Acute Laryngitis Workup

  • Author: Rahul K Shah, MD, FACS, FAAP; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Jul 22, 2011
 

Laboratory Studies

  • No laboratory studies are necessary. If the patient has an exudate in the oropharynx or overlying the vocal folds, a culture may be taken. As Vaughan indicates, do not institute antibiotic coverage until the results of the Gram stain and cultures with sensitivity have been determined.[2]
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Imaging Studies

  • Direct fiberoptic or indirect laryngoscopy may be performed to provide a view of the larynx. This examination reveals redness and small dilated vasculature on the inflamed vocal folds.
  • Analysis of vocal fold movement reveals asymmetry and aperiodicity with reduced mucosal waves and incomplete vibratory closure. The propagation of the mucosal wave is also reduced. Ng describes a finding by Colton and Casper that the mucosal wave appears to have 2 distinct velocities of travel.[1] The wave travels at 1 speed on the surface of the vocal fold; but, at a discrete point, it changes its speed of travel. Indeed, this change may be because of the edema and intrinsic inflammation of the vocal fold, which affects the inherent motion of the vocal fold in an irregular manner.
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Contributor Information and Disclosures
Author

Rahul K Shah, MD, FACS, FAAP  Assistant Professor of Otolaryngology and Pediatrics, George Washington University School of Medicine and Health Sciences; Attending Physician, Department of Otolaryngology, Children's National Medical Center

Rahul K Shah, MD, FACS, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American College of Medical Quality, American College of Physician Executives, American College of Surgeons, Massachusetts Medical Society, Phi Beta Kappa, and Triological Society

Disclosure: Nothing to disclose.

Specialty Editor Board

John M Truelson, MD, FACS  Chairman, Division of Head and Neck Surgery, Associate Professor, Department of Otorhinolaryngology, University of Texas Southwestern Medical Center at Dallas

John M Truelson, MD, FACS is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, Phi Beta Kappa, and Texas Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Erik Kass, MD  Chief, Department of Clinical Otolaryngology, Associates in Otolaryngology of Northern Virginia

Erik Kass, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for Cancer Research, American Medical Association, and American Rhinologic Society

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Stanley Shapshay, MD, to the development and writing of this article.

References

  1. Ng ML, Gilbert HR, Lerman JW. Some aerodynamic and acoustic characteristics of acute laryngitis. J Voice. Sep 1997;11(3):356-63. [Medline].

  2. Vaughan CW. Current concepts in otolaryngology: diagnosis and treatment of organic voice disorders. N Engl J Med. Sep 30 1982;307(14):863-6. [Medline].

  3. Postma GN, Koufman JA. Laryngitis. In: Bailey BJ, ed. Head and Neck Surgery-Otolaryngology. 2nd ed. Philadelphia, Pa: Lippincott-Raven; 1998:731-739.

  4. Schalén L. Acute laryngitis in adults: diagnosis, etiology, treatment. Acta Otolaryngol Suppl. 1988;449:31. [Medline].

  5. Thompson L. Herpes simplex virus laryngitis. Ear Nose Throat J. May 2006;85(5):304. [Medline].

  6. Schalen L, Christensen P, Eliasson I, et al. Inefficacy of penicillin V in acute laryngitis in adults. Evaluation from results of double-blind study. Ann Otol Rhinol Laryngol. Jan-Feb 1985;94(1 Pt 1):14-7. [Medline].

  7. Reveiz L, Cardona AF, Ospina EG. Antibiotics for acute laryngitis in adults. Cochrane Database Syst Rev. Apr 18 2007;CD004783. [Medline]. [Full Text].

  8. Modlin IM, Moss SF, Kidd M, et al. Gastroesophageal reflux disease: then and now. J Clin Gastroenterol. May-Jun 2004;38(5):390-402. [Medline].

  9. Katz PO. Gastroesophageal reflux disease--state of the art. Rev Gastroenterol Disord. 2001;1(3):128-38. [Medline].

  10. [Guideline] Kahrilas PJ, Shaheen NJ, Vaezi MF, Hiltz SW, Black E, Modlin IM, et al. American Gastroenterological Association Medical Position Statement on the management of gastroesophageal reflux disease. Gastroenterology. Oct 2008;135(4):1383-1391, 1391.e1-5. [Medline].

  11. Donoso A, Linares M, Leon J, et al. Activated charcoal laryngitis in an intubated patient. Pediatr Emerg Care. Dec 2003;19(6):420-1. [Medline].

  12. Dworkin JP. Laryngitis: types, causes, and treatments. Otolaryngol Clin North Am. Apr 2008;41(2):419-36, ix. [Medline].

  13. Reveiz L, Cardona AF, Ospina EG. Antibiotics for acute laryngitis in adults. Cochrane Database Syst Rev. Jan 25 2005;CD004783. [Medline].

  14. Spiegel JR, Hawkshaw M, Markiewicz A, et al. Acute laryngitis. Ear Nose Throat J. Jul 2000;79(7):488. [Medline].

 
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This view depicts the larynx of a 62-year-old woman with an intermittent history of exudative acute laryngitis that was treated conservatively. Courtesy of Ann Kearney, Palo Alto, Calif.
This view depicts the larynx of a 53-year-old woman, a sixth-grade science teacher, whose chief symptom was a hoarse and breathy voice. Note the alternating areas of erythema and normal mucosa on the vocal folds. Also note irregularities in the contour of the vocal folds. Courtesy of Ann Kearney, Palo Alto, Calif.
 
 
 
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