Contact your doctor immediately if you have difficulty breathing, if you are coughing up blood, or if you have symptoms of a bacterial infection Table 02. If you are having difficulty breathing, swelling of your vocal cords may be obstructing your airway. Your physician will monitor the condition to ensure that the airway remains open. In extreme cases, an emergency tracheotomy may be necessary.
Coughing up blood is a sign of severe lesions in the throat, esophagus, bronchial tubes, or lungs. Any sign of blood in the sputum should be examined immediately by a physician.
Bacterial infections should be evaluated and treated with antibiotics. Symptoms of these infections include high fever (in excess of 101.5°F or 38.5°C), fever that persists for several days, colored nasal discharge (yellow, green, gray, or rust-colored), sinus pain, or pain localized in one ear.
Table 2. Warning Signs Your Laryngitis May Be Serious
Difficulty breathing Blood in sputum Symptoms of bacterial infection (fever >104?F or 40?C, colored nasal discharge, localized pain in sinuses or ears)
Resting your voice is the primary treatment for acute laryngitis. Other home therapies may ease laryngitis symptoms. Talk softly, but don't whisper, because whispering is as hard on the vocal cords as speaking. Avoid clearing your throat as much as possible, and drink plenty of liquids (preferably water) to dilute the mucus. Gargling with warm saltwater (one teaspoon in eight ounces of water) may reduce throat soreness. Drinking honey in hot water or weak tea may also help. Using a humidifier or taking a hot shower reduces dryness, eases the symptoms, and promotes healing.
If you smoke, quitting will reduce throat irritation and your risk of developing other smoking-related diseases such as cancer and emphysema. Cigarette and cigar smoke can damage the linings of the mouth, throat, and lungs. Experiencing laryngitis should serve as a warning to stop. Laryngitis in smokers may be the first sign of laryngeal cancer.
If you have been diagnosed with acid reflux disease, changing your diet and lifestyle may reduce your symptoms. Avoiding fatty foods, caffeinated beverages, alcohol, chocolate, spicy foods, and foods high in acid (e.g., tomato-based foods) may reduce acid reflux. Eating smaller meals and not eating near bedtime can reduce the amount of acid in your stomach when you are sleeping.
Elevating the head of your bed by placing blocks under the bedposts may help keep the acid in your stomach and away from your esophagus and throat. Simply using additional pillows is not effective, as they can be displaced during sleep.
Your doctor is the best source of information on the drug treatment choices available to you.
Treatment for chronic laryngitis requires identifying and eliminating the underlying cause, if possible. Chronic laryngitis reflects chronic irritation of the vocal cords. To prevent recurrence of inflammation, the underlying cause must be eliminated or corrected. Chronic abuse of the voice may be corrected with vocal training. Chronic acid reflux may be eliminated with dietary changes or drug therapy. Chronic hoarseness caused by nerve damage or cancer may not be completely reversible.
In cases in which swelling of the vocal cords closes the airway, an emergency tracheotomy may be required. Surgery is rarely required for laryngitis. In cases where swelling is so severe that the airway closes, however, an emergency tracheotomy may be required. A tracheotomy procedure involves piercing a hole in the trachea, allowing the patient to breathe through the hole rather than through the nose or mouth.
Most cases of laryngitis resolve within a few days to a week. Acute laryngitis almost invariably resolves after the infection or other transient cause is cleared. Although chronic inflammation can lead to permanent changes in the vocal cords, most people with chronic laryngitis recover completely when the underlying cause (e.g., smoking, allergy, acid reflux) is eliminated. Chronic laryngitis caused by nerve damage or cancer, however, usually does not fully resolve.
Follow-up is generally not required for acute laryngitis. For most cases, resting your voice and treating your symptoms at home are all that is necessary for viral laryngitis. Contact your doctor if your laryngitis persists for more than two weeks after other symptoms of your infection resolve. When being treated with antibiotics for bacterial infections related to acute laryngitis, you may need to visit your doctor after youve completed your course of therapy to ensure that the infection has cleared.
Follow-up for chronic laryngitis depends on the underlying cause. In most cases, you will need to visit your doctor several times during the course of diagnosis and treatment. The frequency and duration of these visits will vary depending on the cause.
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