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Laryngitis

by Clarence T. Sasaki, MD

Laryngitis is inflammation of the voice box (larynx).

  • A virus is usually what causes the inflammation.

  • Typical symptoms include hoarseness and loss of voice.

  • The diagnosis is based on symptoms and changes of the voice.

  • Usually, resting the voice and avoiding any irritants are adequate treatment.

Causes

The most common cause of short-lived (acute, lasting less than 3 weeks) laryngitis is a viral infection of the upper airways, such as the common cold. Laryngitis also may accompany bronchitis or any other inflammation or infection of the upper airways. Excessive use of the voice, an allergic reaction, and inhalation of irritants such as cigarette smoke can cause acute or persistent (chronic) laryngitis. Bacterial infections of the vocal cords are extremely rare.

Chronic laryngitis, in which symptoms last longer than 3 weeks, may be caused by gastroesophageal reflux and, less commonly, by lingering bronchitis. People with bulimia who vomit frequently may develop laryngitis.

Symptoms

Symptoms are an unnatural change of voice, such as hoarseness or a decrease in volume, or even loss of voice that develops within hours to a day or so. The throat may tickle or feel raw, and a person may have a constant urge to clear the throat. Symptoms vary with the severity of the inflammation. Fever, a general feeling of illness (malaise), difficulty in swallowing, and a sore throat may occur in severe infections.

Diagnosis

The diagnosis is based on the typical symptoms and voice changes. In chronic laryngitis, the doctor looks down the throat with a mirror or a thin, flexible viewing tube, which shows some reddening and sometimes some swelling of the lining of the larynx. Because cancer of the larynx may cause hoarseness, a person whose symptoms persist more than a few weeks should be evaluated for cancer (see see Laryngeal Cancer).

Treatment

Treatment of viral laryngitis depends on the symptoms. Resting the voice (by not speaking), taking cough suppressants, drinking extra fluids, and inhaling steam relieve symptoms and help healing. Whispering, however, may irritate the larynx even more. Stopping smoking and treating bronchitis, if present, may alleviate laryngitis. An antibiotic is given only for infection caused by bacteria. Depending on the possible cause, specific treatments to control gastroesophageal reflux, bulimia, or drug-induced laryngitis may be helpful.