Laryngitis is an inflammation of the larynx, characterized by symptoms such as hoarseness and cough, and can be classified into acute and chronic types. The condition is influenced by factors such as age, gender, seasonal incidence, and infectious or non-infectious causes, with medical management tailored to its etiology. Prevention strategies include avoiding respiratory infections, smoking cessation, and proper hydration, while nursing interventions focus on alleviating symptoms and supporting airway clearance.

1. LARYNGITIS

2. OBJECTIVES
• Introduction
• Definition
• Classification
• Epidemiology
• Etiology
• Risk factors
• Pathophysiology
• Clinical manifestations
• Medical management
• Nursing management
• Nursing Diagnosis
• Diagnostic tests
• Prevention
• Bibliography

3. LARYNX

4. DEFINITION
● Laryngitis is an inflammation of larynx ( voice box ) from overuse ,
irritation or infection.
● It leads to edema of laryngeal mucosa and underlying structures.

5. CLASSIFICATION OF LARYNGITIS
Based on the duration of symptoms, laryngitis may be classified into:-
ACUTE LARYNGITIS:- It has an abrupt onset and is self - limiting ; typically, it clears
within 3-5 days.
CHRONIC LARYNGITIS:- It lasts for greater than 3 weeks.

6. EPIDEMIOLOGY
AGE:-
• Acute laryngitis commonly affects children.
• The prevalence of laryngitis decreases with age.
GENDER:-
• Men are more commonly affected with laryngitis than women.
SEASON:-
• The incidence of laryngitis in the winter is double than that of the summer.

7. ETIOLOGY
INFECTIOUS:-
• VIRAL LARYNGITIS:- Can be caused by Rhinovirus, Influenza virus, Parainfluenza
virus, Adenovirus, Coronavirus and RSV(Respiratory Syncytial virus).
• BACTERIAL LARYNGITIS:- Can be caused by Group A Streptococcus, Streptococcus
pneumoniae, C.diphtheriae, M.catarrhalis, Haemophilus influenzae, Bordetella
Pertussis and M.tuberculosis.
• FUNGAL LARYNGITIS:- Can be caused by Histoplasma, Candida(especially in
immunocompromised persons).

8. NON-INFECTIOUS:-
• Inhaled fumes.
• Acid reflux diseases.
• Allergies.
• Excessive coughing, smoking or alcohol consumption.
• Inflammation due to overuse of the vocal cords.
• Prolonged use of inhaled corticosteroids for asthma treatment.
• Thermal or chemical burns.
• Laryngeal trauma, including iatrogenic one caused by endotracheal intubation.

9. RISK FACTORS
• Upper respiratory infection.
• Asthma.
• Cigarette smoking.
• Polluted air.
• Winter season.
• Young age.
• Autoimmune disorders, such as rheumatoid arthritis and sarcoidosis.
• Overactive vocal activity.
• Gastroesophageal reflux disease(GERD).

10. PATHOPHYSIOLOGY
Due to etiological
factors
Inflammation of causative organism into laryngeal mucosa and non- infectious
disease.
Antigen-Antibody reaction.

11. Histamine and Prostaglandin release.
Inflammation of laryngeal mucosa.
Edematous of vocal cords.
Persistent voice disability

12. CLINICAL MANIFESTATIONS
• Hoarseness or Aphonia(?).
• Severe cough.
• Dysphagia.
• Cold or flu-like symptoms.
• Swollen lymph nodes in the throat, chest or face.
• Hemoptysis.
• Fever.
• Body aches,
• Malaise.

13. MEDICAL MANAGEMENT
Viral laryngitis:-
• There is no treatment for viral laryngitis ; the mainstay of therapy is supportive care.
• Ibuprofen and Aspirin may help alleviate fever and some of the discomfort associated with laryngitis.
• HUmidifiers and warm showers can also help alleviate some symptoms.
• Steroids may be prescribed to help accelerate the healing if significant inflammation is present.
Gastroesophageal reflux laryngitis:-
• The mainstay of therapy for gastroesophageal reflux laryngitis is an H2 antagonist(eg. ranitidine) or
a Proton Pump Inhibitor(PPI)(eg. omeprazole, esomeprazole, pantoprazole). These drugs may be
prescribed for a period between 4-6 weeks.

14. MEDICAL MANAGEMENT(cont.)
Bacterial laryngitis:-
• The patient may be prescribed a course of antibiotics however, there is a little
evidence to demonstrate the efficacy of oral antibiotics for laryngitis.

15. NURSING INTERVENTION
I) To prevent dryness or irritation to the vocal cords:
• Do not smoke and avoid passive smoking. Smoke dries throat and irritates the vocal cords.
• Drink plenty of water. Fluid helps keep the mucous in the throat thin and easy to clear.
• Advice the patient to avoid clearing the throat. This does more harm than good , because
it causes an abnormal vibration of the vocal cords and can increase swelling and causes
the throat to secrete more mucous and feel more irritated.
• Avoid upper respiratory infections. Make sure annual flu shot is taken as per doctors
recommendation.
• Avoid alcohol and caffeine.

16. NURSING INTERVENTION(cont.)
II) The following steps may relieve the symptoms of laryngitis and reduce strain on
voice:
• Use a humidifier:- Keep the air throughout the house moist. Try a cool mist
humidifier. Avoid air conditioning.
• Drink plenty of food to prevent dehydration.
• Give your voice a break.
• Steam Inhalation.

17. NURSING DIAGNOSIS
• Ineffective airway clearance, may be related to presence of thick ,tenacious mucus/
edema and constriction of the airway, possibly evidenced by hoarseness/ thick
secretions/ irritability/ persistent barking(croupy) cough, etc.
• Anxiety, may be related to change in health status of infant or small child/ change in
environment<hospitalization>, possibly evidenced by crying and clinging
behaviour(infant or small child)/ persistent cough and difficult in breathing.
• Fatigue, may be related to dyspnea, possibly evidenced by inability to eat/exhausted
appearance/ lethargy.

18. NURSING DIAGNOSIS(cont.)
• Ineffective breathing pattern, may be related to inflammatory process, possible
evidenced by barking , metallic sounding cough / nasal flaring.
• Deficient knowledge, may be related to caregiving to prevent complication and
promote recovery as evidenced by parents or relatives or patient asking information
regarding home care and preventive measures.

19. DIAGNOSTIC TESTS
• Diagnosis is based upon a combination of the complete history and physical examination.
• if symptoms are severe, particularly in children ,the doctor may order an X-ray of the neck
and chest.
• Sometimes in children and rarely in adults, the doctor may order blood test such as
CBC(complete blood count).
• LARYNGOSCOPY:- Doctors can visually examine vocal cords in a procedure called
laryngoscopy, by using a light and a tiny mirror to look into the back of the throat. Tis
involves inserting a thin, flexible tube with a tiny camera and light through nose or mouth
and into the back of the throat.

20. PREVENTION
PRIMARY PREVENTION
Effective measures for the primary prevention of laryngitis includes:-
• Avoidance of people who have upper respiratory infections during cold and flu season.
• Avoidance of crowded places.
• Regular hand washing.
• Smoking cessation.
SECONDARY PREVENTION
Effective measures for the secondary prevention of laryngitis includes:-
• Avoidance of spicy foods.
• Avoidance of throat clearing.
• Increased fluid intake.
• Limit vocal cord usage.

21. BIBLIOGRAPHY
• Sharma S, Hinkle J, et al. Brunner and Suddarth’s textbook of medical- surgical
nursing. volume II, south asian ed.Haryana : wolter; 2019.
• https://www.slideshare.com
• https://www.osmosis.org