Background

Laryngitis is one of the most common conditions

identified in the larynx. Laryngitis, an
inflammation of the larynx, manifests in both acute
and chronic forms.

Acute laryngitis has an abrupt onset and is usually
self-limited. If a patient has symptoms of laryngitis
for more than 3 weeks, the condition is classified as
chronic laryngitis. The etiology of acute laryngitis
includes vocal misuse, exposure to noxious agents,
or infectious agents leading to upper respiratory
tract infections. The infectious agents are most
often viral but sometimes bacterial.

See the image below.

This view depicts the larynx of a 62-year-old woma
This view depicts the larynx of a 62-year-old
woman with an intermittent history of exudative
acute laryngitis that was treated conservatively.
Courtesy of Ann Kearney, Palo Alto, Calif.
Rarely, laryngeal inflammation results from an
autoimmune condition such as rheumatoid arthritis,
relapsing polychondritis, Wegener granulomatosis,
or sarcoidosis. A case report showed a 2-year-old
intubated patient who was given activated charcoal
for poisoning, resulting in obstructive laryngitis.
This unusual case demonstrates the myriad
potential etiologies of acute laryngitis.

Chronic laryngitis, as the name implies, involves a
longer duration of symptoms; it also takes longer to
develop. Chronic laryngitis may be caused by
environmental factors such as inhalation of
cigarette smoke or polluted air (eg, gaseous
chemicals), irritation from asthma inhalers, vocal
misuse (eg, prolonged vocal use at abnormal
loudness or pitch), or gastrointestinal esophageal
reflux. Vocal misuse results in an increased
adducting force of the vocal folds with subsequent
increased contact and friction between the
contacting folds. The area of contact between the
folds becomes swollen. Vocal therapy has the
greatest benefit in the patient with chronic
laryngitis.

Although acute laryngitis is usually not a result of
vocal abuse, vocal abuse is often a result of acute
laryngitis. The underlying infection or
fundal
Laringita este una dintre cele mai comune condiii
identificate nlaringe . Laringita , o inflamatie a
laringelui , se manifest n forme acute i cronice .

Laringita acuta are un debut brusc si este de obicei
auto-limitate . Dac un pacient are simptome de
laringita pentru mai puin de 3 sptmni , starea
este clasificat ca laringita cronica . Etiologia
laringitei acute include abuzul vocal , expunerea la
ageni nocivi , sau ageni infecioi care duc la
infectii ale tractului respirator superior . Agenii
infecioi sunt cel mai adesea virala dar uneori
bacteriene .

A se vedea imaginea de mai jos .

Acest punct de vedere descrie laringe a unui
WOMA 62 de ani,
Acest punct de vedere descrie laringele de o femeie
de 62 de ani, cu o istorie intermitent de laringita
acuta exudativa , care a fost tratat conservator .
Curtoazie de Ann Kearney , Palo Alto , California
Rareori , rezultatele inflamatia laringelui la o
conditie autoimuna, cum ar fi artrita reumatoida ,
recidivante policondrita , granulomatoza Wegener ,
sau sarcoidoza . Un raport de caz a artat un
pacient intubat 2 ani , care a fost dat crbune
activat pentru intoxicaii , care rezult n laringita
obstructiva . Acest caz neobinuit demonstreaz
multitudinea etiologii poteniale de laringita acuta .

Laringita cronica , cum sugereaz i numele ,
implic o durat mai mare de simptome , este
nevoie , de asemenea, mai mult s se dezvolte .
Laringita cronica poate fi cauzata de factori de
mediu , cum ar fi inhalarea de fum de tigara sau
aerului poluat ( de exemplu, produse chimice ,
gazoase ) , iritaie la inhalatoarele pentru astm ,
abuzul vocal ( de exemplu , utilizarea prelungit
vocal la intensitate anormal sau smoal ) , sau
reflux gastro-intestinale . Rezultatele abuz vocale
ntr- o for mai mare adiie a corzilor vocale cu
contact ulterior a crescut i frecare ntre pliurile
contacta. Zona de contact dintre pliurile devine
umflat . Terapia vocal are cel mai mare beneficiu
npacient cu laringita cronic .

Dei laringita acuta nu este de obicei un rezultat de
abuz vocal , abuzul vocal este adesea un rezultat de
laringita acuta . Infectia care stau la baza sau
inflammation results in a hoarse voice. Typically,
the patient exacerbates the dysphonia by misuse of
the voice in an attempt to maintain premorbid
phonating ability.

Pathophysiology
Acute laryngitis is an inflammation of the vocal
fold mucosa and larynx that lasts less than 3 weeks.
When the etiology of acute laryngitis is infectious,
white blood cells remove microorganisms during
the healing process. The vocal folds then become
more edematous, and vibration is adversely
affected. The phonation threshold pressure may
increase to a degree that generating adequate
phonation pressures in a normal fashion becomes
difficult, thus eliciting hoarseness. Frank aphonia
results when a patient cannot overcome the
phonation threshold pressure required to set the
vocal folds in motion.

The membranous covering of the vocal folds is
usually red and swollen. The lowered pitch in
laryngitic patients is a result of this irregular
thickening along the entire length of the vocal fold.
Some authors believe that the vocal fold stiffens
rather than thickens. Conservative treatment
measures, as outlined below, are usually enough to
overcome the laryngeal inflammation and to restore
the vocal folds to their normal vibratory activity.

Epidemiology
Frequency
United States
The exact prevalence of acute laryngitis is not
reported because many patients often use
conservative measures to treat their inflammation
rather than seek medical consultation. Symptoms of
an upper respiratory tract infection often
accompany the disease; thus, patients are
accustomed to managing their own treatment.
Nevertheless, laryngitis is one of the most common
laryngeal pathologies.

Mortality/Morbidity
Because acute laryngitis is usually self-limited and
treated with conservative measures, significant
morbidity and mortality are not encountered.
Patients who develop acute laryngitis from an
infectious etiology rather than vocal trauma may
ultimately injure their vocal folds. The deficient
voice production in patients with acute laryngitis
inflamatie duce la o voce ragusita . De obicei ,
pacientul exacerbeaza disfonie de abuz de voce n
ncercarea de a menine capacitatea de phonating
premorbide .

Fiziopatologie
Laringita acuta este o inflamatie a mucoasei ori
vocale i laringele , care dureaz mai puin de 3
sptmni . Cnd etiologia laringitei acute este
infectioasa , celulele albe din sange elimina
microorganismele n timpul procesului de
vindecare . A corzilor vocale , atunci devin mai
edematoasa , i vibraii este afectat n mod negativ
. Presiunea Pragul fonaie poate crete la un nivel
care genera presiuni fonaie adecvate ntr-o manier
normal devine dificil , da nastere , astfel,
raguseala . Frank afonie rezulta atunci cand un
pacient nu poate depi presiunea de pragul de
fonaie necesare pentru a stabili faldurile vocale n
micare .

Acoperirea membranoas a corzilor vocale este de
obicei de culoare roie i umflat . Smoal redus la
pacienii laryngitic este un rezultat al acestei
ngroarea neregulat a lungul ntregii lungimi aori
vocal . Unii autori cred c devin mai rigide vocale
ori , mai degrab dect se ingroasa . Msuri de
tratament conservator , aa cum sa subliniat de mai
jos , sunt de obicei suficiente pentru a depi
inflamatia laringelui i a restabili corzilor vocale
pentru activitatea lor vibratorii normal .

Epidemiologie
frecven
Statele Unite
Prevalenta exacta a laringitei acute nu este raportat
c muli pacieni folosesc adesea msuri
conservatoare pentru a trata inflamaia lor, mai
degrab dect s caute consultaie medical .
Simptomele de o infectie a tractului respirator
superior nsoi de multe ori boala , astfel , pacientii
sunt obinuii s -i gestiona propriile tratament .
Cu toate acestea , laringita este una dintre cele mai
frecvente patologii laringiene .

Mortalitatea / Morbiditatea
Deoarece laringita acuta este de obicei auto-limitate
si tratate cu msuri conservatoare , morbiditate i
mortalitate nu sunt ntlnite . Pacientii care
dezvolta laringita acuta de la o etiologie infecioas
, mai degrab dect trauma vocal poate rni n cele
may result in application of a greater adduction
force or tension to compensate for the incomplete
glottic closure during an acute laryngitic episode.
This tension further strains the vocal folds and
decreases voice production, ultimately delaying
return of normal phonation.

In 1997, Ng conducted a study of the aerodynamic
and acoustic characteristics of acute laryngitis.[1]
His study demonstrated that across the 5 vowels,
the fundamental frequency values were lower in
patients with acute laryngitis than in patients with a
normal voice. The authors concluded that acute
laryngitis changes the vocal fold mass, resulting in
a reduction of the fundamental frequency; other
authors have anecdotally corroborated this
finding.[2]

Patients with acute laryngitis have an increased
open quotient value. This indicates that the patient's
vocal folds are open longer, and less time is spent
in the closed position, which contributes to the
hoarseness and breathiness of the voice.

Laryngitis has a significant economic impact. Over
the economic burden, pharmaceutical costs were
approximately 30% of such costs.[3]

Age
Studies have demonstrated that, usually, acute
laryngitis affects individuals aged 18-40 years.
Children, a category not included in the above
study, are clinically observed with acute laryngitis
when aged 3 years and older.
din urm falduri vocale . Producie voce deficitar
la pacienii cu laringit acut poate duce la
aplicarea unei fore de aduciune mai mare sau
tensiune pentru a compensanchiderea glotei
incomplet, n timpul unui episod laryngitic acut .
Aceast tensiune alte tulpini a corzilor vocale i
scade producia de voce , ntrzierea n cele din
urm ntoarcerea de Fonaie normal .

n 1997 , Ng a efectuat un studiu al caracteristicilor
aerodinamice i acustice de laringita acuta . [ 1 ]
Studiul su a demonstrat c peste 5 vocalele ,
valorile de frecven fundamentale au fost mai mici
la pacientii cu laringita acuta decat la pacientii cu o
voce normal . Autorii au concluzionat ca laringita
acuta schimb masa ori vocal , rezultnd o reducere
a frecvenei fundamentale ; . Ali autori au
confirmat anecdotic, aceast constatare [ 2 ]

Pacientii cu laringita acuta au o mare valoare
coeficient deschis . Acest lucru indic faptul c
corzilor vocale ale pacientului sunt deschise mai
mult , i mai puin timp este petrecut n poziia
nchis , care contribuie la rgueal i breathiness
de voce .

Laringita are un impact economic semnificativ .
Peste povara economic , costurile farmaceutice au
fost de aproximativ 30 % din aceste costuri . [ 3 ]

vrst
Studiile au demonstrat c , de obicei , laringita
acuta afecteaza persoanele in varsta de 18-40 de ani
. Copii , o categorie care nu sunt incluse n studiul
de mai sus , se observ clinic cu laringita acuta
atunci cand varsta de 3 ani i peste .