lubricating its mucous membrane with them. For catarrhal and hyperplastic forms, substances with anti-inflammatory (hydrocortisone suspension, Kalanchoe juice, dioxidin, streptomycin, etc.), astringent (zinc sulfate 0.25 g, tannin 0.5 g, glycerin 15 g, distilled water 100 g, collardol) are used etc.), softening (vegetable oils, etc.) effect. The hypertrophied areas of the mucous membrane are shaded with a 1-2% solution of silver nitrate.
For atrophic laryngitis Locally used medicinal substances that help thin mucus, crusts, moisturize the mucous membrane and stimulate the function of its glandular apparatus (chymopsin, proteolytic enzymes, peloidin, lysozyme, etc.). General appointment course treatment iodine preparations, vitamins, biostimulants (aloe, FIBS, humizol, etc.).
Inhalation therapy
Among physical methods of treatment, the main place is occupied by inhalation therapy.
When carrying out inhalation therapy, it is necessary to adhere to a certain sequence of application medicinal substances. The presence of a large amount of sputum and crusts on the surface of the mucous membrane prevents the absorption of inhaled substances. In this regard, treatment should begin with the appointment of mucus-thinning and expectorant substances. And only after this, prescribe aerosols of medicinal substances, followed by inhalation after 20-30 minutes of vegetable oils (rose hips, sea buckthorn, retinol, etc.).
For catarrhal and hypertrophic forms For chronic laryngitis, anti-inflammatory drugs are indicated (1% solution of imanin, chymotrypsin, hydrocortisone, prednisolone). Positive results observed when combined use aerosols of hydrocortisone suspension 1 ml, Kalanchoe juice 1 ml, 2% etonium solution 1 ml, 1% quinosol solution 1 ml.
To reduce swelling of the mucous membrane and secretion of mucus, as well as an anti-inflammatory effect, astringents and mild cauterizing agents are prescribed (tannin 2 g, glycerin 10 ml, distilled water 100 ml; zinc sulfate 0.25 g, glycerin 15 ml, distilled water 100 ml; infusion of St. John's wort, immortelle flowers 10.0: 200.0; decoction of oak bark 20.0: 200.0; water infusion of chamomile 10.0: 200.0; sage 5-25% solution, etc.).
In patients with chronic hypertrophic laryngitis in the presence of an inflammatory component, aerosols of steroid drugs (hydrocortisone suspension 25 mg) in combination with antibiotics are also indicated wide range actions (250,000 units each). Positive results are observed with the use of biological stimulants (peloidin, humisol, Kalanchoe juice, 0.5% lysozyme solution, etc.), as well as drugs that regulate tissue metabolism (vitamins B, C, etc.). In order to reduce swelling and inflammation, it is recommended to include heparin in combination with other drugs, which has a vasodilating effect, promotes oxygenation, and inhibits inflammation.
For atrophic laryngitis coarse warm-moist inhalations of alkaline-calcium, salt-alkaline (not higher than 2% solution), alkaline mixtures, mineral waters (kemeri) are prescribed.
Physical treatments
Indicated simultaneously with inhalation therapy physical methods , improving blood circulation, trophic and metabolic processes in the tissues of the larynx. For this purpose, UHF inductothermy is prescribed. Darsonvalization of the larynx area is used. Mud applications are indicated (temperature 38-42 C, duration 8-10 minutes) on the larynx area, for a course of 12-15.
In order to improve efficiency medicinal electrophoresis For diseases of the larynx, a special electrode has been proposed for conducting electrophoresis using the intralaryngeal method.
Treatment of patients with chronic hypertrophic laryngitis should be carried out in stages: first eliminate the inflammatory changes, and then apply methods aimed at restoring the functions of the larynx. For patients with this form of the disease, the use of high-frequency therapy (UHF, microwave, etc.), as well as phototherapeutic factors (sollux, etc.) is contraindicated, even during the period of exacerbation of the disease.
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