From the Guidelines
Laryngitis typically does not require steroids for treatment. The use of steroids for laryngitis is not supported by evidence, as stated in the clinical practice guideline: hoarseness (dysphonia) update 1. This guideline recommends against the empiric use of steroids for dysphonia prior to examination of the larynx, citing a lack of supporting data on their efficacy.
Some key points to consider when evaluating the use of steroids for laryngitis include:
- The potential for significant and serious side effects, such as insomnia, gastrointestinal disturbances, mood disturbances, and increased risk of hip/femur fracture, cataract formation, adrenal insufficiency, diabetes, and changes in bone density 1.
- The risks associated with long-term use of oral glucocorticoids, including obesity, metabolic syndrome, lipodystrophy, and increased cardiovascular risks 1.
- The fact that most cases of laryngitis are viral in nature and resolve on their own within 1-2 weeks with conservative management, including voice rest, adequate hydration, humidification, and avoiding irritants like smoking 1.
In severe cases where significant vocal cord inflammation is causing breathing difficulties or when a person needs rapid voice recovery for professional reasons, a short course of oral steroids might be prescribed by a physician 1. However, this should be done with caution and under close medical supervision, given the potential risks and side effects associated with steroid use 1.
From the Research
Laryngitis and Steroid Treatment
- Laryngitis is an inflammatory process that affects the larynx, and its treatment may involve the use of steroids in certain cases 2, 3, 4.
- The use of steroids in laryngitis is supported by studies that demonstrate their effectiveness in reducing inflammation and improving symptoms 3, 5.
- A study published in The Laryngoscope in 2014 found that steroids reduced proinflammatory mediators and increased anti-inflammatory cytokines in patients with acute vocal fold inflammation 3.
- Another study published in The Laryngoscope in 2014 reviewed the use of glucocorticoids in laryngology and found that they are effective in treating benign laryngeal pathology and laryngeal manifestations of systemic disease 5.
Types of Laryngitis and Steroid Treatment
- Acute laryngitis may benefit from steroid treatment, as it can help reduce inflammation and improve symptoms 3, 6.
- Chronic laryngitis, on the other hand, may require a more comprehensive treatment approach, including steroids, to manage its underlying causes and symptoms 2, 4.
- The use of steroids in laryngitis should be guided by the specific diagnosis and severity of the condition, as well as the patient's overall health status and medical history 5.
Evidence for Steroid Treatment in Laryngitis
- Several studies have demonstrated the effectiveness of steroids in reducing inflammation and improving symptoms in patients with laryngitis 3, 6, 5.
- A systematic review published in the Annals of Family Medicine in 2010 found that steroids were effective in relieving pain in acute pharyngitis, which can be a related condition to laryngitis 6.
- However, more research is needed to establish the safety and efficacy of steroids in specific laryngeal disorders and to guide their use in clinical practice 5.