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Acute and chronic laryngitis - Treatment
Last reviewed: 04.07.2025
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[ Indications for hospitalization
Treatment of acute catarrhal laryngitis is carried out on an outpatient basis. All patients with edematous laryngitis, epiglottitis and abscesses of the epiglottis, complicated forms of the disease (infiltrative and abscessing) with a threat of developing laryngeal stenosis and injuries are subject to hospitalization. Hospitalization is also indicated if surgical treatment is necessary.
Non-drug treatment of acute and chronic laryngitis
Of great importance is the limitation of the voice load, while whispering is prohibited. High clinical efficiency has been proven by local anti-inflammatory, especially inhalation therapy. For this purpose, antibacterial, mucolytic, hormonal medicinal herbs and herbal preparations with anti-inflammatory and antiseptic effect, as well as mineral water are used. Good effect is achieved by the use of physiotherapeutic methods: electrophoresis of 1% potassium iodide, hyaluronidase or calcium chloride on the larynx, therapeutic laser, microwaves, phonophoresis, including endolaryngeal, etc. In complicated abscessing and phlegmonous laryngitis, chondroperichondritis, hyperbaric oxygenation can be used. In the recovery stage and in cases where intense phonation is one of the etiopathogenetic factors in the development of hypotonic disorders of the vocal function as a result of inflammation, phonopedics and stimulating therapy are indicated.
Drug treatment of acute and chronic laryngitis
Of great importance is the treatment of concomitant pathology of the upper and lower respiratory tract, immune status, and gastroesophageal reflux.
Antibacterial therapy for acute laryngitis and exacerbation of chronic laryngitis with severe inflammatory phenomena with the addition of purulent exudation is prescribed empirically, using broad-spectrum drugs (amoxicillin + clavulanic acid, fluoroquinolones). Perioperative antibiotic therapy is prescribed in case of surgical intervention with direct microlaryngoscopy, implantation methods of correction, a large volume of intervention. Antifungal drugs are prescribed for fungal laryngitis. Anti-edematous and desensitizing therapy is carried out, in the presence of viscous sputum or dryness of the mucous membrane, mucolytics and secretolytics, enzyme preparations, stimulating and resorptive therapy, drugs that improve microcirculation and neuromuscular transmission, and also increase muscle tone are prescribed. The use of specific therapy for specific laryngitis does not exclude the use of local and general anti-inflammatory therapy. Much attention should be paid to the treatment of patients with infiltrative and abscessing laryngitis. They are prescribed massive detoxification therapy, parenteral nutrition, correction of water-salt metabolism, intravenous antibacterial therapy.
Surgical treatment of acute and chronic laryngitis
In case of abscessing laryngitis, abscesses are opened during indirect laryngoscopy with a Tobolt knife. In case of complications in the form of phlegmon of the neck or mediastinitis, combined surgical treatment is performed using external and endolaryngeal access.
In case of chronic hyperplastic laryngitis, decortication of the vocal cords and targeted biopsy are performed using direct and indirect laryngoscopy.
In case of edematous-polypous laryngitis, two surgical interventions are possible: decortication of the vocal folds according to Kleinsaster and the Hirano method. In case of decortication of the vocal folds, it is necessary to preserve the epithelium in the commissure area on both sides to avoid their subsequent fusion and the formation of a cicatricial membrane or adhesion. The essence of the Hirano method: an incision is made along the lateral edge of the vocal folds, the gelatinous mass is aspirated, excess epithelial tissue is excised with scissors, and the remaining is placed on the vocal fold. Laser techniques are also used.
Further management
Patients of voice professions after acute laryngitis are recommended to be observed by a phoniatrist until the voice is fully restored. Patients who have undergone endolaryngeal interventions are observed until the clinical and functional state of the larynx is fully restored for an average of 3 months with examinations once a week in the first month and once every 2 weeks, starting from the second month. Patients with chronic hyperplastic laryngitis should be registered with a dispensary with examinations every 3 months, and every six months if the course is favorable.
The period of incapacity for work depends on the patient's profession: in vocal professions, it is extended until the voice function is restored. Uncomplicated acute laryngitis resolves within 7-14 days; infiltrative forms - about 14 days. In surgical treatment of chronic forms of laryngitis, the period of incapacity for work ranges from 7 days to 1 month in persons of vocal professions with complete decortication of the vocal folds.
Information for the patient
In the development of acute laryngitis, it is necessary to limit the vocal load. It is forbidden to eat hot, cold and spicy food, drink alcoholic beverages, smoke, and inhale steam. Constant humidification of the air in the room with the help of special humidifiers is recommended.