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.
Question 1 |
Discuss that due to her occupation, she is at increased risk of leukoplakia of the vocal cords Hint: 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 Hint: 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 Hint: 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 |
List |
References: Merck Manual · UpToDate