Laryngitis is an inflammatory disease of the larynx, which is one of the consequences of influenza, ARVI, whooping cough, scarlet fever, rhinitis, tonsillitis, and pneumonia.
With laryngitis, the vocal cords are the first to suffer - the patient’s voice becomes hoarse or disappears altogether. Breathing becomes difficult, and a so-called “barking” cough appears, which is quite painful.
Laryngitis in adults can also occur as an independent disease, for example, when the voice is overstrained (the so-called “teacher’s disease”).
It is customary to distinguish between acute and chronic laryngitis .
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Diagnosis of laryngitis in MedicCity
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Acute laryngitis
In acute laryngitis, the disease lasts for 7-10 days. Acute laryngitis is quite rare to occur on its own. This disease manifests itself along with inflammation of the pharynx, nasal cavity, bronchi and lungs. The cause of the development of acute laryngitis is considered to be acute respiratory diseases, thermal or chemical burns, and injuries. Severe hypothermia, dry air, excessive vocal tension, existing foci of inflammation and impaired nasal breathing can also lead to laryngitis.
In advanced, severe cases, laryngitis can become life-threatening for the patient. If the pain in the throat is so acute that it is difficult for a person with laryngitis to even swallow his own saliva, you should immediately call a doctor! A tumor in the larynx can block the passage of air. You should also consult a doctor if hoarseness, hoarseness (or complete absence) of the voice does not stop 3-5 days after the onset of the illness.
Methodology
Ultraviolet radiation is short-wavelength light invisible to the human eye with wavelengths from 400 nm to 10 nm. Ultraviolet radiation is divided into near radiation with a wavelength of 200-400, which directly borders the range of light visible to the human eye, and far-range radiation with a wavelength of 200-10 nm.
In medical practice, ultraviolet radiation with a wavelength of 400-180 nm is used, which practically corresponds to the near spectrum. Near UV radiation, in turn, is divided into long-wave, medium-wave, and short-wave, and is designated as A, B, and C.
- Long wavelength, UV-A with a wavelength of 400-320 nm. General exposure to UVA is accompanied by increased production of the skin pigment melanin. Macroscopically, this is manifested by the phenomenon of tanning. With local exposure to UV-A in the corresponding areas of the skin and mucous membranes, blood circulation increases, immune defense is activated, and inflammatory foci resolve.
- Medium wave, UV-B with a wavelength of 320-280 nm. Here the radiation power is greater. Under its action, biologically active substances and mediators are released, which has a positive effect on tissue trophism. Additionally, immune defense is enhanced and pain disappears. Another key point: under the influence of UV-B, vitamin D is activated in the skin, which ensures calcium metabolism.
- Short-wave, UV-C with a wavelength of 280-180 nm. The power of such radiation is maximum. Under its action, denaturation of protein molecules occurs. Hence the bactericidal effect of UV-C.
Selective and integrated lamp sources of ultraviolet radiation are used for therapeutic purposes. Selective ones generate a strictly defined spectrum (UV-A, UV-B, or UV-C). Integral lamps generate the entire range of UV rays that have a therapeutic effect. It is precisely these sources that our center is equipped with. Although in some situations we use selective lamps.
The complex anti-inflammatory, trophic, immunostimulating and bactericidal effect of ultraviolet radiation has found application in the treatment of diseases of the oropharynx. These are acute and chronic tonsillitis , adenoids , pharyngitis . Ultraviolet irradiation of the oropharynx is sometimes carried out by us as an additional treatment for diseases of the oral cavity ( stomatitis , gingivitis ) and other ENT organs ( otitis , rhinitis, sinusitis).
Equipment for ultraviolet radiation is a radiation source isolated from the external environment, a selective or integral lamp. The UV device with a lamp is equipped with a tube. The cone-shaped shape and appropriate dimensions of the tube allow it to be inserted into the oral cavity.
This creates a narrowly focused beam of UV rays to treat limited areas of the oropharynx. The tube must be sterile. Immediately before the procedure, the device is warmed up for several minutes so that the radiation acquires the proper parameters. To facilitate the insertion of the tube, the patient, while sitting, tilts his head back slightly and extends his tongue.
The procedure itself is painless. With ultraviolet irradiation of the oropharynx, as with other methods of phototherapy, the term used is biodose (biological dose). By biodose we mean the minimum time required to create erythema (redness of the skin) 12-24 hours after irradiation when the UV source is removed at a distance of 0.5 m from the skin.
Since biodose is a temporary value, it is measured in minutes and seconds. This indicator is individual for each patient. Therefore, a few days before the start of treatment, we determine the biodose. To do this, we use a plate with holes that is placed on the tube of the device. Through this plate, ultraviolet radiation of the skin of the nipple passes. The sensitivity of this area is approximately the same as the sensitivity of the mucous membranes.
Treatment usually begins with 1/2 biodose. In weakened patients and children, at the initial stage, 1/4 or 1/8 of the biodose is possible. During treatment, we gradually increase the intensity of ultraviolet irradiation, bringing it to 1-2 biodoses. We carry out the procedures daily or once every 2-3 days. The course of treatment includes from 6 to 10-12 procedures. After the UVB session, the patient rests in comfortable conditions for half an hour.
Chronic laryngitis
If inflammation of the larynx continues for more than a month, then we are talking about chronic laryngitis . Quick diagnosis and proper treatment of the disease are very important here.
The causes of chronic laryngitis can be:
- untreated acute laryngitis;
- significant professional voice loads for teachers, artists, announcers;
- excessive smoking;
- alcoholic drinks with high alcohol content that dry out the throat;
- too hot and spicy food;
- untreated gastroesophageal reflux disease with reflux of hydrochloric acid into the esophagus and larynx.
It is very important to consult an ENT doctor if you have symptoms of inflammation of the larynx. Otolaryngologists at our clinic will help you cope with the unpleasant symptoms of laryngitis and other diseases of the ear, nose and throat.
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Consultation with an otolaryngologist in MedicCity
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Chronic catarrhal laryngitis
Characterized by superficial inflammation of the laryngeal mucosa. We can talk about chronicity of catarrhal laryngitis when the symptoms of the disease last more than six months. Most often it occurs as a consequence of other diseases that have become chronic, such as: rhinitis, sinusitis, tonsillitis, periodontitis, periodontitis, bronchitis - that is, diseases in which there is a focus of chronic infection. Often one of the main causes of catarrhal laryngitis is extraesophageal reflux (reflux of contents from the stomach into the esophagus, and then from the esophagus into the hypopharynx and larynx). Extrafood reflux occurs in people with gastroesophageal reflux disease (GERD) and most often occurs during sleep, so the patient may not be aware of the problem. Also, factors contributing to the development of the disease include: smoking, specifics of the profession (increased vocal load, dust, gas pollution, frequent hypothermia). Thus, chronic catarrhal laryngitis occurs due to a combination of reasons: chronic infection, both bacterial and mixed, various types of irritants, insufficient immune response.
Symptoms: change in voice (hoarseness or hoarseness, voice fatigue), soreness or discomfort in the throat.
On examination, redness and unevenness of the laryngeal mucosa are visible, the vocal folds are often pink in color, thickened, with a pronounced vascular pattern; during phonation, the vocal folds do not close tightly. Enlarged lymphoid granules of the larynx and hypopharynx are often detected.
Treatment: identification and elimination of the cause of inflammation of the mucous membrane of the larynx and hypopharynx, identification of foci of infection of the ENT organs, oral cavity, tracheobronchial tree, GERD. A culture and PCR test from the pharyngeal mucosa is prescribed to identify pathogens. Drug treatment is most often local antibacterial and anti-inflammatory therapy, treatment of the source of infection and GERD (if present).
Laryngitis in children
This disease begins with a runny nose and dry cough, then the child develops a sore throat, and the voice becomes hoarse and unrecognizable. At night, the child most often begins to wheeze because the lumen of the airways narrows. He develops a suffocating cough, his face becomes pale, and the nasolabial triangle begins to acquire a bluish tint. Temperatures may rise to 40 degrees.
How to treat laryngitis in a child? The treatment regimen and medications for laryngitis should be prescribed by a doctor: many medications that are used in the treatment of laryngitis in adults can cause an allergic reaction in a child.
It is recommended to give the child plenty of alkaline drinks (warm milk, mineral water). Antihistamines and hypoallergenic syrups are prescribed to relieve irritation and inflammation of the laryngeal mucosa. Alkaline inhalations are also very effective for laryngitis in children. Parents who are faced with laryngitis in children, as a rule, even travel with an inhaler-nebulizer, which allows them to quickly stop a coughing attack in their child.
If a child develops a “barking cough,” delay is especially dangerous—spasm of the respiratory tract (“false croup”) may occur. In severe cases, progression of the disease can lead to respiratory arrest. Call an ambulance immediately!
Chronic atrophic pharyngitis
A disease in which the mucous membrane of the larynx thins (atrophies) and its function is impaired. The mucous membrane of the larynx consists of multirow ciliated epithelium (except for the vocal folds). On its surface there are special cilia that are responsible for the movement of mucus in the programmed direction; in the thickness of the mucosa there are goblet cells that secrete viscous mucus, and in the submucosal layer there are tubular glands that secrete liquid mucus. With chronic atrophic pharyngitis, the number of cilia of the ciliated epithelium decreases (sometimes almost to their complete absence). The quantity and quality of mucus secreted by the glands decreases, and the thickness of the mucous membrane decreases. This disease occurs as a consequence of long-term catarrhal laryngitis. Iron deficiency anemia and vitamin deficiency may also be causes. Prof. plays an important role. hazards - hot and dry air, industrial dust, particles of volatile compounds. Atrophic laryngitis often occurs after radiation and chemotherapy. One of the factors, but little studied, is the genetic factor.
Symptoms: dry cough, sore throat, discomfort in the throat, dryness, change in timbre and voice fatigue. Complaints of dryness, sore throat, and sore throat come first, as this greatly worries the patient; complaints of a change in voice fade into the background.
Upon examination, the mucous membrane of the larynx is dry or drier than normal, with overlays of mucous crusts, and often has a “varnished” appearance. The vocal folds do not change much; breathing difficulties, as a rule, are not noted.
Treatment: it is difficult to treat this disease, since changes in the mucous membrane can be irreversible. If occupational hazards are identified, they must be excluded. Drug treatment is the prescription of alkaline inhalations for a long time and oral medications with a regenerative effect (Aloe extract, Mumiyo, vitamins, dexpanthenol), iron supplements for iron deficiency.
Contraindications to ultraviolet irradiation
Among the general restrictions to ultraviolet irradiation of the oropharynx:
- acute purulent inflammatory processes
- individual intolerance to UV rays
- malignant neoplasms
- severe cardiovascular diseases
- peptic ulcer of the stomach and duodenum
- liver and kidney dysfunction
- anemia, blood clotting disorders
- hypothyroidism (overactive thyroid)
- systemic lupus erythematosus
- malignant neoplasms
- tuberculosis.
If the inflammatory process in the oropharynx is purulent in nature, we also do not perform ultraviolet radiation until the purulent foci are eliminated.
