Chronic laryngitis

Chronic laryngitis refers to an

inflammatory process that determines
irreversible alterations of the
laryngeal mucosa
Reactive and reparative processes of
the larynx represent the main
pathogenetic factor, which can persist
even when the causative stimulus
ends

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2.
3.
4.

Non specific : No specific detectable

cause
Chronic hyperemic
Ch Hypertrophic
Atrophic
Pachydermia (contact granuloma /
contact ulcer )
Specific Chronic granulomatous
lesions e.g. Tuberculosis, Syphilis,
Scleroma, leprosy, fungal infections
& amyloidosis

Chronic Hyperemic
laryngitis

Diffuse inflammatory condition

involving the whole larynx
particularly true & False vocal
cords

Causes
Recurrent acute laryngitis /
Incompletely resolved Ac laryngitis
more than 3 weeks
Chronic infection in the vicinity
sinusitis, tonsillitis, bad orodental
hygiene , Ch Bronchitis
Occupational factors dust &
Fumes
Smoking & Alcohol
Voice abuse
GERD

Clinical Features
Males affected more than females
Hoarseness of voice
Fatigue of voice
Hawking & irritation larynx
Dry irritating cough
Laryngoscopy Hyperemia , Vocal
cords appear dull & edges are
rounded, Viscid secretions on VC /
interarytnoid region

Treatment
Eliminate The cause infection /
irritating factors
Complete voice rest / Observe
proper vocal hygiene
Medicated steam inhalation
? Expectorants

Chronic hypertrophic
laryngitis
Advanced stage of hyperemic
laryngitis
Cellular infiltrate in the submucosa
Epithelium may undergo
hyperplasia / metaplasia
May be generalized involvement
False VC (ventricular bands)
Dysphonia plica ventricularis
True vocal cords Rinkes Edema

Causes As for hyperemic

chronic laryngitis
Laryngoscopy Laryngeal
mucosa is thickened & dusky red
in colour
Vocal cords red & swollen, Edges
loose sharp demarcation
In Dysphonia plica venticularis
false vocal cords swollen, may
cover true VCs

Treatment
Conservative
Surgical Stripping of
edematous mucosa with microscissor
Ablation with LASER
One side done at a time to
prevent Web

Atrophic laryngitis
Common in women
Associated with Atrophic Rhinitis
Laryngitis Sicca
Exact cause not known
Hormonal disturbance, Dietary
deficiency, Autoimmune disorder
Bacillus ozaenae secondary
infection

Clinical features
Hoarseness
Dry irritating cough
Dyspnoea due to crusts
Laryngoscopy Laryngeal
mucosa is dry & atrophic
Covered with foul smelling crusts

Treatment
Primary condition Atrophic
rhinitis
Steam inhalation
25% glucose in glycerin sprays
Expectorants containing Iodides
to loosen the crusts

Tuberculous laryngitis
Secondary to Pulmonary
tuberculosis
Common in adult males
Brochogenic / hematogenous route
Bronchogenic route affects
posterior larynx --- Interarytnoid
region, submucosal tubercles &
granuloma
Hematogenous Multiple painful
ulcers in larynx & pharynx

Clinical features
Hoarseness
Painful ulcers / referred otalgia
Odynophagia
Laryngoscopy Pale
granulations in the interarytnoid
region

1.
2.
3.

Ulcers of vocal cords mouse

eaten appearance
Swelling of false VCs &
Aryepiglottic folds
X-Ray chest
Sputum for AFB
Biopsy
Treatment : As for pulmonary
tuberculosis

Vocal Nodules
Singer nodules
Common in voice misusers
Teachers, singers, preachers &
Vendors
Vocal trauma submucosal
hemorrhage fibrosis &
hyalinization
At the junction of anterior 1/3 7
posterior 2/3 ( subject to
maximum trauma )

Clinical features
H/o misuse of voice
Hoarseness
Vocal fatigue
Laryngoscopy Symmetrical
nodular pinkish or grey masses
at junction of ant 1/3 & post 2/3
of true vocal cords

treatment

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2.

3.

Conservative
Avoid misuse of voice
Speech therapy / proper use of
voice No shouting / No
whisper
? May change the profession
Surgical Microlaryngoscopy &
LASER