When symptoms such as hoarseness, coughing, and a sore throat occur, it may be a warning sign of an abnormality with the voice box, which many people think will go away on its own. However, laryngitis can become chronic if not treated promptly and properly. Therefore, understanding this condition is important for everyone to pay attention to.
About the Voice Box
The voice box is located at the front of the neck, following the Adam’s apple, and is attached to the top part of the windpipe, in a position related to the opening of the esophagus. When breathing in, air enters through both nostrils to the back of the nasal cavity, then turns down flowing through the Adam’s apple to the voice box and the windpipe to the lungs. Consequently, when breathing out, air from the lungs flows through the windpipe, the voice box, the Adam’s apple, and exits through the nose. Thus, the voice box plays an important role in human breathing.
Laryngitis
Laryngitis can be caused by infections, such as viruses, bacteria, tuberculosis, etc., as well as overuse of the voice like shouting, yelling, talking all day long, or singing for extended periods. The condition can become more severe if not promptly treated correctly, excessive voice use, and exposure to irritants like cigarette smoke, air pollution, and chemical smells can further aggravate the symptoms. If the infection-induced laryngitis is severe, it may spread to other parts of the respiratory system and could even lead to vocal cord paralysis, bronchitis, or pneumonia. Therefore, seeking treatment promptly is crucial.
Symptoms of Laryngitis
Laryngitis can be acute, resolving within 3 weeks, or chronic, where hoarseness persists for a long period. Symptoms include:
- Hoarseness, loss of voice
- Throat pain, pain when vocalizing
- Unclear speech
- Irritation in the throat
- Accompanied by cough or phlegm
- Possibly mild fever
Diagnosis
Currently, there are 3 methods for examining the voice box:
1) Mirror Examination The patient sits leaning forward slightly, opens their mouth and sticks out the tongue. The doctor will pull the patient’s tongue forward and insert a small mirror specifically designed for examining the voice box into the patient’s mouth to the area of the Adam’s apple and the epiglottis, allowing the inside of the voice box to be reflected in the mirror. This examination does not require anesthesia.
2) Endoscopic Examination A local anesthetic spray is applied to the throat area, and after about 1 – 2 minutes when the patient’s throat is numb, the doctor will insert the instrument. This method is painless and provides clear images on a monitor. There are two types of scopes used in examining the voice box:
- Rigid Endoscope The scope is a straight metal rod. The patient will sit leaning forward slightly, open the mouth, and stick out the tongue to make the inside of the Adam’s apple more accessible. The scope is inserted through the mouth to the epiglottis in the Adam’s apple, then images of the voice box located below the Adam’s apple are displayed on a monitor.
- Fiber Optic Laryngoscope The scope consists of special fibers called Fiber Optic, which can bend. The patient sits upright, leaning forward slightly without the need to open the mouth or stick out the tongue. The scope is inserted through the nostril, passing through the nasal cavity down into the Adam’s apple to take images of the voice box, providing details of the inner nasal cavity as well.
3) Special Equipment Examination called Stroboscope is used with the endoscope to examine the patient’s voice box. The scope is connected to the Stroboscope, and when images inside the voice box are captured, they are processed by the Stroboscope and displayed on a monitor in both normal and slow motion. This allows the doctor to easily and clearly check for abnormalities, such as inflammation, tumors, cysts, cancer, ulcers, vocal cord function, vocal cord paralysis, acid reflux, bleeding or bruising of the vocal cords, muscle atrophy of the vocal cords, etc. It also enables comparison of images before and after treatment, such as before and after surgery. However, the examination with Stroboscope requires vocalization, so it cannot be performed if the patient cannot make sound, such as if they are out of breath or unconscious.
Treatment of Laryngitis
Treating laryngitis requires both medication as prescribed by the doctor and changes in behavior. It usually takes about 2 weeks (at least) to recover from the disease. Behaviors to be followed include resting the voice, speaking less, not shouting, staying in clean places, avoiding smoke and air pollution, avoiding spicy food, not drinking alcohol, not smoking, and drinking warm water. Exposure to different irritants affecting the voice box can further delay the healing process. Importantly, if laryngitis persists, it may become chronic and lead to other conditions, such as tumors on the vocal cords, which may require surgery.
Preventing Laryngitis
- Get enough rest, about 6 – 8 hours per night
- Drink 8 glasses of water per day (about 2 liters) to prevent dehydration, preferably at room temperature
- Avoid caffeine and alcohol beverages
- Avoid smoking
- Avoid air pollution, such as dust, smoke, toxic substances
- Avoid close contact with people who are suffering from infectious respiratory diseases
- Practice proper vocalization techniques for speaking or singing without straining the voice; regular practice can strengthen the vocal cord muscles
- Avoid forceful coughing as it may cause abnormal vibration of the vocal cords, leading to swelling and inflammation
- Seek proper treatment when ill, do not let the illness resolve on its own, as a persistent cold may make hoarseness worse
- Do not strain your voice when it is hoarse, or when the respiratory tract is inflamed and infected, indicating a condition of laryngitis
Laryngitis requires prompt examination and treatment by experienced doctors to ensure proper treatment as soon as possible, because if left untreated, it may become chronic and lead to other diseases.
