From the Guidelines
Treatment for laryngitis typically involves rest, hydration, and voice conservation, with most cases resolving on their own within 1-2 weeks with supportive care. The primary goal is to reduce throat pain and inflammation, and promote healing of the vocal cords. According to the most recent and highest quality study 1, acute laryngitis is self-limited, with most patients experiencing symptomatic improvement within 7 to 10 days irrespective of treatment.
Some key recommendations for managing laryngitis include:
- Drinking plenty of fluids (at least 8-10 glasses of water daily) to keep the throat moist
- Avoiding whispering, which strains the voice more than soft speaking, and limiting talking until symptoms improve
- Humidifying the air with a cool-mist humidifier to help soothe irritated vocal cords
- Using over-the-counter pain relievers like acetaminophen (Tylenol, 325-650mg every 4-6 hours) or ibuprofen (Advil, 200-400mg every 4-6 hours) to reduce throat pain and inflammation
- Avoiding irritants like smoking, secondhand smoke, and alcohol
It's also important to note that antibiotics should not be routinely prescribed to treat hoarseness, as they are ineffective in treating viral infections and can have harmful side effects 1. However, in select circumstances, such as bacterial infections or immunosuppressed patients, antibiotics may be warranted 1. Additionally, antireflux medications may be considered in patients with symptoms of gastroesophageal reflux disease (GERD), but their use as empiric therapy for dysphonia is not recommended due to limited evidence of benefit and potential adverse effects 1.
For persistent laryngitis lasting more than two weeks, medical evaluation is recommended to determine the underlying cause and develop an appropriate treatment plan, which may include prescription medications like corticosteroids or further testing to rule out other conditions.
From the Research
Treatment for Laryngitis
- The treatment for laryngitis is often directed towards controlling symptoms, as diagnosis is often made by case history alone 2, 3, 4.
- Antibiotics appear to have no benefit in treating acute laryngitis, as they do not objectively improve symptoms 2, 3, 4.
- Erythromycin could reduce voice disturbance at one week and cough at two weeks when measured subjectively, but these outcomes may not be relevant in clinical practice 2, 3, 4.
- Fusafungine could increase the cure rate at day five, but the included RCTs had important methodological problems and these modest benefits from antibiotics may not outweigh their cost, adverse effects, or negative consequences for antibiotic resistance patterns 4.
- Treatment of specific pathologies depends on the causative pathogen or etiology, as well as the age, vocal demands, and clinical characteristics of the individual 5.
- A thorough history is the most important step towards developing a differential diagnosis, and counseling patients on the course of the disease process is key 5.
Types of Laryngitis and Their Causes
- Laryngeal inflammation can be present secondary to direct effects of irritants, toxins, and antigens, but can also involve mechanical and infectious effects as well as secondary inflammation from behavioral mechanisms 6.
- Laryngeal inflammation includes a broad spectrum of pathologies, from infectious processes that need to be managed as airway emergencies, to indolent diseases that mimic head and neck cancer 5.
Management of Laryngitis
- The importance of a thorough history cannot be emphasized enough, as it is the most important step towards developing a differential diagnosis 5.
- Vocal pathologies often have a noticeable impact on a person's quality of life and daily activities, and therefore, it is key to counsel patients on the course of the disease process 5.