Patient will present as → a 27-year-old mezzo-soprano who states that she developed acute hoarseness 2 days ago. Prior to that, she had a cold, the symptoms of which are improving. There is no history of smoking or other tobacco use. She is very worried as she has an upcoming performance 3 days from now.
Laryngitis is inflammation of the larynx, usually the result of a virus or overuse. The result is an acute change in the voice, with decreased volume and hoarseness.
- Associated with a viral infection
- Consider squamous cell carcinoma if hoarseness persists > 2-3 weeks, history of ETOH and or smoking
- Consider GERD if no associated viral etiology
Diagnosis is based on clinical findings
- Laryngoscopy is required for symptoms persisting > 3 wk
- Deviation of the soft palate and asymmetric rise of the uvula are highly suggestive of abscess
Symptomatic treatment (eg, cough suppressants, voice rest, steam inhalations)
- Viral laryngitis is self-limited. Other infectious or irritating causes may require specific treatment.
- Oral or IM corticosteroids may also hasten recovery for performers but requires vocal fold evaluation before starting therapy.
Discuss that due to her occupation, she is at increased risk of leukoplakia of the vocal cords
Leukoplakia is related to tobacco and alcohol use, along with dental irritation.
She should be placed on an antibiotic as she most likely has a bacterial infection
Most cases of laryngitis are viral in etiology and this patient’s symptoms were resolving, therefore antibiotic treatment is not indicated.
Discuss her increased risk of vocal cord paralysis
Laryngitis is not a risk factor for vocal cord paralysis. There are many causes of vocal cord paralysis, but laryngitis, even if protracted is not one of them.
Advise the patient to avoid singing or shouting until her normal voice returns
References: Merck Manual · UpToDate