The condition is self – limiting and most patients will feel better within two weeks.
Referral for urgent management is indicated in acute airway compromise or presumed epiglottitis.
Management options include: (1)
- vocal hygiene
- care of voice is beneficial in relieving symptoms in all patients with vocal difficulties
- voice rest
- periods of voice rest may vary between 48 hours to one week. Recommendation is to rest the voice until patients find it comfortable to hum
- whispering also should be avoided (whispering strains the voice more than normal speech)
- modest speech can be resumed after voice rest
- hydration
- especially important in patients who snore or mouth-breathe at night
- chewing sugar-free gum, or increase in total fluid intake (250 mL per waking hour) is beneficial
- humidification
- by using a humidifier
- by inhalation of steam
- by avoiding air conditioning and dry heat
- limiting caffeine intake
- caffeine exacerbates both snoring and pharyngolaryngeal irritation.
- less than two standard espressos a day is recommended
- various sodas and “smart drinks” which contains caffeine should also be avoided
- stop any predisposing factor - for example, stop smoking or alcohol
- antibiotics
- there is limited evidence about benefits of antibiotics in the treatment of acute laryngitis
- one Cochrane review concluded that there appears to be no clinically significant benefit to the use of antibiotics to treat acute laryngitis (2)
- should be considered in patients who have a persistent fever (for more than 48 hours), purulent sputum, associated distant disease or other problems such as immune system deficiency (1)
Evidence in the literature for corticosteroid use for acute laryngitis is incomplete (3)
Small children with subglottic oedema should be admitted to hospital for possible respiratory support because of the risk of airway obstruction.
References:
- (1) Wood JM, Athanasiadis T, Allen J. Laryngitis. BMJ. 2014;349:g5827
- Reveiz L, Cardona AF. Antibiotics for acute laryngitis in adults. Cochrane Database Syst Rev. 2015;(5):CD004783
- Ingle JW, Helou LB, Li NY, et al. Role of steroids in acute phonotrauma: a basic science investigation. Laryngoscope. 2014 Apr;124(4):921-7.