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My focus is on adding and correcting information for sections: introduction and diagnosis. Every change is underlined.

Introduction[edit]

The term laryngitis (lɑrɪnˈʤaɪtəs) refers to is an inflammation of the larynxIt causes hoarse voice Common symptoms include pain or discomfort in the throat and hoarseness or temporary loss of the voice due to irritation of the vocal folds (also called vocal cords). It may also include symptoms such as coughing and throat clearing.[1] Laryngitis is one possible cause of dysphonia, the medical term for a vocal phonation disorder.

Laryngitis may be acute or chronic. Laryngitis is categorized as acute if it less than three weeks and chronic if symptoms persist beyond it lasts over three weeks. [1] The chronic form occurs mostly in middle age and is much more common in men than women.[citation needed] Antibiotics do not appear to be very useful in the acute form.[2]

Epedimiology[edit]

Laryngitis is the most common laryngeal disease. It is significantly more prevalent in the elderly as well as in males.[2] According to a review conducted by the Royal College of General Practitioners in the United Kingdom in 2010, the average incidence of cases of laryngitis is 6.6 per week from a sample of 100 000 patients of all ages. [1]

Chronic laryngitis[edit]

There are approximately 800,000 adult cases of chronic laryngitis in the United States per year. As of 2013, the yearly chronic laryngitis incidence was 3.47 per 1,000 people. Up to 21% of the population might have chronic laryngitis at some point in their life.[3]

Diagnosis[edit]

Types of inflammation[edit]

Acute[edit]

Acute inflammation is a defense mechanism which typically occurs rapidly after the appearance of an infectious, traumatic, or antigenic agent. While typically brief in duration, the degree of inflammation can be severe.[4]

Acute laryngitis is typically diagnosed by primary health care professionals. It is often self limiting and typically resolves within two weeks. [1] Referral to an otolaryngologist should be considered for at-risk populations or if symptoms persist.

Chronic[edit]

The signs and symptoms of chronic inflammation are generally less impressive than those of acute inflammation. Pain and erythema can be minimal, swelling tends to be mild, and fever is infrequent. A chronic inflammation can last for many weeks and cause substantial localized tissue fibrosis, scarring, and necrosis as a result.[4]

The persistence of laryngeal symptoms beyond three weeks is defined as chronic laryngitis. It can indicate additional laryngeal disease and warrants examination. [1]

Granulomatous[edit]

Pathogens left unchecked can turn into granulomatous disease, which is characterized by the formation of a granuloma. Common etiologic factors for this condition include sustained or repetitive physical trauma and intrinsic acidic irritation.[4]

  • Granulomatous laryngitis
  • Pseudomyxomatous laryngitis

Assessment Process [1][edit]

Initial assessments should rule out the presence of a malignant tumor. If symptoms persist, diagnosis should be re-visited and an endoscopic examination should be performed.  

1) Examination of the openness of the airway[edit]

Patients who experience respiratory distress should be assessed in a setting where respiratory support can be provided quickly if needed. Those with their acute airway compromised need go to the emergency at a hospital to be assessed.

2) Case history[edit]

A complete case history includes the following:

- nature and chronology of voice symptoms

- any exacerbating and relieving factors

- patient's voice use and requirements

- impact on quality of life

- impact on psychosocial wellbeing

- medical conditions

- lifestyle factors (smoking, diet, hydration)

This information can be obtained through interviewing or the use of a questionnaire.

3) General head and neck examination[edit]

Physical examination of the oral cavity, the oropharynx, and the neck.

4) Assessment of patient's voice[edit]

  • Simple scale: Uses grades 1-5 for degree of severity for dysphonia and additional voice qualifiers: breathy, strained,etc.
  • GRBAS: The GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) scale is a widely used grading system. This tool perceptually assesses voice change and quality by grading voice characteristics on a scale of 0-3 (normal, mild, moderate, high). Asthenia, roughness and breathiness are typical symptoms of acute laryngitis.

Scales are useful to track changes in voice over time and they allow other practitioners to understand the degree of voice dysfunction.

Sources:

[5] Dominguez, L. M., & Simpson, C. B. (December 1, 2015). Viral laryngitis. Current Opinion in Otolaryngology & Head and Neck Surgery, 23, 6, 454-458.

[4] Dworkin, J. P. (January 1, 2008). Laryngitis: types, causes, and treatments. Otolaryngologic Clinics of North America, 41, 2, 419-36.

[6] Hanson, D. G., & Jiang, J. J. (January 1, 2000). Diagnosis and management of chronic laryngitis associated with reflux. The American Journal of Medicine: Supplement 1, 108, 4, 112-119.

[7] Rafii, B., Taliercio, S., Achlatis, S., Ruiz, R., Amin, M. R., & Branski, R. C. (June 1, 2014). Incidence of underlying laryngeal pathology in patients initially diagnosed with laryngopharyngeal reflux. The Laryngoscope, 124, 6, 1420-1424.

[8] Stein, D. J., & Noordzij, J. P. (January 1, 2013). Incidence of chronic laryngitis. The Annals of Otology, Rhinology, and Laryngology, 122, 12, 771-4.

[9] Witt, D. R., Chen, H., Mielens, J. D., McAvoy, K. E., Zhang, F., Hoffman, M. R., & Jiang, J. J. (January 1, 2014). Detection of Chronic Laryngitis due to Laryngopharyngeal Reflux Using Color and Texture Analysis of Laryngoscopic Images. Journal of Voice, 28, 1, 98-105.

[1] Wood, John; Athanasiadis, Theodore; Allen, Jacqui (October 9, 2014). "Laryngitis" (PDF). The BMJ. The BMJ. 331 (09). Retrieved September 25, 2016.

[10] Yuksel, E. S., Slaughter, J. C., Mukhtar, N., Ochieng, M., Sun, G., Goutte, M., Muddana, S., ... Vaezi, M. F. (January 1, 2013). An oropharyngeal pH monitoring device to evaluate patients with chronic laryngitis. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 25, 5, 315-23.

References[edit]

  1. ^ a b c d Wood, John M (October 17, 2016). "Laryngitis" (PDF). http://www.bmj.com/bmj/section-pdf/777848?path=/bmj/349/7978/Clinical_Review.full.pdf. BMJ. {{cite web}}: External link in |website= (help)
  2. ^ Hah, J. Hun; Sim, Songyong; An, Soo-Youn; Sung, Myung-Whun; Choi, Hyo Geun (2015-11-01). "Evaluation of the prevalence of and factors associated with laryngeal diseases among the general population". The Laryngoscope. 125 (11): 2536–2542. doi:10.1002/lary.25424. ISSN 1531-4995.
  3. ^ Stein, D. J., & Noordzij, J. P. (2013). Incidence of Chronic Laryngitis. Annals Of Otology, Rhinology & Laryngology122(12), 771-774.
  4. ^ a b c d "Laryngitis: Types, Causes, and Treatments". www.sciencedirect.com. Retrieved 2016-10-18.
  5. ^ "Viral laryngitis: a mimic and a monster – range, presentati... : Current Opinion in Otolaryngology & Head and Neck Surgery". LWW. doi:10.1097/MOO.0000000000000203.
  6. ^ Hanson, David G.; Jiang, Jack J. (2000-03-06). "Diagnosis and management of chronic laryngitis associated with reflux". The American Journal of Medicine. 108 (4, Supplement 1): 112–119. doi:10.1016/S0002-9343(99)00349-6.
  7. ^ Rafii, Benjamin; Taliercio, Salvatore; Achlatis, Stratos; Ruiz, Ryan; Amin, Milan R.; Branski, Ryan C. (2014-06-01). "Incidence of underlying laryngeal pathology in patients initially diagnosed with laryngopharyngeal reflux". The Laryngoscope. 124 (6): 1420–1424. doi:10.1002/lary.24483. ISSN 1531-4995.
  8. ^ Stein, Daniel J.; Noordzij, J. Pieter (2013-12-01). "Incidence of Chronic Laryngitis". Annals of Otology, Rhinology & Laryngology. 122 (12): 771–774. doi:10.1177/000348941312201207. ISSN 0003-4894.
  9. ^ Witt, Daniel R.; Chen, Huijun; Mielens, Jason D.; McAvoy, Kieran E.; Zhang, Fan; Hoffman, Matthew R.; Jiang, Jack J. (2014-01-01). "Detection of Chronic Laryngitis due to Laryngopharyngeal Reflux Using Color and Texture Analysis of Laryngoscopic Images". Journal of Voice. 28 (1): 98–105. doi:10.1016/j.jvoice.2013.08.015. PMC 3910322. PMID 24314831.
  10. ^ Yuksel, E. S.; Slaughter, J. C.; Mukhtar, N.; Ochieng, M.; Sun, G.; Goutte, M.; Muddana, S.; Gaelyn Garrett, C.; Vaezi, M. F. (2013-05-01). "An oropharyngeal pH monitoring device to evaluate patients with chronic laryngitis". Neurogastroenterology & Motility. 25 (5): e315–323. doi:10.1111/nmo.12109. ISSN 1365-2982. PMID 23495894.