Laryngitis

Laryngitis is an inflammation or irritation of the vocal cords that makes the voice hoarse, or too soft to be heard.

An Unspoken Problem

During Bill Clinton's first campaign to become president of the United States, he kept losing his voice. He had developed laryngitis (lar-in-JY-tis), an inflammation or irritation of the vocal cords that makes the voice hoarse, or too soft to be heard. In President Clinton's case, doctors said his voice problem was due to a combination of overuse and allergies. The laryngitis got so bad that a speech therapist ^* was hired to travel with President Clinton.

How Are Sound and Speech Created?

The human voice is produced by the back and forth movement of the vocal cords. These are two bands of smooth muscle tissue that lie across from each other in the larynx (LAR-inks), or voice box. The larynx is located between the base of the tongue and the top of the windpipe ^* . When at rest, the vocal cords are open to let air move past freely. When the person speaks, however, the cords close in a firm but relaxed way. As air from the lungs forces its way between them, they move back and forth rapidly (vibrate), and this produces sound. When the vocal cords become inflamed or irritated, they swell. This keeps them from moving as they should, which affects the sounds they make.

What Causes Laryngitis?

There are several things that can cause a short-term case of laryngitis. One common cause is speaking or singing too loudly or too long. Another is a common cold or other infections of the upper respiratory tract, such as flu. Other things that can irritate the vocal cords include an allergic reaction or the breathing of harsh chemicals.

Constant irritation of the vocal cords can lead to long-term problems with laryngitis. Two common causes of long-term problems are heavy drinking of alcohol and smoking. Another cause is frequent heart-burn, in which acid from the stomach comes back up into the throat and spills over into the larynx, irritating the vocal cords.

What Happens When People Get Laryngitis?

Symptoms

The main symptom of laryngitis is hoarseness, ranging from slight hoarseness to deep raspiness to an almost total loss of the voice. The throat may tickle or feel raw, too, and people with laryngitis may feel as if they need to clear the throat. When these symptoms are caused by a short-term illness or mild irritation, they usually go away after a few days. If the hoarseness lasts for two weeks or longer, then it is time to see a doctor. Although lasting hoarseness is often caused by long-term overuse or irritation, it sometimes signals a more serious medical condition.

Parts of the body involved in the creation of sound and speech include the larynx, epiglottis, trachea, vocal cords, tongue, and palate.

Diagnosis

To find the cause of laryngitis, the doctor asks about symptoms and performs an exam. As part of the exam, the doctor may look directly at the vocal cords using a tiny mirror held inside the mouth at the back of the throat. In more complex cases, the doctor may look at the vocal cords using a thin tube with a tiny camera and light attached. The tube can be passed through the mouth or nose and into the throat. This method lets the doctor view the movement of the vocal cords during speech. In some cases, the doctor may refer the person for further testing by a speech therapist.

Treatment

A person with laryngitis should rest the voice as much as possible, since talking or even whispering irritates the vocal cords further. In addition, it may help to drink warm liquids and to use a home humidifier, a machine that puts moisture into the air. For brief attacks of laryngitis caused by overuse, a minor infection, or an irritating chemical that was breathed, these steps may be all that are needed. If the laryngitis is due to an infection caused by bacteria, the doctor also may prescribe an antibiotic, a drug that fights bacteria. If the laryngitis is due to allergies, the doctor may prescribe an antihistamine (an-tee-HISS-ta-meen), a drug that counteracts the allergic reaction.

In cases of long-lasting hoarseness, the continuing source of irritation must be removed. If the laryngitis is caused by heavy drinking of alcohol or smoking, the person should give up these harmful habits. If it is caused by frequent heartburn, the person should seek medical care for the condition.

Long-term overuse of the voice can lead to the development of small growths or sores on the vocal cords. These problems often occur in professional singers and speakers. People with such problems may have to rest their voice for several weeks before the vocal cords get back to normal. In some cases, an operation also may be needed to remove the growths. In other cases, speech therapy may help the person learn how to put less strain on the vocal cords.

Speaking of Prevention

People can help maintain healthy voices by avoiding overuse of the voice, by keeping the vocal cords moist, and by avoiding things that irritate or dry out the throat. Tips include:

• avoiding talking or singing too loudly or for too long
• drinking plenty of water and using a humidifier if the air is dry
• gargling with saltwater, sucking on lozenges, or chewing gum
• avoiding drinks that contain caffeine (coffee, tea, and cola), as caffeine may dry out the throat
• avoiding alcoholic beverages, as alcohol may dry out the throat
• avoiding smoking or breathing smoke from other people's cigarettes, as cigarette smoke is irritating.