Acute laryngitis

1. Non-specific

i. Acute simple laryngitis (False

croup)
ii. Acute laryngo-tracheao-bronchitis
(true croup)
iii. Epiglottitis (H. Influenza)

2. Specific
i) Diphteria
 Acute simple (Catarrhal) laryngitis
(False Croup)
Aetiology:
* Secondary to URTI, common cold
* Voice trauma; Abuse/misuse of voice
* Physical trauma; irritant fumes or chemical
•Clinical picture:
• Dysphonia of varying degree
• Painful talking, sticky throat secretions,
• Cough, respiratory distress, low grade fever
•Congested, oedematous vocal folds, subglottic oedema
Treatment:
• Antibiotics, Cortisone is helpful
• Excessive fluid intake, Vocal rest
LARYNGO-TRACHEO-BRONCHITIS:
(True Croup)

 Acute croup is a type of respiratory infection that

is usually caused by the parainfluenza virus
typically occurs in fall and spring.

 It is manifested in a young infant usually with a

low grade fever, barking cough, and occasionally
biphasic stridor occurring over a period of days.

 Tachypnea, retractions, and cyanosis indicate

immediate hospitalization.
Laryngeal examination: severe congestion, dome-shaped
subglottic oedema
X-ray showed: Pencil shaped or steeple sign

Hospitalization usually involves treatment with air

humidification, oxygen, epinephrine, and steroids.
One dose of steroids seems to be effective in a dose of
1 mg/kg.
Intubation is necessary only for severe respiratory distress
and may be required for 4 to 5 days.
 EPIGLOTTITIS:

 Epiglottitis is an inflammatory condition that involves

not only the epiglottis but also adjacent tissues,
including the ventricular bands, arytenoids and
aryepiglottic folds.

 Epiglottitis is bacterial in origin with H. Influenza B

being the predominant organism.

 Children are usually affected between the ages of 2

to 6. It usually develops suddenly with high fever,
drooling, sitting forward, and severe odenophagia.
Epiglottitis
Examination, revealing a cherry red, swollen
epiglottis, congestion and oedema of supraglottic
areas.
Antibiotics should be given to cover for B-lactamase
producing Haemophilus Influenza. HIB vaccination
incidence of epiglottitis has decreased significantly.
Acute specific Laryngitis:
 Definition
Diphtheria is a potentially fatal, contagious disease that
usually involves the nose, throat, and air passages, but
may also infect the skin.
•Its most striking feature is the formation of a grayish

membrane covering the tonsils and upper part of the

throat.
* it is now rare in developed countries because of •
immunization.widespread
* spread most often by droplets.
The incubation period is two to seven days, with an
average of three days.
 Causes & symptoms
The symptoms of diphtheria are caused by toxins
produced by the diphtheria bacillus, Corynebacterium
diphtheriae.

The most serious complications caused by the exotoxin are

(myocarditis) and heart failure. The symptoms of nervous
system involvement can include seeing double (diplopia),
painful or difficult swallowing, and loss of voice.

The exotoxin may also cause severe swelling in the neck

("bull neck").

The signs and symptoms of diphtheria vary according to the

location of the infection
 Pharyngeal

This is the most common form of diphtheria,

causing the characteristic throat membrane.

Other signs and symptoms of pharyngeal diphtheria

include mild sore throat, fever of 101–102°F
(38.3–38.9°C), a rapid pulse, and general body
weakness.
 Treatment
Treatment includes a combination of medications and
supportive care:

Antitoxin
The most important step is prompt administration of
diphtheria antitoxin, without waiting for laboratory
results.

The dose ranges from 20,000–100,000 units, depending

on the severity and length of time of symptoms.
Diphtheria antitoxin is usually given intravenously.
Antibiotics
They are not a substitute for treatment with
antitoxin. Both adults and children may be given
penicillin, ampicillin, or erythromycin.

Antibiotics for 10 days

Erythromycin appears to be more effective than

penicillin in treating people who are carriers
because of better penetration into the infected
area.

.
 Chronic Laryngitis
 Non specific: due to
 “laryngeal insulting factors”

* Smoking, Alcohol, Irritant fumes

* Abuse/Misuse of voice,
* Voice professionals: teacher
* GERD,
* Sex (Anabolic) Hormones
* Recurrent URTIs
* Minor trauma with infection; intubation
 Prevention of laryngitis

To prevent dryness or irritation to your vocal folds:

 Don't smoke, and avoid secondhand smoke .

Smoke dries throat and irritates vocal cords .

 Drink alot of water .

Fluids help keep the mucus in throat thin and

easy to clear .
 Limit alcohol and caffeine to prevent a dry
throat .
If have laryngitis, avoid both substances .
 Avoid clearing throat .

It causes vocal trauma and increase of swelling.

 Chronic Laryngitis
 Specific
1. T.B
2. Laryngoscleroma
3. Laryngoscleroma
 T.B. Laryngitis
Pathology:
Secondary to pulmonary T.B.
Affecting the posterior areas of the larynx
(interarytenoid area)
The lesions includes: infiltration, ulceration,
vegetations, grannulomatous or ulcerative lesions.

Clinical picture:
Dysphonia
Painful cough
Referred pain to the ear
Odenophagia especially in the ulceration of posterior
laryneal region.

Treatment:
Anti-T.B
 Laryngoscleroma
 Secondary to rhinoscleroma
 Affect mainly subglottic region:
Active stage: purulent, viscid dried custation
Inactive (fibrotic stage): subglottic web/stenosis
Clinical picture:
Dysphonia: variable degrees
Dyspnea / Stridor: Late stages
Nasal symptoms: Discharge, atrophy
Laryngeal Exam. viscid dried custation
Treatment: Rimactane, Ciprofloxacin
 Syphilis of the larynx
 Very rare
 Affects the anterior parts of the larynx
Epiglottis Anterior portion of V.Fs
 Pathology:
Perichondritis and necrosis of cartilages
Laryngeal stenosis