CASE ABSTRACT

LARYNGITIS

Submitted to: Dioni Herson C. Viloria, RN
Clinical Instructor

Submitted by: Mark Lloyd C. Miranda
Student

Weakness of one side of the larynx can prevent simple cyclic vibration and lead to irregular movement in one or both sides of the glottis. an impairment in the ability to produce spoken words). or excessively breathy. Description of Laryngitis Laryngitis. chest. it is most often observed in the production of vowel sounds. which lasts only a few days. The most common symptom of either form is hoarseness that may. Thus. sore throat. For example. and possibly a temporary loss of speech. or face Difficulty eating Fever y Dysphonia is the medical term for disorders of the voice: an impairment in the ability to produce voice sounds using the vocal organs (it is distinct from dysarthria which means disorders of speech. and inflammation restricts the air passages even further. However. during typical normal phonation. Php. and chronic. but some kind of phonation is still possible (contrasted with the more severe aphonia where phonation is impossible). and swallowing difficulty may occur as well. Children face the added risk of encountering breathing difficulty. which is located in the upper part of the respiratory tract. dysphonia is a phonation disorder. The dysphonic voice can be hoarse or weak. an inflammation of the larynx. because the opening of a child's larynx is narrow to begin with. the vocal folds come together to vibrate in a simple open/closed cycle modulating the airflow from the lungs. Fever. typically it is caused by some kind of interruption of the ability of the vocal folds to vibrate normally during exhalation. Thus. Statistic *********************************************** Signs and Symptoms y y y y y y y y y y y y Hoarseness (harshness sound) Weak voice or voice loss Tickling sensation and rawness of your throat (prickle/itchiness and complexity/roughness of throat) Sore throat Dry throat Dry cough Difficulty breathing (in children) Difficulty swallowing Swollen lymph glands in the throat. harsh. Dysphonia has either organic or functional causes due to impairment of any one of the vocal organs. This irregular motion is heard as roughness. or rough. progress to partial or total loss of voice. . It causes hoarseness. within several days. that is. which persists over a period of weeks or months. Acute. occurs in two forms.Overview of the Disease Laryngitis is an inflammation of the mucous membrane lining the larynx (voice box). This is quite common in vocal fold paresis.

and manometry . ranging from mild hoarseness to almost total loss of voice. Biopsy. The doctor may ask whether a smoker or if have any health conditions ² such as a cold or allergies ² that may be causing vocal irritations. Acute laryngitis y y Investigations are rarely helpful in primary care. If the doctor sees a suspicious area. an endoscope.may be required to exclude GORD Videostrobe . and the doctor may also ask if overuse of vocal cords ² such as singing or shouting that may have irritated the vocal cords. These techniques are sometimes used to help diagnose laryngitis: y y Laryngoscopy. Then the doctor can watch the motion of vocal cords as you speak. the doctor may listen to your voice for examination and to examine the vocal cords. . useful in diagnosing vocal cysts. Changes in voice that is different with the degree of infection or irritation. In chronic hoarseness.unit consists of stroboscopic unit (light source and microphone). flexible tube (endoscope) with a tiny camera and light through the nose or mouth and into the back of throat. Clinicians with the skill to perform indirect laryngoscopy will typically find redness and small dilated vasculature on the inflamed vocal folds.may show supraglottic or retropharyngeal swelling. Visually examine of vocal cords in a procedure called laryngoscopy. by using a light and a tiny mirror to look into the back of throat. Chronic laryngitis y y Laboratory Tests: o Full blood count with differential to exclude infection o Sputum culture for bacteria. The most common sign of laryngitis is hoarseness. double-contrast upper GI series. Some physicians might wish to do a laryngoscopy (visualization of the vocal cords). biopsy may occur taking a sample of tissue for examination under a microscope.Diagnostic Procedures and Laboratory Tests Diagnosis is based upon a combination of the clinical history and a physical exam. a video camera. or soft tissue density in subglottic airway o Chest radiograph o CT scanning and MRI may be appropriate if detailed morphology of the larynx required o Barium swallow study. and a video recorder. A swab for microbiological analysis may be contributory if excessive exudate is present. fungi and viruses o Laryngeal mucosal swab for microbiological analysis o Serology for autoimmune markers o Tests for syphilis and tuberculosis if clinically indicated Radiology: o Lateral Xray of neck . Non-drug measures found to be helpful include inhaling humidified air and minimal use of the voice. polyps and nodules. Management Acute laryngitis y y Most cases are mild and self-limiting. Or the doctor may use fiber-optic laryngoscopy. This involves inserting a thin.

Failure to respond to symptomatic relief should raise the possibility of other conditions.this may be contributory in the relief of laryngeal stenosis.e. gastro-oesophageal reflux disease GORD may need appropriate lifestyle advice. Some palliative measures that can be taken include: y y y y y y Avoid public speaking during recovery Be aware that whispering puts greater strain on the vocal cords than normal speaking Inhale steam from a bowl of hot water or from a warm shower Drink warm. Antibiotics may be helpful in patients who have persistent symptoms or who have other problems such as immune system deficiency.g. soothing liquids (but do not drink alcoholic beverages) Try a cool-mist humidifier. antibiotics will be prescribed. steam inhalation.be prepared to arrange hospital admission if the patient develops stridor. Treatment of Laryngitis If laryngitis is caused by a bacterial infection. avoidance of pollutants and cigarette smoke. and the treatment of GORD.y y y y Inhaling humidified air promotes moisture of the upper airway. prokinetic drugs and proton pump inhibitors. especially if there are other features such as dyspnoea. Surgery . Indeed these treatments may cause temporary respite leading to overuse of the voice.these include hydration (approximately 2 litres per day). and avoidance or limitation of exposure to environmental or occupational sensitisers. such as tracheobronchitis. becomes systemically unwell. Hospital admission . avoid air conditioning Use nonprescription pain relievers and throat lozenges to ease the discomfort Avoid cigarettes until the symptoms have subsided Anatomy and Physiology The Voice Production   . Chronic laryngitis y y y y Supportive measures . helping to clear secretions and exudate. se of antihistamines and corticosteroids is not supported by evidence. as well as drying of the larynx. Acute laryngitis is unusual in children under the age of 18. or is at risk of food aspiration. Treat the underlying condition .

vocal ligament (intermediate and deep laminae propria). mouth cavity. and body (thyroarytenoid muscle) Glottis (also called Rima Glottides) Opening between the two vocal folds. abdominal muscles folds to vibrate Lungs Vibratory system Voice box (larynx) Vocal folds Vocal folds vibrate.Larynx Highly specialized structure atop the windpipe responsible for sound production. air passage during breathing and protecting the airway during swallowing Vocal Folds (also called Vocal Cords) "Fold-like" soft tissue that is the main vibratory component of the voice box. The resonators produce a person's recognizable voice. nasal passages Changes the "buzzy sound" into a person's recognizable voice The key function of the voice box is to open and close the glottis (the space between the two vocal folds). Voice Mechanism Speaking and singing involve a voice mechanism that is composed of three subsystems. changing air pressure to sound waves producing "voiced sound. resonance. and articulation. Resonance: Voice sound is amplified and modified by the vocal tract resonators (the throat. oral cavity. The articulators produce recognizable words. soft palate. y y y Voiced sound: The basic sound produced by vocal fold vibration is called "voiced sound. Provides and regulates air pressure to cause vocal ribs. Voiced sound for singing differs significantly from voiced sound for speech. Voice "As We Know It" The "spoken word" results from three components of voice production: voiced sound. Articulation: The vocal tract articulators (the tongue. Each subsystem is composed of different parts of the body and has specific roles in voice production." frequently described as a "buzzy sound" Varies pitch of sound Resonating system Vocal tract: throat (pharynx). Three Voice Subsystems Subsystem Air pressure system Voice Organs Role in Sound Production Diaphragm." This is frequently described as a "buzzy" sound. comprised of a cover (epithelium and superficial lamina propria). chest muscles. and lips) modify the voiced sound. the glottis opens during breathing and closes during swallowing and sound production Understanding for Voice Disorders Knowing how normal voice is produced and the roles the voice box and its parts play in speaking and singing helps patients understand their voice disorders. and nasal passages). .

y y y y Role in breathing: Open glottis Role in cough reflex: Close. then open glottis Role in swallowing: Close glottis Role in voice: Close glottis and adjust vocal fold tension (plus additional functions for singing) Key Components of the Voice Box y y y y Cartilages Muscles Nerves Vocal folds Pathopysiology .

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