Chronic Laryngitis

What Is It?

Laryngitis is an inflammation of the larynx, the "voice box" that contains the vocal cords in the upper portion of the neck. Laryngitis occurs in two forms, acute and chronic. Acute laryngitis typically is a brief illness producing hoarseness and a sore throat. In most cases, an upper respiratory tract infection causes it. Chronic laryngitis is a more persistent disorder that produces lingering hoarseness and other voice changes. It usually is painless and has no significant sign of infection.

Among adults, the most common causes of chronic laryngitis are:

• Smoking - Cigarette smoke irritates the larynx, causing swelling and inflammation that thickens the vocal cords. This thickening can lower the pitch of the voice or make it sound raspy and harsh.

• Drinking alcohol heavily - Alcohol causes a chemical irritation of the larynx that produces changes similar to those seen in smokers.

• Gastroesophageal reflux disease (GERD) - GERD is a disorder in which acidic fluids from the stomach flow backward (reflux) into the esophagus and throat, irritating the larynx. Because acid reflux usually is worse when lying down, the hoarseness caused by GERD often is most noticeable in the morning right after awakening. Although some people with GERD also suffer from heartburn, indigestion and other symptoms related to the digestive tract, these symptoms are absent in 60% to 80% of people who have chronic laryngitis because of GERD. Instead, these people usually have a large number of complaints involving the nose and throat, including the sensation of having a lump in the throat (a symptom called globus), a persistent need to clear the throat, heavy mucus in the throat, chronic cough or postnasal drip, or discomfort during swallowing.

• Work-related exposure to irritating chemicals or dusts - Many industrial products are suspected of causing chronic laryngitis and other respiratory problems. Among them are petroleum products, pesticides, solvents, adhesives and glues, materials found in new carpets, cleaning agents, fiberglass, carpet shampoos and industrial cleaning agents, isocyanates, formaldehyde, glutaraldehyde, ammonium, and even certain types of stage fog. The U.S. Department of Labor monitors many of these products and provides safety guidelines for handling and exposure through the Occupational Safety and Health Administration (OSHA).

• Voice abuse or misuse - This means talking too much or too loudly. It can be an ongoing problem for people whose jobs depend on their voices, including singers, actors, telephone operators, lawyers, teachers, referees, coaches and anyone who must shout over loud noise at work (construction workers, personnel in airports and train stations, factory workers). Even children can develop chronic laryngitis from voice overuse or misuse, especially if they shout or strain their voices during choir practice, cheerleading or playground games.