Binaya Bhandari BDS, 1st Batch, Kathmandu University School Of Medical Science, Dhulikhel, Kavre Nepal

1. Inflammatory Disorders Of Larynx
Binaya Bhandari
Roll no. 4
BDS,1st Batch,KUSMS ,Nepal

3. Classification
Acute infections;
-Acute simple laryngitis
-Acute epiglottitis
-Viral LTB
-Bacterial LTB
-Spasmodic croup
Chronic infections;
-Chronic laryngitis
-Tuberculosis
-Scleroma
-Candidiasis
-Sarcoidosis
Laryngeal edema
Laryngo-Pharyngeal
Reflux Disease (LPRD)
Inflammatory Disorders Of Larynx

4. Acute Laryngitis
 Definition;
It is the acute inflammation of larynx leading to
oedema of laryngeal mucosa and underlying
structures.

5. Aetiology
Infectious;
Viral – Influenza, Parainfluenza, Rhino virus
Bacterial – H.influenzae, Strept. Pneumoniae, H.
Streptococci
Non Infectious;
Inhaled fumes
Allergy
Polluted atmospheric conditions
Vocal abuse
Iatrogenic trauma

6. Inhaled Fumes Polluted atmospheric conditions
Vocal abuse Trauma

7. Pathology
 The mucosa of the larynx becomes congested and may
become oedematous.
 A fibrinous exudate may occur on the surface.
 Sometimes infection involves the perichondrium of
laryngeal cartilages producing perichondritiis.

8. Clinical Features
 Hoarseness which may lead to complete loss of voice
 Discomfort or pain in throat, particularly after talking
 Dry, irritating cough which is usually worse at night
 General symptoms including headache, cold, dryness
of throat, malaise and fever if laryngitis has followed
viral infection of upper respiratory tract.

9. Clinical Diagnosis
 Signs of acute URTI.
 Dry thick sticky secretions.
 Dusky red and swollen vocal cords.
 Diffuse congestion of laryngeal mucosa.

10. Differential Diagnosis
 Acute epiglottitis
 Acute laryngo tracheo bronchitis.
 Laryngeal perichondritis
 Laryngeal oedema
 Laryngeal diphtheria
 Reinke’s oedema

11. Treatment
Supportive;
Voice rest.
Steam inhalation.
Cough suppressants.
Avoid smoking and cold.
Fluid intake.
Definitive;
Antibiotics
Steroids
Analgesics

12. Chronic Laryngitis
 Definition;
It is a diffuse inflammatory condition symmetrically
involving the whole larynx, i.e. true cords, ventricular
bands, interarytenoid region and root of epiglottis.

13. Aetiology
 It may follow incompletely resolved acute simple laryngitis or
its recurrent attack
 Presence of Ch. Infections PNS, teeth, tonsils and chest.
 Occupational factors – exposure to dust and fumes such as in
miners, strokers, gold, iron smiths and workers in chemical
industries
 Smoking and alcohol
 Persistent trauma of cough as in chronic lung disease
 Vocal abuse

14. Clinical Features
 Hoarseness. This is the commonest complaint. Voice
become easily tired and patient becomes aphonic by
end of the day
 Constant hawking. There is dryness and intermittent
tickling in the throat and patient is compelled to clear
the throat repeatedly
 Discomfort in the throat
 Cough. It is dry and irritating

15. Clinical Diagnosis
 Diagnosis is based upon a combination of the clinical
history and a physical exam. Some physicians might
wish to do a laryngoscopy (visualization of the vocal
cords).
Hyperemia of laryngeal structures
Vocal cords appear dull red or rounded
Flecks of viscid mucus are seen on the vocal cords and
interarytenoid region

16. Differential Diagnosis
Reinkes oedema
Vocal nodules
Vocal cord polyp
Contact ulcer
Hyperkeratosis and leukoplakia
Atrophic laryngitis
Laryngeal lupus
Tuberculous laryngitis

17. Treatment
 Eliminate URTI/LRTI
 Avoidance of irritating factors
 Voice rest and speech therapy
 Steam inhalations
 Expectorants
 Antibiotics

18. References
 Diseases of Ear, Nose and Throat – P L Dhingra , 3rd edition
 Atlas of Acute and Chronic Laryngitis
 www.healthline.com
 www.patient.co.uk/health/
 www.myoclinic.org
 www.emedicine.medscape.com
Any Queries ???