Infectious or Allergic Chronic Laryngitis

Updated: Apr 20, 2015
  • Author: Stefano Berliti, MD, FACP; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Overview

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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