Laryngitis, an inflammation of the larynx, often occurs as a re-sult of voice abuse or exposure to dust, chemicals, smoke, and other pollutants, or as part of an upper respiratory tract infection.It also may be caused by isolated infection involving only the vocal cords.
The cause of infection is almost always a virus. Bacterial inva-sion may be secondary. Laryngitis is usually associated with aller-gic rhinitis or pharyngitis. The onset of infection may be associated with exposure to sudden temperature changes, dietary deficien-cies, malnutrition, and an immunosuppressed state. Laryngitis is common in the winter and is easily transmitted.
Signs of acute laryngitis include hoarseness or aphonia (complete loss of voice) and severe cough. Chronic laryngitis is marked by persistent hoarseness. Laryngitis may be a complication of upper respiratory infections.
Management of acute laryngitis includes resting the voice, avoid-ing smoking, resting, and inhaling cool steam or an aerosol. If the laryngitis is part of a more extensive respiratory infection due to a bacterial organism or if it is severe, appropriate antibacterial therapy is instituted. The majority of patients recover with con-servative treatment; however, laryngitis tends to be more severe in elderly patients and may be complicated by pneumonia.
For chronic laryngitis, the treatment includes resting the voice, eliminating any primary respiratory tract infection, eliminat-ing smoking, and avoiding second-hand smoke. Topical corti-costeroids, such as beclomethasone dipropionate (Vanceril) inhalation, may also be used. These preparations have no sys-temic or long-lasting effects and may reduce local inflammatory reactions.
The nurse instructs the patient to rest the voice and to maintain a well-humidified environment. If laryngeal secretions are present during acute episodes, expectorant agents are suggested, along with a daily fluid intake of 3 L to thin secretions.
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