Zapalenie krtani
Patofizjologia i mechanizm

Zapalenie krtani (laryngitis) to stan zapalny błony śluzowej krtani i strun głosowych, charakteryzujący się przekrwieniem, obrzękiem i podrażnieniem, co prowadzi do zmiany właściwości akustycznych głosu, w tym chrypki i obniżenia jego wysokości. Etiologia obejmuje zakażenia wirusowe (m.in. wirusy paragrypy, grypy, RSV, SARS-CoV-2), bakteryjne (np. Streptococcus pneumoniae, Haemophilus influenzae) oraz grzybicze (Candida albicans), a także czynniki niezakaźne, takie jak nadużywanie głosu, refluks żołądkowo-przełykowy (GERD, LPR) oraz ekspozycja na substancje drażniące (dym papierosowy, zanieczyszczenia). Patogeneza obejmuje reakcje humoralne i komórkowe, w tym produkcję immunoglobulin, fibryny oraz aktywację neutrofili, prowadzące do obrzęku i zaburzeń wibracji strun głosowych, co zwiększa próg ciśnienia fonacyjnego i zmienia dynamikę fali śluzowej.

  1. Patogeneza zapalenia krtani
    1. Mechanizm zapalny
    2. Etiologia zapalenia krtani
    3. Zmiany patofizjologiczne
    4. Mechanizm przewlekłego zapalenia krtani
  2. Ostre zapalenie krtani
  3. Przewlekłe zapalenie krtani
    1. Zapalenie krtani związane z paleniem
    2. Zapalenie krtani związane z refluksem
    3. Alergiczne zapalenie krtani
    4. Zmiany patologiczne w przewlekłym zapaleniu krtani
  4. Konsekwencje zapalenia krtani
    1. Wpływ na produkcję głosu
    2. Komplikacje
    3. Mikrobiom krtani a zapalenie
  5. Podsumowanie mechanizmu patogenetycznego
    1. Kolejne rozdziały

Patogeneza zapalenia krtani

Zapalenie krtani (laryngitis) to stan zapalny krtani (larynx), który prowadzi do obrzęku i podrażnienia strun głosowych oraz okolicznych tkanek. Proces patogenetyczny różni się w zależności od przyczyny i typu zapalenia, ale zawsze wiąże się z reakcją zapalną tkanek krtani12.

Mechanizm zapalny

Zapalenie krtani charakteryzuje się stanem zapalnym błony śluzowej krtani i strun głosowych. We wczesnych etapach dochodzi do przekrwienia i obrzęku struktur krtani, co prowadzi do zmiany właściwości akustycznych głosu34. Kiedy krtań ulega zapaleniu, struny głosowe puchną i stają się podrażnione, co zniekształca dźwięki wytwarzane przez przepływające przez nie powietrze. W rezultacie głos staje się chrypliwy, a w niektórych przypadkach prawie niesłyszalny5.

Proces zapalny obejmuje zarówno reakcje humoralne, jak i komórkowe, które mają na celu zwalczenie szkodliwego czynnika. Reakcje te obejmują produkcję przeciwciał immunoglobulinowych, białek krzepnięcia krwi (fibryny), które zapobiegają rozprzestrzenianiu się zapalenia na sąsiednie tkanki, oraz neutrofili i fagosomów, które wspólnie uwalniają silne enzymy chemiczne promujące gojenie i homeostazę6.

Etiologia zapalenia krtani

Zapalenie krtani można sklasyfikować jako ostre lub przewlekłe, a jego etiologia obejmuje czynniki zakaźne i niezakaźne7. Postać zakaźna jest częstsza i zwykle następuje po infekcji górnych dróg oddechowych8.

Czynniki zakaźne

Infekcje wirusowe są najczęstszą przyczyną ostrego zapalenia krtani. Wirusy powodujące zapalenie krtani to910:

11

Kiedy dochodzi do zakażenia wirusowego, makrofagi (komórki prezentujące antygen) prezentują antygen limfocytom T pomocniczym. Limfocyty T pomocnicze aktywują następnie limfocyty B i indukują produkcję przeciwciał przeciwko wirusowi. Przeciwciała te mogą również działać przeciwko zainfekowanej krtani, wywołując objawy zapalenia krtani12.

Infekcje bakteryjne są mniej powszechną przyczyną zapalenia krtani. Do najczęściej izolowanych bakterii należą13:

14

Infekcje grzybicze są rzadkie, ale mogą wywoływać zapalenie krtani, szczególnie u osób z osłabionym układem odpornościowym lub u pacjentów przyjmujących antybiotyki bądź wziewne kortykosteroidy. Najczęstszym patogenem grzybiczym jest Candida albicans1516.

Czynniki niezakaźne

Nadmierne używanie głosu może powodować stan zapalny krtani. Kiedy struny głosowe są nadmiernie używane poprzez krzyczenie, śpiewanie lub długotrwałe mówienie, mogą stać się podrażnione i obrzęknięte17. Powtarzające się uderzenia strun głosowych o siebie mogą prowadzić do mikrourazu i miejscowego obrzęku strun głosowych18.

Refluks żołądkowo-przełykowy (GERD) i refluks krtaniowo-gardłowy (LPR) są powszechnymi przyczynami przewlekłego zapalenia krtani. Kwas z żołądka i enzymy trawienne mogą przepływać wstecznie do krtani, powodując podrażnienie i stan zapalny błony śluzowej krtani19. Istnieją dwa główne mechanizmy, przez które refluks może powodować zapalenie krtani:

  1. Bezpośrednie uszkodzenie kwasowo-peptyczne krtani i okolicznych tkanek
  2. Stymulacja odruchów nerwu błędnego prowadząca do przewlekłego chrząkania i kaszlu, co ostatecznie prowadzi do zmian w krtani20

Substancje drażniące inhalacyjne, takie jak dym papierosowy, zanieczyszczenia, opary chemiczne i alergeny, mogą również powodować zapalenie krtani21. Palenie papierosów powoduje chemiczne podrażnienie krtani, co prowadzi do obrzęku i stanu zapalnego, który powoduje pogrubienie strun głosowych. To pogrubienie może obniżyć wysokość głosu lub sprawić, że będzie on brzmiał chrapliwie i szorstko22.

Zmiany patofizjologiczne

W ostrym zapaleniu krtani następują charakterystyczne zmiany patofizjologiczne23:

Błona śluzowa krtani staje się czerwona, obrzęknięta i bolesna. Proces patologiczny jest najbardziej wyraźny w obszarze fałdów głosowych. Zapalenie może powodować rozszerzenie tętnic i naczyń włosowatych, co może powodować krwawienie. W przypadku zapalenia krtani związanego z grypą, na błonie śluzowej pojawiają się jasne czerwone kropki24.

Membranowa powłoka strun głosowych jest zwykle czerwona i obrzęknięta. Obniżona wysokość głosu u pacjentów z zapaleniem krtani jest wynikiem nieregularnego pogrubienia na całej długości strun głosowych. Niektórzy autorzy uważają, że struny głosowe stają się raczej sztywne niż pogrubiałe25.

U pacjentów z ostrym zapaleniem krtani występuje zwiększona wartość współczynnika otwarcia. Wskazuje to, że struny głosowe pacjenta są dłużej otwarte, a mniej czasu spędzają w pozycji zamkniętej, co przyczynia się do chrypki i duszności głosu26.

Mechanizm przewlekłego zapalenia krtani

Przewlekłe zapalenie krtani odnosi się do procesu zapalnego, który powoduje nieodwracalne zmiany w błonie śluzowej krtani. Reaktywne i naprawcze procesy krtani stanowią główny czynnik patogenetyczny, który może utrzymywać się nawet po zakończeniu działania bodźca przyczynowego27.

Ta transformacja w fazę przewlekłą może być spowodowana niezdolnością organizmu do wystarczającej obrony przed silnym czynnikiem szkodliwym lub ciągłym narażeniem na szkodliwy czynnik28.

Proces zapalny uszkadza nabłonek rzęskowy krtani, szczególnie w tylnej ścianie. Zaburza to ważną funkcję usuwania śluzowego przepływu z drzewa tchawiczo-oskrzelowego. Gdy ruch rzęskowy nabłonka jest zaburzony, wynikający z tego zastój śluzu na tylnej ścianie krtani i wokół strun głosowych wywołuje odruchowy kaszel. Śluz przecinający struny głosowe może objawiać się skurczem krtani29.

W błonie śluzowej strun głosowych mogą wystąpić znaczące zmiany w postaci hiperkeratozy, dyskeratozy, parakeratozy, akantozy i atypii komórkowej30.

Ostre zapalenie krtani

Ostre zapalenie krtani jest definiowane jako stan trwający mniej niż 3 tygodnie i jest spowodowane miejscowym zapaleniem strun głosowych oraz otaczających tkanek w odpowiedzi na bodziec, niezależnie od tego, czy jest on zakaźny, czy niezakaźny3132.

Przebieg patogenetyczny ostrego zapalenia krtani obejmuje33:

  1. Ogólnoustrojową odpowiedź immunologiczną
  2. Rozprzestrzenianie się infekcji do krtani przez górne drogi oddechowe
  3. Zakażenie strun głosowych i otaczających tkanek
  4. Podrażnienie strun głosowych i otaczających tkanek
  5. Wywołanie kaskady zapalnej

Kiedy dochodzi do infekcji wirusowej, białe krwinki usuwają mikroorganizmy podczas procesu gojenia. Struny głosowe stają się bardziej obrzęknięte, a wibracja jest niekorzystnie zaburzona. Ciśnienie progowe fonacji może wzrosnąć do stopnia, w którym generowanie odpowiednich ciśnień fonacyjnych w normalny sposób staje się trudne, wywołując chrypkę34.

Wraz z postępem obrzęku ciśnienie progowe fonacji może wzrosnąć. Generowanie odpowiedniego ciśnienia fonacyjnego staje się trudniejsze, a pacjent rozwija zmiany fonacyjne w wyniku zmieniającej się dynamiki fali płynowej zapalnej i obrzękniętej tkanki, ale także w wyniku świadomej i nieświadomej adaptacji, próbując złagodzić te zmienione dynamiki tkankowe35.

W ostrym zapaleniu krtani może wystąpić odruchowy mimowolny kaszel. W rzeczywistości jest to rodzaj reakcji obronnej organizmu na czynniki drażniące. Oznaką rozpowszechnionego procesu zapalnego jest ostry kaszel, któremu towarzyszy ból gardła. Uporczywy kaszel komplikuje przebieg choroby, rani błonę śluzową i utrudnia jej odzyskanie. Kaszel produktywny z odkrztuszaniem obserwuje się w końcowej fazie choroby36.

Przewlekłe zapalenie krtani

Przewlekłe zapalenie krtani rozwija się stopniowo, a objawy podstawowe mogą narastać i słabnąć przez bardzo długie okresy37. Jest definiowane jako zapalenie krtani trwające dłużej niż trzy tygodnie38.

Jednym z możliwych wyjaśnień przewlekłego zapalenia krtani jest to, że zapalenie jest spowodowane przez refluks żołądkowo-przełykowy, który powoduje późniejsze podrażnienie strun głosowych39.

Te zmiany zapalne przypisywano różnym czynnikom etiologicznym, w tym nadużywaniu głosu, paleniu, refluksowi, czynnikom środowiskowym, doustnie inhalowanym lekom oraz zakażeniu Helicobacter pylori40.

Zapalenie krtani związane z paleniem

Hipotezuje się, że dym papierosowy prowadzi do zapalenia krtani poprzez wiele mechanizmów. Po wdychaniu dymu tytoniowego, produkty uboczne wywołują zapalenie i rumień błony śluzowej krtani41.

Zapalenie krtani związane z refluksem

Refluks krtaniowo-gardłowy (LPR), choroba, która według szacunków dotyka 35% osób powyżej 40 roku życia, jest powszechnie uznawany za najczęstszy czynnik etiologiczny przyczyniający się do przewlekłego zapalenia krtani, szczególnie u osób niepalących42.

Istnieją dwie główne hipotezy dotyczące mechanizmu, przez który LPR wywołuje zapalenie krtani:

  1. Bezpośrednie uszkodzenie kwasowo-peptyczne krtani i otaczających tkanek, teoria poparta dowodami z tkanki ludzkiej43
  2. Kwas w dystalnym przełyku stymuluje odruchy nerwu błędnego, powodując przewlekłe chrząkanie i kaszel, które ostatecznie prowadzą do zmian w krtani44

Reakcje zapalne w drogach oddechowych zostały również wykazane jako wywoływane przez składniki refluksu żołądkowego, takie jak kwas solny45.

Alergiczne zapalenie krtani

Komórki tuczne błony śluzowej wydają się być głównie odpowiedzialne za patogenezę zapalenia alergicznego krtani46.

Reakcje alergiczne krtani mogą występować w formie ostrej, anafilaktycznej i w formie przewlekłej. Ostra, anafilaktyczna forma jest reakcją pośredniczoną przez IgE na alergen, np. leki, ukąszenia owadów lub alergeny pokarmowe, powodującą zaburzenia oddychania, często następujące po zapaści naczyniowej lub wstrząsie. Objawy i oznaki pojawiają się szybko i mogą być ciężkie i szybko śmiertelne. Wyraźny obrzęk gardła i krtani może powodować niedrożność dróg oddechowych, stridor wdechowy, uczucie globusa, chrypkę i dysfagię47.

Zmiany patologiczne w przewlekłym zapaleniu krtani

Przewlekłe zapalenie krtani może powodować obciążenie strun głosowych i urazy lub rozrost na strunach głosowych (polipy lub guzki)48.

Guzki strun głosowych to obustronne włókniste obrzęki wzdłuż połączenia krawędzi przyśrodkowej przedniej i środkowej trzeciej części prawdziwych strun głosowych. Działają jak odciski i zapobiegają propagacji płynnej fali śluzowej, powodując dysfonię. Są wtórne do czynnościowych zaburzeń głosu oraz nadużywania lub niewłaściwego używania głosu49.

Obrzęk Reinkego, nazywany również corditis polypoidea, obejmuje obrzęk prawdziwych strun głosowych z powodu gromadzenia się płynu w potencjalnej przestrzeni między powierzchowną blaszką właściwą a więzadłami głosowymi (tzw. przestrzeń Reinkego). Gromadzenie się płynu wynika z podnabłonkowej hiperwakulatyzacji, prowadzącej do przepuszczalności naczyń i zaburzenia odkładania kolagenu50.

Konsekwencje zapalenia krtani

Zapalenie krtani ma różne konsekwencje dla zdrowia pacjenta, które mogą wpływać na jakość życia i codzienne funkcjonowanie51.

Wpływ na produkcję głosu

Niedostateczna produkcja głosu u pacjentów z ostrym zapaleniem krtani może prowadzić do zastosowania większej siły przywodzenia lub napięcia w celu zrekompensowania niekompletnego zamknięcia głośni podczas ostrego epizodu zapalenia krtani. To napięcie dodatkowo obciąża struny głosowe i zmniejsza produkcję głosu, ostatecznie opóźniając powrót normalnej fonacji52.

Zapalenie i obrzęk strun głosowych powoduje zmiany w dynamice fali płynowej, co wpływa na wibracje strun głosowych i generację dźwięku53.

Komplikacje

Trudności w oddychaniu są rzadkim powikłaniem zapalenia krtani. Mogą wystąpić, jeśli w krtani występuje dużo zapalenia i obrzęku, co powoduje zwężenie tchawicy54.

Jeśli przyczyną zapalenia krtani jest porażenie strun głosowych, mechanizm połykania może również zostać zaburzony, a cząstki pokarmu mogą dostać się do krtani i płuc, prowadząc do kaszlu. Proces ten może również prowadzić do zachłystowego zapalenia płuc i towarzyszących mu objawów, gdy pokarm jest aspirowany głęboko do płuc i powoduje podrażnienie i zapalenie tkanki płucnej55.

W niektórych przypadkach zapalenia krtani spowodowanego infekcją, infekcja może rozprzestrzenić się na inne części układu oddechowego56.

Mikrobiom krtani a zapalenie

Mikrobiom, składający się ze wszystkich mikroorganizmów i ich genomów, jest złożonym systemem charakteryzującym się interakcjami mikroorganizm-mikroorganizm i gospodarz-mikroorganizm, które wpływają na różne aspekty fizjologii gospodarza57.

Do tej pory przeprowadzono niewiele badań dotyczących mikrobioty tkanki krtaniowej i jej roli w zdrowiu i chorobie błony śluzowej. Sugerowano, że Helicobacter pylori kolonizuje powierzchnię krtani i jego wykrycie koreluje z zapaleniem krtani i łagodnymi zmianami strun głosowych58.

Podstawowe badania badające konkretne mechanizmy biologiczne leżące u podstaw zapalenia krtani są bardzo potrzebne, aby poprawić leczenie przewlekłego zapalenia krtani59.

Podsumowanie mechanizmu patogenetycznego

Zapalenie krtani to złożony stan patologiczny charakteryzujący się stanem zapalnym krtani, w szczególności strun głosowych. Mechanizm patogenetyczny zależy od przyczyny, która może być zakaźna (wirusowa, bakteryjna lub grzybicza) lub niezakaźna (nadużywanie głosu, refluks, czynniki środowiskowe)6061.

W zapaleniu krtani struny głosowe stają się obrzęknięte i podrażnione, co zmienia sposób ich wibracji i dźwięk głosu. Zmiany patofizjologiczne obejmują przekrwienie, obrzęk i zapalenie błony śluzowej krtani, co prowadzi do zwiększonego progu ciśnienia fonacyjnego i zmiany dynamiki fali śluzowej6263.

Przewlekłe zapalenie krtani może prowadzić do długotrwałych zmian w błonie śluzowej krtani, w tym hiperkeratozy, dyskeratozy i atypii komórkowej, a także do rozwoju zmian takich jak polipy i guzki strun głosowych6465.

Zrozumienie mechanizmów patogenetycznych zapalenia krtani jest kluczowe dla opracowania skutecznych metod leczenia, szczególnie w przypadku przewlekłego zapalenia krtani, gdzie obecne terapie wykazują ograniczoną skuteczność66.

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Acute Laryngitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534871/
    Laryngitis refers to inflammation of the larynx, most commonly caused by an acute viral infection, resulting in hoarseness, sore throat, and voice loss. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. […] As the edema progresses, the phonation threshold pressure can increase. […] The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] In such situations, referral to an otolaryngologist and/or speech-language pathologist is warranted.
  • #2 Infectious or Allergic Chronic Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864767-overview
    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. Depending on the causes, the pattern of changes can be very different. Inflammation, edema, hyperemia, and infiltration and proliferation of the mucosa can represent different levels of response to insults. […] The inflammatory process damages the ciliated epithelium of the larynx, particularly in the posterior wall. This impairs the important function of moving the mucous flow out of the tracheobronchial tree. When the ciliary beating motion of the epithelium is impaired, the resultant mucus stasis on the posterior wall of the larynx and around the vocal cords provokes a reactive cough. Mucus across the vocal cords may manifest with laryngospasm. Significant changes may arise in the vocal cord epithelium in the form of hyperkeratosis, dyskeratosis, parakeratosis, acanthosis, and cellular atypia.
  • #3 Acute Laryngitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534871/
    Laryngitis refers to inflammation of the larynx, most commonly caused by an acute viral infection, resulting in hoarseness, sore throat, and voice loss. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. […] As the edema progresses, the phonation threshold pressure can increase. […] The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] In such situations, referral to an otolaryngologist and/or speech-language pathologist is warranted.
  • #4 Acute Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864671-overview
    Laryngitis, an inflammation of the larynx, is one of the most common laryngeal conditions identified. It manifests in acute and chronic forms. […] The etiology of acute laryngitis includes vocal misuse, exposure to noxious agents, or infectious agents leading to upper respiratory tract infections. The infectious agents are most often viral but sometimes bacterial. […] Acute laryngitis is an inflammation of the vocal fold mucosa and larynx that lasts less than 3 weeks. When the etiology of acute laryngitis is infectious, white blood cells remove microorganisms during the healing process. The vocal folds then become more edematous, and vibration is adversely affected. The phonation threshold pressure may increase to a degree that generating adequate phonation pressures in a normal fashion becomes difficult, thus eliciting hoarseness.
  • #5 Laryngitis – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/laryngitis/symptoms-causes/syc-20374262
    Laryngitis is an inflammation of your voice box (larynx) from overuse, irritation or infection. […] But with laryngitis, your vocal cords become inflamed or irritated. This makes the vocal cords swell, which distorts the sounds produced by air passing over them. As a result, your voice sounds hoarse. In some cases of laryngitis, your voice can become almost undetectable. […] Most cases of laryngitis are temporary and improve after the underlying cause gets better. Causes of acute laryngitis include: Viral infections similar to those that cause a cold, Vocal strain, caused by yelling or overusing your voice, Bacterial infections, although these are less common. […] Laryngitis that lasts longer than three weeks is known as chronic laryngitis. This type of laryngitis is generally caused by exposure to irritants over time. Chronic laryngitis can cause vocal cord strain and injuries or growths on the vocal cords (polyps or nodules). Chronic laryngitis can be caused by: Inhaled irritants, such as chemical fumes, allergens or smoke, Acid reflux, also called gastroesophageal reflux disease (GERD), Chronic sinusitis, Excessive alcohol use, Habitual overuse of your voice (such as in singers or cheerleaders), Smoking. […] In some cases of laryngitis caused by infection, the infection may spread to other parts of the respiratory tract.
  • #6 Laryngitis: Types, Causes, and Treatments | Ento Key
    https://entokey.com/laryngitis-types-causes-and-treatments/
    Inflammatory processes that affect the unified airway can concurrently exert significant influence on the larynx and surrounding mucosal surfaces. […] This review examines laryngeal inflammation in the context of the unified airway and discusses pathophysiologic mechanisms that are central to the development of acute and chronic laryngitis. […] In general, inflammation involves both humoral and cellular reactions to combat the injurious effects of the inciting agent. […] These defensive processes include the production of (1) immunoglobulin antibodies, (2) blood-clotting (fibrin) proteins that prevent the spread of inflammation into neighboring tissues, and (3) neutrophils and phagosomes that collectively release powerful chemical enzymes to promote healing and homeostasis. […] In some cases of chronic inflammation the pathogenesis is an unexpectedly persistent acute reaction.
  • #7 Acute Laryngitis | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/24052
    Laryngitis refers to larynx inflammation and can present in acute and chronic forms. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. This can encompass the supraglottic, glottic, or subglottic larynx (or any combination thereof), depending on the inciting organism. […] As the edema progresses, the phonation threshold pressure can increase. The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] If symptoms persist beyond this timeframe, it is either due to superinfection or a transition to chronic laryngitis.
  • #8 Acute Laryngitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534871/
    Laryngitis refers to inflammation of the larynx, most commonly caused by an acute viral infection, resulting in hoarseness, sore throat, and voice loss. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. […] As the edema progresses, the phonation threshold pressure can increase. […] The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] In such situations, referral to an otolaryngologist and/or speech-language pathologist is warranted.
  • #9 Laryngitis and Pharyngitis
    https://www.uspharmacist.com/article/laryngitis-and-pharyngitis
    Laryngitis can result from overuse of the voice, irritation from allergies or other environmental irritants, stomach acid reflux, or a viral or bacterial infection. In most cases, laryngitis is due to an infection from a virus, or less often, bacteria. […] If laryngitis is a chronic problem, the doctor will investigate the possible causes for the swelling and inflammation. If laryngitis is not due to an infection, it is most often a result of injuring the vocal cords through overuse, smoking, or stomach acid reflux. Hoarseness can also be a result of growths or other abnormalities of the vocal cords. A specialist of the ear, nose, and throat can perform tests on the vocal cords to determine the cause of the hoarseness and the appropriate treatment.
  • #10 Laryngitis | Johns Hopkins ABX Guide
    https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540306/all/Laryngitis
    Common agents causing laryngitis: […] Parainfluenza virus […] Influenza […] Respiratory syncytial virus […] Coronavirus […] Rhinovirus […] Adenovirus […] Herpes simplex virus […] Varicella zoster virus […] Metapneumovirus. […] Viral: Parainfluenza virus, Influenza virus, Coronavirus (Non-SARS), Respiratory syncytial virus, Rhinovirus, Adenovirus, Herpes Simplex/H1 Zoster. […] Non-viral: C. pneumoniae, C. diphtheriae, C. neoformans, M. pneumoniae, M. tuberculosis, Group A streptococci, H. influenzae, H. capsulatum, M. catarrhalis, S. pneumoniae, Candida. […] Rare: Coccidioides immitis, Blastomyces dermatitidis, Paracoccidioidomycosis, Leishmaniasis.
  • #11 Laryngitis | 5-Minute Clinical Consult
    https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116339/all/Laryngitis
    Laryngitis is inflammation, erythema, and edema of the mucosa of the larynx and/or vocal cords characterized by hoarseness, loss of voice, throat pain, coughing, and often a negative impact on a persons quality of life and daily activities. […] There is a range of severity, but most cases are acute and are associated with viral upper respiratory infection, irritation, or acute vocal strain. […] Misuse or abuse of voice […] Infectious […] Viral: influenza A, B; parainfluenza; adenovirus; coronavirus; rhinovirus; human papillomavirus; cytomegalovirus; varicella-zoster virus; herpes simplex virus; respiratory syncytial virus; coxsackievirus, COVID-19 (SARS-CoV-2) […] Fungal: uncommon but thought to be underdiagnosed, potentially accounting for up to 10% of presentations in both immunocompromised and immunocompetent patients; risk factors include recent antibiotic or inhaled corticosteroid use (1): histoplasmosis, blastomycosis, Coccidioides, Cryptococcus, and Candida.
  • #12 Laryngitis pathophysiology – wikidoc
    https://www.wikidoc.org/index.php/Laryngitis_pathophysiology
    Laryngitis is the result of an immunological sequelae to an infection, generally an upper respiratory viral infection. […] During an infection, activated antigen-presenting cells, such as macrophages, present the antigen to helper T cells. […] Helper T cells subsequently activate B cells and induce the production of antibodies against the virus. […] The antibodies may also act against the affected larynx, producing the symptoms of laryngitis.
  • #13 Laryngitis | 5-Minute Clinical Consult
    https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116339/all/Laryngitis
    Bacterial (uncommon): -hemolytic streptococcus, Streptococcus pneumoniae, Haemophilus influenzae, tuberculosis (TB), leprosy, Moraxella catarrhalis, Mycoplasma pneumoniae, Chlamydophila pneumoniae; in patients with chronic laryngitis, methicillin-resistant Staphylococcus aureus (MRSA) should be considered as a potential cause. […] Irritants […] Inhalation of irritating substances (e.g., air pollution, cigarette smoke) […] Gastroesophageal reflux disease (GERD)/laryngopharyngeal reflux disease (LPRD) […] Anatomic […] Aging changes: muscle atrophy, loss of moisture in larynx, and bowing of vocal cords […] Neuromuscular disorder (e.g., myasthenia gravis); stroke […] Trauma (e.g., blunt or penetrating trauma to neck).
  • #14 Treatment for Laryngitis: Uncovering the Causes | Henrico
    https://virginiaent.com/treatment-for-laryngitis-uncovering-the-causes/
    Laryngitis can result from several factors, each contributing to inflammation and irritation of the larynx: […] The most frequent cause of laryngitis is viral infections, such as those associated with the common cold or flu. These viruses cause inflammation of the larynx, leading to symptoms like hoarseness and throat discomfort. […] Although less common, bacterial infections can cause laryngitis. Bacteria like Streptococcus or Haemophilus influenzae can lead to more severe symptoms and may require antibiotic treatment to resolve. […] Excessive or improper use of the voice such as shouting, singing loudly, or prolonged speaking can strain the vocal cords, leading to acute laryngitis. […] GERD involves the frequent backflow of stomach acid into the esophagus, which can irritate the larynx and lead to chronic laryngitis.
  • #15 Infectious Laryngitis
    https://app1.unmc.edu/medicine/heywood/laryngealdisease/Data/infection.htm
    Bacterial laryngitis occurs frequently with bronchitis and is predominantly caused by M.catarrhalis and H.influenzae. […] Fungal laryngitis is most commonly caused by candid albicans and occurs in immuno-compromised patients. The patients on long courses of antibiotics or patients receiving inhaled steroids are also susceptible to this type of laryngitis. Treatment includes systemic antifungals. […] Viral laryngitis is the most common cause of hoarseness and it occurs very frequently with upper respiratory infections. This is usually an acute laryngitis that lasts a few days up to one week. It is treated with supportive care.
  • #16 Laryngitis | 5-Minute Clinical Consult
    https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116339/all/Laryngitis
    Laryngitis is inflammation, erythema, and edema of the mucosa of the larynx and/or vocal cords characterized by hoarseness, loss of voice, throat pain, coughing, and often a negative impact on a persons quality of life and daily activities. […] There is a range of severity, but most cases are acute and are associated with viral upper respiratory infection, irritation, or acute vocal strain. […] Misuse or abuse of voice […] Infectious […] Viral: influenza A, B; parainfluenza; adenovirus; coronavirus; rhinovirus; human papillomavirus; cytomegalovirus; varicella-zoster virus; herpes simplex virus; respiratory syncytial virus; coxsackievirus, COVID-19 (SARS-CoV-2) […] Fungal: uncommon but thought to be underdiagnosed, potentially accounting for up to 10% of presentations in both immunocompromised and immunocompetent patients; risk factors include recent antibiotic or inhaled corticosteroid use (1): histoplasmosis, blastomycosis, Coccidioides, Cryptococcus, and Candida.
  • #17 Laryngitis: Diagnosis, Symptoms, Causes, Treatments & Recovery
    https://my.clevelandclinic.org/health/diseases/22268-laryngitis
    Laryngitis occurs when your larynx, or voice box, is inflamed. The condition can develop when your vocal cords are overused, irritated or infected. […] When you get laryngitis, your vocal cords become swollen and irritated. As a result, your voice can be affected, and sometimes is reduced to a whisper. […] Laryngitis may occur for several reasons. However, laryngitis causes can vary depending on whether your condition is acute or chronic: […] Acute laryngitis causes include temporary vocal strain from yelling, singing or frequent speaking, viral infections, bacterial infections, and candida (yeast) infections. […] Chronic laryngitis causes include persistent overuse of your voice, chronic sinusitis, GERD (chronic acid reflux), smoking, and heavy drinking.
  • #18 Hoarseness in Adults | AAFP
    https://www.aafp.org/pubs/afp/issues/2017/1201/p720.html
    Dysphonia (i.e., voice impairment) can result from any pathology affecting these complex mechanisms of vocalization, but hoarseness primarily results from vocal fold changes. […] The most common cause of hoarseness in adults is laryngitis, which is classified as acute or chronic. Acute laryngitis is a common, self-limited condition lasting less than three to four weeks. Common causes include acute vocal strain or upper respiratory infection. Short-term vocal abuse (e.g., singing, screaming) or protracted coughing can cause microtrauma and focal vocal fold edema. Hoarseness is often part of a constellation of upper respiratory symptoms caused by viruses and less commonly by bacterial or fungal sources. […] Chronic laryngitis is diagnosed when symptoms persist for more than three to four weeks. Long-term inhalation of irritants (usually through smoking), reflux, chronic vocal strain, and postnasal drip are common causes. Irritation of vocal fold mucosa by reflux can be caused by laryngopharyngeal reflux (LPR) or gastroesophageal reflux disease (GERD).
  • #19 Understanding Reflux Laryngitis – THE VOICE FOUNDATION
    https://voicefoundation.org/health-science/voice-disorders/voice-disorders/reflux-laryngitis/understanding-reflux-laryngitis/
    The voice disorder caused by backflow of stomach fluids to the voice box is known as reflux laryngitis. Unlike the stomach, the voice box and throat are sensitive to the acid and enzymes in stomach fluids. […] Exposure of the voice box to stomach acid and enzymes results in swelling and irritation (inflammation). […] Reflux laryngitis is a product of backflow of stomach fluids to the voice box, also known as laryngopharyngeal reflux (LPR), which occurs when there is: […] Three Main Causes of Reflux Laryngitis […] There are three main causes of over-secretion of stomach acid, and abnormal muscle function of the throat-food pipe tract (pharyngo-esophageal tract). […] Delayed clearance worsens backflow […] Any delay in esophageal clearance or emptying results in worsening of problems from backflow by: […] Stomach fluids in esophagus able to backflow beyond upper gate or UES into throat and voice box […] Delayed emptying increases risk of backflow […] Acids and enzymes that remain longer in the stomach due to delayed emptying have a higher risk of backflow.
  • #20 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    The second hypothesis suggests that acid in the distal esophagus stimulates vagally mediated reflexes resulting in chronic throat clearing and coughing which eventually lead to laryngeal lesions and symptoms. […] Inflammatory reactions in the airway have also been demonstrated to be induced by components of gastric reflux such as hydrochloric acid. […] While there is limited research investigating the immunologic mechanisms specific to LPR-induced inflammation in the larynx, examinations of laryngeal tissues collected from patients with LPR have demonstrated increased CD8+ cell counts. […] There has been limited research demonstrating a causal link between inhaled or ingested allergens and laryngitis to date. […] Mucosal mast cells appear to be primarily responsible for the pathogenesis of allergic inflammation in the larynx.
  • #21 Laryngitis | PPT
    https://www.slideshare.net/slideshow/laryngitis-235619168/235619168
    It is the acute inflammation of larynx which lasts less than a few days and leads to oedema of laryngeal mucosa and underlying structures. Most cases of acute laryngitis are temporary and improve after the underlying cause gets better. […] Laryngitis that lasts more than 3 weeks is known as chronic laryngitis. Chronic laryngitis is a more persistent disorder that produces lingering hoarseness and other voice changes. […] Vocal misuse, exposure to noxious agents, infectious agents leading to upper respiratory tract infections. The infectious agents are most often viral but sometimes bacterial. Inhaled irritants such as chemical fumes, allergens or smoking. Acid reflux, also gastro esophageal reflux disease (GERD). […] Chronic sinusitis, bronchitis. Excessive alcohol use. Habitual overuse of the voice such as with singers or cheerleaders. Smoking.
  • #22 Laryngitis | PPT
    https://www.slideshare.net/slideshow/laryngitis-235619168/235619168
    Laryngitis is frequently caused by Rhinovirus, other causative organisms include Para influenza virus, respiratory syncytial virus, Adenovirus, Measles and mumps, and bacterial infection such as diphtheria. […] Cigarette smoke irritates the larynx, causing swelling and inflammation that thickens the vocal cords. This thickening can lower the pitch of the voice or make it sound raspy and harsh. […] Alcohol causes a chemical irritation of the larynx that produces changes similar to those seen in smokers. […] GERD is a disorder in which acidic fluids from the stomach flow backward (reflux) into the oesophagus and throat, irritating the larynx. […] Many industrial products are suspected of causing chronic laryngitis and other respiratory problems. […] Symptoms include hoarseness, a low, raspy voice, voice loss, tickling sensation and rawness in throat, a voice that tires easily, breaks or cracks, and difficulty swallowing. […] Diagnosis is based upon a combination of the complete history and physical exam. […] Treatment may include voice rest, steam inhalation, and supportive therapy.
  • #23 Laryngitis: causes, symptoms, and treatment at «K+31»
    https://www.k31.ru/en/service/otorinolaringologiya/laringit.html
    Laryngitis is an inflammatory pathology of the mucous membrane of the larynx and vocal cords. It is a consequence of colds, overstrain of the larynx, allergies, smoking, and inhalation of dust. The most common provoking factor of inflammation is exposure to infectious agents. […] In acute inflammation, the larynx looks red, swollen and painful. The pathological process is most pronounced in the area of the vocal folds. Inflammation can provoke dilation of arteries and capillaries, and this can cause bleeding: with influenza laryngitis, bright red dots appear on the mucous membrane. Isolated laryngitis is characterized by the occurrence of hyperemia (redness) only in the area of the epiglottis. […] Intoxication of the body is often accompanied by fever, progressive weakness, pain in muscles and joints. Sometimes acute inflammation spreads not only to the mucous membrane of the larynx, but also to the trachea. This type of disease is called laryngotracheitis.
  • #24 Laryngitis: causes, symptoms, and treatment at «K+31»
    https://www.k31.ru/en/service/otorinolaringologiya/laringit.html
    Laryngitis is an inflammatory pathology of the mucous membrane of the larynx and vocal cords. It is a consequence of colds, overstrain of the larynx, allergies, smoking, and inhalation of dust. The most common provoking factor of inflammation is exposure to infectious agents. […] In acute inflammation, the larynx looks red, swollen and painful. The pathological process is most pronounced in the area of the vocal folds. Inflammation can provoke dilation of arteries and capillaries, and this can cause bleeding: with influenza laryngitis, bright red dots appear on the mucous membrane. Isolated laryngitis is characterized by the occurrence of hyperemia (redness) only in the area of the epiglottis. […] Intoxication of the body is often accompanied by fever, progressive weakness, pain in muscles and joints. Sometimes acute inflammation spreads not only to the mucous membrane of the larynx, but also to the trachea. This type of disease is called laryngotracheitis.
  • #25 Acute Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864671-overview
    The membranous covering of the vocal folds is usually red and swollen. The lowered pitch in laryngitic patients is a result of this irregular thickening along the entire length of the vocal fold. Some authors believe that the vocal fold stiffens rather than thickens. […] The deficient voice production in patients with acute laryngitis may result in application of a greater adduction force or tension to compensate for the incomplete glottic closure during an acute laryngitic episode. This tension further strains the vocal folds and decreases voice production, ultimately delaying return of normal phonation. […] Patients with acute laryngitis have an increased open quotient value. This indicates that the patient’s vocal folds are open longer, and less time is spent in the closed position, which contributes to the hoarseness and breathiness of the voice.
  • #26 Acute Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864671-overview
    The membranous covering of the vocal folds is usually red and swollen. The lowered pitch in laryngitic patients is a result of this irregular thickening along the entire length of the vocal fold. Some authors believe that the vocal fold stiffens rather than thickens. […] The deficient voice production in patients with acute laryngitis may result in application of a greater adduction force or tension to compensate for the incomplete glottic closure during an acute laryngitic episode. This tension further strains the vocal folds and decreases voice production, ultimately delaying return of normal phonation. […] Patients with acute laryngitis have an increased open quotient value. This indicates that the patient’s vocal folds are open longer, and less time is spent in the closed position, which contributes to the hoarseness and breathiness of the voice.
  • #27 Infectious or Allergic Chronic Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864767-overview
    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. Depending on the causes, the pattern of changes can be very different. Inflammation, edema, hyperemia, and infiltration and proliferation of the mucosa can represent different levels of response to insults. […] The inflammatory process damages the ciliated epithelium of the larynx, particularly in the posterior wall. This impairs the important function of moving the mucous flow out of the tracheobronchial tree. When the ciliary beating motion of the epithelium is impaired, the resultant mucus stasis on the posterior wall of the larynx and around the vocal cords provokes a reactive cough. Mucus across the vocal cords may manifest with laryngospasm. Significant changes may arise in the vocal cord epithelium in the form of hyperkeratosis, dyskeratosis, parakeratosis, acanthosis, and cellular atypia.
  • #28 Laryngitis: Types, Causes, and Treatments | Ento Key
    https://entokey.com/laryngitis-types-causes-and-treatments/
    This transformation into a chronic phase may be caused by (1) inability of the body to mount a sufficient defense against a powerful offending agent, or (2) continuous exposure to a noxious agent. […] The term laryngitis generically refers to inflammation of the tissues of the larynx. […] Chronic laryngitis usually develops gradually, and the underlying signs and symptoms can wax and wane over very long periods of time; some granulomatous forms can result from a single traumatic insult, and others may emerge when the larynx is repetitively exposed to the offending agent over a longer duration. […] Viruses, bacteria, and fungi or molds can infect the larynx and cause acute laryngitis. […] In general, viruses are transmitted by infected individuals via air droplets during exhalation, sneezing, or coughing. […] The presence of endolaryngeal purulent secretions is more commonly observed in patients with bacterial versus viral laryngitis.
  • #29 Infectious or Allergic Chronic Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864767-overview
    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. Depending on the causes, the pattern of changes can be very different. Inflammation, edema, hyperemia, and infiltration and proliferation of the mucosa can represent different levels of response to insults. […] The inflammatory process damages the ciliated epithelium of the larynx, particularly in the posterior wall. This impairs the important function of moving the mucous flow out of the tracheobronchial tree. When the ciliary beating motion of the epithelium is impaired, the resultant mucus stasis on the posterior wall of the larynx and around the vocal cords provokes a reactive cough. Mucus across the vocal cords may manifest with laryngospasm. Significant changes may arise in the vocal cord epithelium in the form of hyperkeratosis, dyskeratosis, parakeratosis, acanthosis, and cellular atypia.
  • #30 Infectious or Allergic Chronic Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864767-overview
    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. Depending on the causes, the pattern of changes can be very different. Inflammation, edema, hyperemia, and infiltration and proliferation of the mucosa can represent different levels of response to insults. […] The inflammatory process damages the ciliated epithelium of the larynx, particularly in the posterior wall. This impairs the important function of moving the mucous flow out of the tracheobronchial tree. When the ciliary beating motion of the epithelium is impaired, the resultant mucus stasis on the posterior wall of the larynx and around the vocal cords provokes a reactive cough. Mucus across the vocal cords may manifest with laryngospasm. Significant changes may arise in the vocal cord epithelium in the form of hyperkeratosis, dyskeratosis, parakeratosis, acanthosis, and cellular atypia.
  • #31 Acute Laryngitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534871/
    Laryngitis refers to inflammation of the larynx, most commonly caused by an acute viral infection, resulting in hoarseness, sore throat, and voice loss. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. […] As the edema progresses, the phonation threshold pressure can increase. […] The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] In such situations, referral to an otolaryngologist and/or speech-language pathologist is warranted.
  • #32 Acute Laryngitis | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/24052
    Laryngitis refers to larynx inflammation and can present in acute and chronic forms. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. This can encompass the supraglottic, glottic, or subglottic larynx (or any combination thereof), depending on the inciting organism. […] As the edema progresses, the phonation threshold pressure can increase. The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] If symptoms persist beyond this timeframe, it is either due to superinfection or a transition to chronic laryngitis.
  • #33 Acute Laryngitis | Calgary Guide
    https://calgaryguide.ucalgary.ca/acute-laryngitis-pathogenesis-and-clinical-findings/acute-laryngitis/
    Acute Laryngitis: Pathogenesis and clinical findings […] Systemic immune response […] Spread of infection to larynx through upper respiratory tract […] Infection of the vocal folds and surrounding tissue […] Irritation of the vocal folds and surrounding tissue […] Inflammatory cascade triggered.
  • #34 Acute Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864671-overview
    Laryngitis, an inflammation of the larynx, is one of the most common laryngeal conditions identified. It manifests in acute and chronic forms. […] The etiology of acute laryngitis includes vocal misuse, exposure to noxious agents, or infectious agents leading to upper respiratory tract infections. The infectious agents are most often viral but sometimes bacterial. […] Acute laryngitis is an inflammation of the vocal fold mucosa and larynx that lasts less than 3 weeks. When the etiology of acute laryngitis is infectious, white blood cells remove microorganisms during the healing process. The vocal folds then become more edematous, and vibration is adversely affected. The phonation threshold pressure may increase to a degree that generating adequate phonation pressures in a normal fashion becomes difficult, thus eliciting hoarseness.
  • #35 Acute Laryngitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534871/
    Laryngitis refers to inflammation of the larynx, most commonly caused by an acute viral infection, resulting in hoarseness, sore throat, and voice loss. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. […] As the edema progresses, the phonation threshold pressure can increase. […] The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] In such situations, referral to an otolaryngologist and/or speech-language pathologist is warranted.
  • #36 Laryngitis: causes, symptoms, and treatment at «K+31»
    https://www.k31.ru/en/service/otorinolaringologiya/laringit.html
    In acute laryngitis, a reflex involuntary cough may develop. In fact, this is a kind of protective reaction of the body to irritants. A sign of a widespread inflammatory process is a sharp cough accompanied by a sore throat. A persistent cough complicates the course of the disease, injures the mucous membrane and interferes with its recovery. A productive cough with sputum is observed at the final stage of the disease.
  • #37 Laryngitis: Types, Causes, and Treatments | Ento Key
    https://entokey.com/laryngitis-types-causes-and-treatments/
    This transformation into a chronic phase may be caused by (1) inability of the body to mount a sufficient defense against a powerful offending agent, or (2) continuous exposure to a noxious agent. […] The term laryngitis generically refers to inflammation of the tissues of the larynx. […] Chronic laryngitis usually develops gradually, and the underlying signs and symptoms can wax and wane over very long periods of time; some granulomatous forms can result from a single traumatic insult, and others may emerge when the larynx is repetitively exposed to the offending agent over a longer duration. […] Viruses, bacteria, and fungi or molds can infect the larynx and cause acute laryngitis. […] In general, viruses are transmitted by infected individuals via air droplets during exhalation, sneezing, or coughing. […] The presence of endolaryngeal purulent secretions is more commonly observed in patients with bacterial versus viral laryngitis.
  • #38 Laryngitis – Wikipedia
    https://en.wikipedia.org/wiki/Laryngitis
    Laryngitis is categorized as acute if it lasts less than 3 weeks and chronic if symptoms last more than 3 weeks. […] The underlying mechanism involves irritation of the vocal cords. […] Laryngitis can be infectious as well as noninfectious in origin. The resulting inflammation of the vocal folds results in a distortion of the sound produced there. […] One possible explanation of chronic laryngitis is that inflammation is caused by gastro-esophageal reflux, which causes subsequent irritation of the vocal folds.
  • #39 Laryngitis – Wikipedia
    https://en.wikipedia.org/wiki/Laryngitis
    Laryngitis is categorized as acute if it lasts less than 3 weeks and chronic if symptoms last more than 3 weeks. […] The underlying mechanism involves irritation of the vocal cords. […] Laryngitis can be infectious as well as noninfectious in origin. The resulting inflammation of the vocal folds results in a distortion of the sound produced there. […] One possible explanation of chronic laryngitis is that inflammation is caused by gastro-esophageal reflux, which causes subsequent irritation of the vocal folds.
  • #40 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    Chronic laryngitis is a term used to describe a variety of specific and nonspecific inflammatory changes observed in patients with an array of symptoms. […] These inflammatory changes have been attributed to a variety of etiologic factors including vocal overuse, smoking, reflux, environmental factors, orally inhaled medications, and Helicobacter pylori infection. […] It is hypothesized that cigarette smoke leads to laryngeal inflammation via multiple mechanisms. […] Following inhalation of cigarette smoke, these by-products trigger inflammation and erythema of the laryngeal mucosa. […] LPR, a disease that is estimated to affect 35% of people over the age of 40, is widely accepted as the most common etiologic factor contributing to chronic laryngitis, particularly in nonsmokers. […] The first suggests a direct acid-peptic injury to the larynx and surrounding tissues, a theory that is supported by evidence from human tissue.
  • #41 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    Chronic laryngitis is a term used to describe a variety of specific and nonspecific inflammatory changes observed in patients with an array of symptoms. […] These inflammatory changes have been attributed to a variety of etiologic factors including vocal overuse, smoking, reflux, environmental factors, orally inhaled medications, and Helicobacter pylori infection. […] It is hypothesized that cigarette smoke leads to laryngeal inflammation via multiple mechanisms. […] Following inhalation of cigarette smoke, these by-products trigger inflammation and erythema of the laryngeal mucosa. […] LPR, a disease that is estimated to affect 35% of people over the age of 40, is widely accepted as the most common etiologic factor contributing to chronic laryngitis, particularly in nonsmokers. […] The first suggests a direct acid-peptic injury to the larynx and surrounding tissues, a theory that is supported by evidence from human tissue.
  • #42 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    Chronic laryngitis is a term used to describe a variety of specific and nonspecific inflammatory changes observed in patients with an array of symptoms. […] These inflammatory changes have been attributed to a variety of etiologic factors including vocal overuse, smoking, reflux, environmental factors, orally inhaled medications, and Helicobacter pylori infection. […] It is hypothesized that cigarette smoke leads to laryngeal inflammation via multiple mechanisms. […] Following inhalation of cigarette smoke, these by-products trigger inflammation and erythema of the laryngeal mucosa. […] LPR, a disease that is estimated to affect 35% of people over the age of 40, is widely accepted as the most common etiologic factor contributing to chronic laryngitis, particularly in nonsmokers. […] The first suggests a direct acid-peptic injury to the larynx and surrounding tissues, a theory that is supported by evidence from human tissue.
  • #43 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    Chronic laryngitis is a term used to describe a variety of specific and nonspecific inflammatory changes observed in patients with an array of symptoms. […] These inflammatory changes have been attributed to a variety of etiologic factors including vocal overuse, smoking, reflux, environmental factors, orally inhaled medications, and Helicobacter pylori infection. […] It is hypothesized that cigarette smoke leads to laryngeal inflammation via multiple mechanisms. […] Following inhalation of cigarette smoke, these by-products trigger inflammation and erythema of the laryngeal mucosa. […] LPR, a disease that is estimated to affect 35% of people over the age of 40, is widely accepted as the most common etiologic factor contributing to chronic laryngitis, particularly in nonsmokers. […] The first suggests a direct acid-peptic injury to the larynx and surrounding tissues, a theory that is supported by evidence from human tissue.
  • #44 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    The second hypothesis suggests that acid in the distal esophagus stimulates vagally mediated reflexes resulting in chronic throat clearing and coughing which eventually lead to laryngeal lesions and symptoms. […] Inflammatory reactions in the airway have also been demonstrated to be induced by components of gastric reflux such as hydrochloric acid. […] While there is limited research investigating the immunologic mechanisms specific to LPR-induced inflammation in the larynx, examinations of laryngeal tissues collected from patients with LPR have demonstrated increased CD8+ cell counts. […] There has been limited research demonstrating a causal link between inhaled or ingested allergens and laryngitis to date. […] Mucosal mast cells appear to be primarily responsible for the pathogenesis of allergic inflammation in the larynx.
  • #45 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    The second hypothesis suggests that acid in the distal esophagus stimulates vagally mediated reflexes resulting in chronic throat clearing and coughing which eventually lead to laryngeal lesions and symptoms. […] Inflammatory reactions in the airway have also been demonstrated to be induced by components of gastric reflux such as hydrochloric acid. […] While there is limited research investigating the immunologic mechanisms specific to LPR-induced inflammation in the larynx, examinations of laryngeal tissues collected from patients with LPR have demonstrated increased CD8+ cell counts. […] There has been limited research demonstrating a causal link between inhaled or ingested allergens and laryngitis to date. […] Mucosal mast cells appear to be primarily responsible for the pathogenesis of allergic inflammation in the larynx.
  • #46 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    The second hypothesis suggests that acid in the distal esophagus stimulates vagally mediated reflexes resulting in chronic throat clearing and coughing which eventually lead to laryngeal lesions and symptoms. […] Inflammatory reactions in the airway have also been demonstrated to be induced by components of gastric reflux such as hydrochloric acid. […] While there is limited research investigating the immunologic mechanisms specific to LPR-induced inflammation in the larynx, examinations of laryngeal tissues collected from patients with LPR have demonstrated increased CD8+ cell counts. […] There has been limited research demonstrating a causal link between inhaled or ingested allergens and laryngitis to date. […] Mucosal mast cells appear to be primarily responsible for the pathogenesis of allergic inflammation in the larynx.
  • #47 Laryngitis, Allergic | SpringerLink
    https://link.springer.com/doi/10.1007/978-3-319-28618-1_1859
    Allergic reactions of the larynx can occur in the acute, anaphylactic form and in the chronic form. […] The acute, anaphylactic form is an IgE-mediated reaction to an allergen, e.g., drugs, insect bites, or food allergens, causing respiratory distress often followed by vascular collapse or shock. Symptoms and signs appear rapidly and can be severe and rapidly fatal. Pronounced edema of the pharynx and larynx may cause airway obstruction, inspiratory stridor, globus sensation, hoarseness, and dysphagia. Laryngeal involvement is often accompanied by edema of the uvula, the tongue, and eyelids, by nasal congestion, and by urticaria. […] Chronic allergic reaction affecting the larynx is much more controversial. There is little data in the literature regarding the chronic effects of allergy on the larynx, though recent evidence is…
  • #48 Laryngitis – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/laryngitis/symptoms-causes/syc-20374262
    Laryngitis is an inflammation of your voice box (larynx) from overuse, irritation or infection. […] But with laryngitis, your vocal cords become inflamed or irritated. This makes the vocal cords swell, which distorts the sounds produced by air passing over them. As a result, your voice sounds hoarse. In some cases of laryngitis, your voice can become almost undetectable. […] Most cases of laryngitis are temporary and improve after the underlying cause gets better. Causes of acute laryngitis include: Viral infections similar to those that cause a cold, Vocal strain, caused by yelling or overusing your voice, Bacterial infections, although these are less common. […] Laryngitis that lasts longer than three weeks is known as chronic laryngitis. This type of laryngitis is generally caused by exposure to irritants over time. Chronic laryngitis can cause vocal cord strain and injuries or growths on the vocal cords (polyps or nodules). Chronic laryngitis can be caused by: Inhaled irritants, such as chemical fumes, allergens or smoke, Acid reflux, also called gastroesophageal reflux disease (GERD), Chronic sinusitis, Excessive alcohol use, Habitual overuse of your voice (such as in singers or cheerleaders), Smoking. […] In some cases of laryngitis caused by infection, the infection may spread to other parts of the respiratory tract.
  • #49 Hoarseness: When to observe and when to refer | Cleveland Clinic Journal of Medicine
    https://www.ccjm.org/content/90/8/475
    Vocal-fold nodules are bilateral fibrous swellings along the junction of the medial edge of the anterior and middle third of the true vocal folds. They act like calluses and prevent the propagation of a smooth mucosal wave, resulting in dysphonia. They are secondary to functional voice disorders and vocal abuse or misuse; 80% of patients will recover with voice therapy alone, while those with recalcitrant lesions may require surgical excision. […] Reinke edema is also referred to as polypoid corditis and involves swelling of the true vocal folds owing to accumulation of fluid within the potential space between the superficial lamina propria and the vocal ligaments (also called the Reinke space). The fluid accumulation is due to subepithelial hypervascularity, leading to vascular permeability and the disruption of collagen deposition. Reinke edema is almost exclusively caused by smoking, but vocal abuse or laryngopharyngeal reflux may also play a role. Primary treatment is smoking cessation, treating reflux, and voice therapy. Severe obstructive Reinke edema may require surgery after these conservative treatments.
  • #50 Hoarseness: When to observe and when to refer | Cleveland Clinic Journal of Medicine
    https://www.ccjm.org/content/90/8/475
    Vocal-fold nodules are bilateral fibrous swellings along the junction of the medial edge of the anterior and middle third of the true vocal folds. They act like calluses and prevent the propagation of a smooth mucosal wave, resulting in dysphonia. They are secondary to functional voice disorders and vocal abuse or misuse; 80% of patients will recover with voice therapy alone, while those with recalcitrant lesions may require surgical excision. […] Reinke edema is also referred to as polypoid corditis and involves swelling of the true vocal folds owing to accumulation of fluid within the potential space between the superficial lamina propria and the vocal ligaments (also called the Reinke space). The fluid accumulation is due to subepithelial hypervascularity, leading to vascular permeability and the disruption of collagen deposition. Reinke edema is almost exclusively caused by smoking, but vocal abuse or laryngopharyngeal reflux may also play a role. Primary treatment is smoking cessation, treating reflux, and voice therapy. Severe obstructive Reinke edema may require surgery after these conservative treatments.
  • #51 Laryngitis | 5-Minute Clinical Consult
    https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116339/all/Laryngitis
    Laryngitis is inflammation, erythema, and edema of the mucosa of the larynx and/or vocal cords characterized by hoarseness, loss of voice, throat pain, coughing, and often a negative impact on a persons quality of life and daily activities. […] There is a range of severity, but most cases are acute and are associated with viral upper respiratory infection, irritation, or acute vocal strain. […] Misuse or abuse of voice […] Infectious […] Viral: influenza A, B; parainfluenza; adenovirus; coronavirus; rhinovirus; human papillomavirus; cytomegalovirus; varicella-zoster virus; herpes simplex virus; respiratory syncytial virus; coxsackievirus, COVID-19 (SARS-CoV-2) […] Fungal: uncommon but thought to be underdiagnosed, potentially accounting for up to 10% of presentations in both immunocompromised and immunocompetent patients; risk factors include recent antibiotic or inhaled corticosteroid use (1): histoplasmosis, blastomycosis, Coccidioides, Cryptococcus, and Candida.
  • #52 Acute Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864671-overview
    The membranous covering of the vocal folds is usually red and swollen. The lowered pitch in laryngitic patients is a result of this irregular thickening along the entire length of the vocal fold. Some authors believe that the vocal fold stiffens rather than thickens. […] The deficient voice production in patients with acute laryngitis may result in application of a greater adduction force or tension to compensate for the incomplete glottic closure during an acute laryngitic episode. This tension further strains the vocal folds and decreases voice production, ultimately delaying return of normal phonation. […] Patients with acute laryngitis have an increased open quotient value. This indicates that the patient’s vocal folds are open longer, and less time is spent in the closed position, which contributes to the hoarseness and breathiness of the voice.
  • #53 Laryngitis: Symptoms, causes, and treatments
    https://www.medicalnewstoday.com/articles/180271
    Laryngitis is swelling and inflammation of the larynx. Common causes include viral infections, overuse of the voice, acid reflux, smoking, and exposure to irritants and allergens. […] Laryngitis is an inflammation of the vocal cords. […] When a person has laryngitis, their vocal cords are swollen. […] As a result of this swelling, vocal fold vibration and mucosal wave will change, which alters the sound of the voice. […] In chronic laryngitis, the inflammation is ongoing. Vocal cords can become strained and develop growths, such as polyps or nodules. […] The most common cause of laryngitis is a viral infection. […] Overuse of the voice can also cause inflammation of the larynx, which can lead to laryngitis. […] There are a number of causes of chronic laryngitis. Common causes of chronic laryngitis include: acid reflux, a condition in which stomach acid and contents make their way up into the throat; bacterial, fungal, or parasitic infections; chronic sinusitis; excessive coughing; inhaling irritants, such as allergens or toxic fumes; high alcohol intake; habitual misuse or overuse of voice; smoking, including secondhand smoke; inhaling steroid medicines, such as asthma inhalers. […] Chronic laryngitis may require more extensive ongoing treatment. The cause of the inflammation will determine the specific treatment. […] If polyp or nodule growth causes damage to a person’s vocal cords and speech therapy is not successful, they may need surgery.
  • #54 Laryngitis: Symptoms, Causes, and Treatment
    https://patient.info/ears-nose-throat-mouth/laryngitis-leaflet
    Laryngitis is an inflammation of the mucus membranes of your voice box (larynx), which causes you to have a hoarse voice. It is most commonly due to an infection, usually a virus. […] Most cases of laryngitis are caused by a virus infection but there are many other possible causes. When caused by a virus infection, it usually starts suddenly and resolves within 1-2 weeks. […] Laryngitis is most often due to infection with a germ. The commonest germ causing laryngitis is a virus (viral laryngitis) although bacteria and fungi can also be causes of laryngitis. Other causes are much less common. […] Laryngitis may also be caused by a long period of screaming, yelling or singing very loudly. This causes your vocal cords to bang together which can make them inflamed. […] If laryngitis doesn’t settle after three weeks, it is called chronic laryngitis. Causes for this include less common infections, overuse of your voice, allergies, reflux of acid from the stomach, cigarette smoke, trauma or injury to your neck, other diseases, and certain medicines. […] Breathing difficulty is an uncommon complication with laryngitis. This may occur if there is a lot of inflammation and swelling in the voice box (larynx), which causes the windpipe (trachea) to narrow. […] Laryngoscopy also checks your hoarseness is not caused by anything more serious.
  • #55 Laryngitis: Symptoms, Causes & Treatment
    https://www.medicinenet.com/laryngitis/article.htm
    If the cause of laryngitis is vocal cord paralysis, the swallowing mechanism may also be affected, and food particles may enter the larynx and lungs, leading to coughing. This process can also lead to aspiration pneumonia and its accompanying symptoms when the food is aspirated deep into the lungs and causes irritation and inflammation of lung tissue.
  • #56 Laryngitis – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/laryngitis/symptoms-causes/syc-20374262
    Laryngitis is an inflammation of your voice box (larynx) from overuse, irritation or infection. […] But with laryngitis, your vocal cords become inflamed or irritated. This makes the vocal cords swell, which distorts the sounds produced by air passing over them. As a result, your voice sounds hoarse. In some cases of laryngitis, your voice can become almost undetectable. […] Most cases of laryngitis are temporary and improve after the underlying cause gets better. Causes of acute laryngitis include: Viral infections similar to those that cause a cold, Vocal strain, caused by yelling or overusing your voice, Bacterial infections, although these are less common. […] Laryngitis that lasts longer than three weeks is known as chronic laryngitis. This type of laryngitis is generally caused by exposure to irritants over time. Chronic laryngitis can cause vocal cord strain and injuries or growths on the vocal cords (polyps or nodules). Chronic laryngitis can be caused by: Inhaled irritants, such as chemical fumes, allergens or smoke, Acid reflux, also called gastroesophageal reflux disease (GERD), Chronic sinusitis, Excessive alcohol use, Habitual overuse of your voice (such as in singers or cheerleaders), Smoking. […] In some cases of laryngitis caused by infection, the infection may spread to other parts of the respiratory tract.
  • #57 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    The microbiome, comprised of all microbes and their genomes, is a complex system characterized by microbe-microbe and host-microbe interactions that influence various aspects of host physiology. […] To date, there has been a paucity of research examining the microbiota of laryngeal tissue and its role in mucosal health and disease. […] It has been suggested that Helicobacter pylori colonizes the surfaces of the larynx and that its detection is correlated with laryngeal inflammation and benign vocal fold lesions. […] The overarching aim of my developing line of research is to elucidate the pathophysiology of laryngeal inflammation by examining host factors such as local microbiota, immune cell responses, and epithelial barrier composition. […] Foundational studies investigating the specific biological mechanisms underlying laryngeal inflammation are much needed to improve treatment for chronic laryngitis.
  • #58 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    The microbiome, comprised of all microbes and their genomes, is a complex system characterized by microbe-microbe and host-microbe interactions that influence various aspects of host physiology. […] To date, there has been a paucity of research examining the microbiota of laryngeal tissue and its role in mucosal health and disease. […] It has been suggested that Helicobacter pylori colonizes the surfaces of the larynx and that its detection is correlated with laryngeal inflammation and benign vocal fold lesions. […] The overarching aim of my developing line of research is to elucidate the pathophysiology of laryngeal inflammation by examining host factors such as local microbiota, immune cell responses, and epithelial barrier composition. […] Foundational studies investigating the specific biological mechanisms underlying laryngeal inflammation are much needed to improve treatment for chronic laryngitis.
  • #59 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    The microbiome, comprised of all microbes and their genomes, is a complex system characterized by microbe-microbe and host-microbe interactions that influence various aspects of host physiology. […] To date, there has been a paucity of research examining the microbiota of laryngeal tissue and its role in mucosal health and disease. […] It has been suggested that Helicobacter pylori colonizes the surfaces of the larynx and that its detection is correlated with laryngeal inflammation and benign vocal fold lesions. […] The overarching aim of my developing line of research is to elucidate the pathophysiology of laryngeal inflammation by examining host factors such as local microbiota, immune cell responses, and epithelial barrier composition. […] Foundational studies investigating the specific biological mechanisms underlying laryngeal inflammation are much needed to improve treatment for chronic laryngitis.
  • #60 Acute Laryngitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534871/
    Laryngitis refers to inflammation of the larynx, most commonly caused by an acute viral infection, resulting in hoarseness, sore throat, and voice loss. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. […] As the edema progresses, the phonation threshold pressure can increase. […] The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] In such situations, referral to an otolaryngologist and/or speech-language pathologist is warranted.
  • #61 Acute Laryngitis | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/24052
    Laryngitis refers to larynx inflammation and can present in acute and chronic forms. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. This can encompass the supraglottic, glottic, or subglottic larynx (or any combination thereof), depending on the inciting organism. […] As the edema progresses, the phonation threshold pressure can increase. The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] If symptoms persist beyond this timeframe, it is either due to superinfection or a transition to chronic laryngitis.
  • #62 Acute Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864671-overview
    Laryngitis, an inflammation of the larynx, is one of the most common laryngeal conditions identified. It manifests in acute and chronic forms. […] The etiology of acute laryngitis includes vocal misuse, exposure to noxious agents, or infectious agents leading to upper respiratory tract infections. The infectious agents are most often viral but sometimes bacterial. […] Acute laryngitis is an inflammation of the vocal fold mucosa and larynx that lasts less than 3 weeks. When the etiology of acute laryngitis is infectious, white blood cells remove microorganisms during the healing process. The vocal folds then become more edematous, and vibration is adversely affected. The phonation threshold pressure may increase to a degree that generating adequate phonation pressures in a normal fashion becomes difficult, thus eliciting hoarseness.
  • #63 Acute Laryngitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534871/
    Laryngitis refers to inflammation of the larynx, most commonly caused by an acute viral infection, resulting in hoarseness, sore throat, and voice loss. […] The etiology of acute laryngitis can be classified as either infectious or non-infectious. The infectious form is more common and usually follows an upper respiratory tract infection. […] Acute laryngitis resolves within 2 weeks and is due to local inflammation of the vocal folds and surrounding tissues in response to a trigger, whether that trigger is infectious or non-infectious. […] Acute laryngitis is characterized by inflammation and congestion of the larynx in the early stages. […] As the edema progresses, the phonation threshold pressure can increase. […] The generation of adequate phonation pressure becomes more difficult, and the patient develops phonatory changes as a result of the changing fluid-wave dynamics of the inflamed and edematous tissue but also as a result of both conscious and unconscious adaptation to attempt to mitigate these altered tissue dynamics. […] In such situations, referral to an otolaryngologist and/or speech-language pathologist is warranted.
  • #64 Infectious or Allergic Chronic Laryngitis: Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/864767-overview
    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. Depending on the causes, the pattern of changes can be very different. Inflammation, edema, hyperemia, and infiltration and proliferation of the mucosa can represent different levels of response to insults. […] The inflammatory process damages the ciliated epithelium of the larynx, particularly in the posterior wall. This impairs the important function of moving the mucous flow out of the tracheobronchial tree. When the ciliary beating motion of the epithelium is impaired, the resultant mucus stasis on the posterior wall of the larynx and around the vocal cords provokes a reactive cough. Mucus across the vocal cords may manifest with laryngospasm. Significant changes may arise in the vocal cord epithelium in the form of hyperkeratosis, dyskeratosis, parakeratosis, acanthosis, and cellular atypia.
  • #65 Hoarseness: When to observe and when to refer | Cleveland Clinic Journal of Medicine
    https://www.ccjm.org/content/90/8/475
    Vocal-fold nodules are bilateral fibrous swellings along the junction of the medial edge of the anterior and middle third of the true vocal folds. They act like calluses and prevent the propagation of a smooth mucosal wave, resulting in dysphonia. They are secondary to functional voice disorders and vocal abuse or misuse; 80% of patients will recover with voice therapy alone, while those with recalcitrant lesions may require surgical excision. […] Reinke edema is also referred to as polypoid corditis and involves swelling of the true vocal folds owing to accumulation of fluid within the potential space between the superficial lamina propria and the vocal ligaments (also called the Reinke space). The fluid accumulation is due to subepithelial hypervascularity, leading to vascular permeability and the disruption of collagen deposition. Reinke edema is almost exclusively caused by smoking, but vocal abuse or laryngopharyngeal reflux may also play a role. Primary treatment is smoking cessation, treating reflux, and voice therapy. Severe obstructive Reinke edema may require surgery after these conservative treatments.
  • #66 Toward an Understanding of the Pathophysiology of Chronic Laryngitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7451247/
    Chronic laryngitis, characterized by inflammation of the laryngeal tissues, is the most commonly diagnosed organic voice disorder, yet treatments targeting suspected etiologic factors have demonstrated limited efficacy. […] A major barrier to the development of improved medical therapies for chronic laryngitis is a fundamental gap in knowledge related to the pathophysiology of laryngeal inflammation. […] An incomplete understanding of the pathophysiology of laryngeal inflammation is a major barrier to the development of improved medical therapies for chronic laryngitis. […] It has been hypothesized that the larynx is an important organ for immunological decision-making in the airway. […] There is evidence that the larynx has a distinct immunological blueprint designed to address these challenges.

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