Infectious or Allergic Chronic Laryngitis 

  • Author: Stefano Berliti, MD, FACP; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Aug 11, 2011
 

Background

Chronic laryngitis is a current topic of interest, primarily because of newly identified etiopathogenetic factors related to the change in the quality of environmental pollutants and toxic products found in workplaces. The continuous evolution of such factors constitutes a challenge for medical experts, who must update their knowledge of new toxic/irritative materials being used by the industrial market. The need to implement strategies that recognize the deleterious effects on the human body and to use necessary corrective therapies represents a very active research field. Symptoms of chronic laryngitis can be present in otherwise healthy people.

Illustration of the larynx. Illustration of the larynx.
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Pathophysiology

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 mucous stasis on the posterior wall of the larynx and around the vocal cords provokes a reactive cough. Mucous 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.

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Epidemiology

Frequency

United States

The authors found no data regarding precise frequency. Because chronic laryngitis is usually part of a more complex disease, it is probably underreported.

Mortality/Morbidity

Chronic laryngitis presents a frustrating treatment problem. Voice loss, chronic cough, and airway obstruction, respectively, are the most likely complications. An association with cancer of the larynx is unclear. Mortality is obviously related to the main disease with which chronic laryngitis is associated.

Race

The condition apparently affects all races equally.

Sex

Traditionally, men have been mostly affected. In recent reports, a 2:1 male predominance still exists; however, the trend is changing, probably because of more women smoking cigarettes and their increasing involvement in work activities in toxic environments.

Age

Adults in the sixth decade of life are mainly affected. Neonates and infants share similar risk factors with adults for developing chronic laryngitis. Additionally, various congenital lesions of the larynx may present with voice changes.

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Contributor Information and Disclosures
Author

Stefano Berliti, MD, FACP  Physician, Department of Medicine - Geriatrics, Kent and Canterbury Hospital, East Kent Hospitals University Trust, UK

Stefano Berliti, MD, FACP is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Michael Omidi, MD  Staff Physician, Department of Surgery, Northwestern University Memorial Hospital

Disclosure: Nothing to disclose.

Barry L Wenig, MD, MPH, FACS  Professor, Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University; Chief, Division of Otolaryngology-Head and Neck Surgery, Evanston Northwestern Healthcare

Barry L Wenig, MD, MPH, FACS is a member of the following medical societies: Academy of Medicine of New Jersey, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Bronchoesophagological Association, American College of Surgeons, American Laryngological Association, American Laryngological Rhinological and Otological Society, American Medical Association, American Rhinologic Society, American Society for Head and Neck Surgery, American Society for Laser Medicine and Surgery, Association for Research in Otolaryngology, Chicago Medical Society, New York Academy of Medicine, New York Academy of Sciences, New York Head and Neck Society, Society for Ear, Nose and Throat Advances in Children, and Society of University Otolaryngologists-Head and Neck Surgeons

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

Robert M Kellman, MD  Professor and Chair, Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University

Robert M Kellman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Neurotology Society, American Rhinologic Society, American Society for Head and Neck Surgery, Medical Society of the State of New York, and Triological Society

Disclosure: GE Healthcare Honoraria Review panel membership; Revent Medical Honoraria Review panel membership

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

References

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Illustration of the larynx.
Illustration of the glottic and supraglottic larynx.
Illustration of the larynx, posterior view.
Illustration of the larynx, nasopharyngeal view.
Illustration of the intrinsic muscles of the larynx, sagittal view.
Illustration of the intrinsic muscles of the larynx, sagittal view.
Illustration of the extrinsic muscle insertions of the larynx.
Illustration of the intrinsic muscles of the larynx, superior view.
Illustration of the intrinsic muscles of the larynx.
 
 
 
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