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Laryngitis: Lost Voice and Cough

Dr. Michelle Frank

|

May 12, 2023
CoughPro is not a medical product. It is a wellness app intended only for users to obtain a better understanding of their cough. It is not intended to diagnose, monitor, or treat any illness.

We at Hyfe, Inc., are a company devoted to working on tools to better understand the importance of cough. It is Hyfe’s intention in the future to seek regulatory approval for medical products that analyze cough in order that they may be used to diagnose, monitor, and facilitate better treatment of respiratory illnesses.

A woman with sore throat

Quite frequently, a lingering feeling of soreness in our throats is paired with a small, hoarse, muffled voice when it comes time to speak. This achy feeling can also result in a cough or difficulty swallowing. These signs frequently hint at underlying laryngitis. 

However, while the symptoms can be distressing, laryngitis can often be managed with a simple mix of home remedies and medications. 

What Is Laryngitis?

Your larynx is the voice box located at the back of your throat. Laryngitis is the inflammation of the larynx.

Inflammation results in swelling and irritation of surrounding structures, which is why you feel hoarseness in your voice and soreness in your throat. Frequently, soreness and a loss of voice may be the only indications of underlying laryngitis.

A review of medical literature documented approximately 52% of people with “hoarseness,” “hoarse voice,” or “dysphonia” had either acute or chronic laryngitis1.

What Causes Laryngitis? 

Several reasons have been linked as a cause for laryngitis, with viral infections topping the list.

Allergies

Those with seasonal allergies don’t commonly report voice hoarseness, but it definitely is a result2. This is likely due to breathing in allergens, as people with other allergies can also develop laryngitis after exposure3. Additionally, long-term exposure to allergies can lead to chronic upper airway cough syndrome (previously called post-nasal drip), of which voice hoarseness can be a symptom4. can result in symptoms such as a constant post-nasal drip and coughing. These can aggravate the larynx leading to laryngitis.

A woman allergic to pollen

Infection

Common viral infections responsible for causing acute laryngitis include human parainfluenza viruses (HPIVs), rhinovirus (cause of the common cold), influenza viruses, and adenovirus5. Cases of laryngitis tend to increase during winter months when these viral infections are frequently on the rise6.

Since most of these viruses result in similar symptoms, such as a runny nose, cough, and a loss of voice, it can be difficult to differentiate the exact cause without conducting specific tests. 

Chronic Cough and Vocal Cord Overuse or Injury

A persistent chronic cough is connected with a higher likelihood of developing laryngitis/laryngeal dysfunction due to paradoxical vocal fold movement7 – a condition where your vocal cords don’t operate properly. Chronic cough and paradoxical vocal fold movement have only slightly different symptoms8, meaning that what you think is a long-term cough may be problems with your vocal cords that leave you open to developing laryngitis. 

Or, if your chronic cough is caused by gastroesophageal reflux9 or smoking, it can also cause laryngitis5.

Additionally, vocal cord overuse and injury are sources of laryngitis. Voice misuse, like screaming or singing without warm-up and vocal care, and throat cancer (laryngeal malignancy) have been observed as causes of laryngitis10. A reason these resulted in laryngitis was due to the consistent strain put on the larynx which eventually led to inflammation and a loss of voice. Injury from intubation - where a tube is inserted down the throat to facilitate breathing during surgery or other medical scenarios - can also occasionally lead to vocal hoarseness11.

Medication Side-Effects

Frequently, medications can also be potential causes of laryngitis. One such example is the consistent use of steroid inhalers for treating asthma symptoms as, in addition to causing laryngeal changes and hoarseness, they can also make it more likely you develop oral thrush (an overgrowth of fungus naturally present in the mouth), which can worsen laryngeal function(DelGaudio J. M. (2002). Steroid inhaler laryngitis: dysphonia caused by inhaled fluticasone therapy. Archives of otolaryngology--head & neck surgery, 128(6), 677–681. https://doi.org/10.1001/archotol.128.6.677)). 

More rarely, medications that cause coughing as a side effect, such as ACE inhibitors, have also been linked to causing laryngitis12.

Pills on a yellow surface

How Do I Know If I Have Laryngitis?

Regardless of other symptoms, if your pain and loss of voice have lasted for more than two weeks, consult with a doctor to rule out more serious underlying causes, such as cancer13.

Hoarse Voice

One of the primary indications that you might have laryngitis is the lingering hoarseness in your voice. While you attempt to speak, your voice will be muffled or you may have to whisper. In some instances, a complete loss of voice is noticed during laryngitis. Some research indicates that continuous exposure to allergens causes a worsening of voice quality. After treating these allergies and avoidance of allergen exposure, these voice indices tended to improve14.

Based on the underlying condition which may have caused your laryngitis, you may also have accompanying symptoms, but an affected voice is the key symptom

Sore/Painful Throat

Lingering throat soreness is another primary indication that you have laryngitis. Along with soreness due to laryngeal inflammation, many patients also report feeling pain, especially when swallowing. This sharper pain usually lasts a day or two, especially when the inflammation from the laryngitis is at its peak. 

Cough

Another common symptom is a chronic cough or urge to cough a lot, or a feeling that something is in your throat so you need to clear it. These symptoms occur with laryngitis caused by many things, making them tricky to tell apart.

Typically, in laryngitis caused by exposure to allergens coughing occurs due to mucus running down the back of your throat from your sinuses (called upper airway cough syndrome or post-nasal drip). A cough is a common symptom of an airway infection, and this holds true for laryngitis-causing infections. Laryngitis resulting from GERD will generally also present with a cough, as GERD suffers also experience mucus running down the back of the throat, and acid reflux events may prompt coughing,

If laryngitis doesn’t improve on its own with rest and self-care, as it would with a viral infection or overuse injury, consider reducing your exposure to potential allergens and discuss the possibility of GERD or a more serious infection. 

Woman coughing outdoors

Other Symptoms

If your laryngitis is caused by allergies, you will likely also be feeling stuffy. With infections, a mild fever, headache, and a runny nose might also be present. Additionally, the previously mentioned soreness in the throat can be present before the illness as well as during.

Some people with GERD also report a sensation of a foreign body in their throats during their dry coughing spells15 that they want to get rid of, along with their laryngitis symptoms. GERD also typically presents with some chest discomfort and heartburn.

Home Laryngitis Treatments

Most cases of laryngitis resolve on their own over a few days to a week. Especially when viral infections are sourced as the cause, supportive care, bed rest and warm liquids usually do the trick. 

Here are some simple ways to heal your inflamed larynx at home: 

1. Rest Your Larynx

This is one of the first and most simple ways to heal laryngitis. Speaking continuously agitates the larynx and can worsen inflammation. This may make whispering a tempting alternative. However, even this causes a strain on your vocal cords. Giving your vocal cords complete rest for a few days can often aid with quicker recovery. 

2. Give Your Body Some Rest

Underlying infections and the inflammation of the larynx can also take a toll on your overall health, causing mild fever and fatigue. During a phase of laryngitis, it is often best to take a few days off to let your body heal itself.

3. Consume Plenty of Fluids

Keeping your throat moist can help with healing. Opt for warm beverages such as warm teas, soup, and broths. Stay away from dehydrating liquids such as coffee and alcohol. Honey, either dissolved in water or taken on its own, may help soothe a sore throat.

4. Opt For Salt Water Gargles

Saline gargles have often been used as a remedy to heal an aching throat. Studies have shown when used regularly it can help with reducing the hoarseness of the voice along with other symptoms, such as a runny nose and a cough16.

A woman holding a cup and gargling saltwater

5. Humidify The Air

The key aspect to healing is to keep your larynx moist and reduce dehydration. An additional way to enable this is to breathe moist air using a humidifier. Not only does it keep the throat moist, but it also helps to clear out stuffy sinuses and moisturize the rest of your respiratory pathways. You can also increase humidity in your immediate vicinity by leaning over a  bowl of freshly boiled water and laying a towel over your head and bowl to trap the air. Being mindful of scalding yourself, stay here for as long as you can to allow the warm humidity to ease your symptoms.

6. Cut Back On Smoking

Smoking not only causes laryngitis but can also aggravate it if the cause is something else. It delays the healing process and also works to dehydrate the vocal cords17. This is why it is best to cut back or kick the habit altogether.

Further Laryngitis Treatment

Medication

In most cases, you can manage laryngitis with these simple home remedies. However, in some instances, you might need medications to aid in the recovery. Often, pain can be managed with over-the-counter acetaminophen or ibuprofen. 

However, for severe cases, with a complete loss of voice and heightened accompanying symptoms, doctors may consider other medications. Antibiotics are frequently used if there are signs of underlying bacterial infections. However, antibiotics do not work if the underlying infection is viral. Severe laryngeal inflammation is sometimes managed with steroids, similar to asthma. If GERD is causing your laryngitis, your doctor may prescribe proton pump inhibitors (PPIs) if lifestyle changes don’t have sufficient effect.

Lifestyle Changes

Some causes of laryngitis can be managed by lifestyle changes. For instance, GERD can often be managed with alterations in diet and sleeping position, as well as weight loss. Those who have laryngeal trauma due to vocal cord misuse, which often leads to the development of nodules, will need to alter the way they use their vocal cords to prevent further damage. This may include taking vocal training lessons or altering singing habits, particularly for musicians18.

Speech Therapy

First-line of management for laryngitis due to vocal misuse is often speech therapy which includes improving vocal hygiene and behavioral modification19.

In a similar manner, when chronic persistent cough results in laryngeal dysfunction and a loss of voice, aiming to treat the underlying cause often works. However, many cases of chronic cough have no known source. In such cases, incremental benefits have been sourced in speech-language treatment20

Surgery

Surgery is rarely needed to manage laryngitis. However, in cases with chronic misuse of the vocal cords, there might be a development of nodules. These may benefit from surgical intervention if standard behavioral modifications do not help19. Similarly, laryngitis due to cancer is also frequently treated with surgery21.

Are There Any Ways To Prevent Laryngitis?

Laryngitis caused due to infections is not always preventable. Especially since viruses spread easily, evading the infection might seem slightly difficult. However, some viral sources such as influenza have seasonal vaccines, which can work to prevent severe symptoms leading to laryngitis. Additionally, building habits such as regularly washing your hands and wearing masks when potentially in locations with infected people will reduce the chances of you catching a respiratory disease.

Quitting habits such as smoking or reducing your exposure to smoke can help with reducing irritation to your larynx, making it less likely to become inflamed. Similarly, finding out your allergens can also reduce symptoms, such as a post-nasal drip, which can work as a cause for laryngitis. Constant exposure to laryngeal irritants like smoke, air pollution, and allergens can lead to chronic inflammation.

Tackling GERD early on through simple lifestyle changes, such as smaller meals, different foods, avoidance of triggers, and weight loss can help to reduce long-term trauma to the larynx due to reflux.

Vocal cord misuse may not always be identifiable. However, singers, television hosts, or other professionals who require continuous use of their voice may benefit from regular check-ins with vocal coaches and therapists who can help prevent and identify early laryngeal dysfunction18.

The Bottom Line

Sore throat, hoarseness in the voice, and persistent cough often hint toward underlying laryngitis. For the most part, you can manage this at home by giving your vocal cords some rest, and warm fluids, and taking it easy for a few days. Over-the-counter medications such as acetaminophen are often the only ones needed for laryngitis. If these do not help and you have more serious symptoms such as a high fever, chest discomfort, or a loss of voice, check in with your doctor. 

If after all these initial attempts to manage your laryngitis fail, and your symptoms progress for a couple of weeks, it is best to make an appointment with your healthcare provider to rule out possible serious causes of laryngitis.

  1. Reiter, R., Hoffmann, T. K., Pickhard, A., & Brosch, S. (2015). Hoarseness causes and treatments. Deutsches Arzteblatt international, 112(19), 329–337. https://doi.org/10.3238/arztebl.2015.0329[]
  2. Millqvist, E., Bende, M., Brynnel, M., Johansson, I., Kappel, S., & Ohlsson, A.-C. (2008). Voice Change in Seasonal Allergic Rhinitis. Journal of Voice, 22(4), 512–515). Elsevier BV. https://doi.org/10.1016/j.jvoice.2006.12.003[]
  3. Campagnolo, A., & Benninger, M. S. (2019). Allergic laryngitis: chronic laryngitis and allergic sensitization. Brazilian Journal of Otorhinolaryngology, 85(3), 263–266. https://doi.org/10.1016/j.bjorl.2019.02.001[]
  4. Pratter, M. R. (2006). Chronic Upper Airway Cough Syndrome Secondary to Rhinosinus Diseases (Previously Referred to as Postnasal Drip Syndrome ). Chest, 129(1), 63S-71S. https://doi.org/10.1378/chest.129.1_suppl.63s[]
  5. Caserta M. T. (2015). Acute Laryngitis. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 760–761.e1. https://doi.org/10.1016/B978-1-4557-4801-3.00060-6[][]
  6. Tristram D. (2018). Laryngitis, Tracheitis, Epiglottitis, and Bronchiolitis: Sore Throat, Change in Voice, Feverora Wheezing Infant in Respiratory Distress. Introduction to Clinical Infectious Diseases: A Problem-Based Approach, 75–85. https://doi.org/10.1007/978-3-319-91080-2_7[]
  7. Ryan, N. M., Vertigan, A. E., & Gibson, P. G. (2009). Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement. Cough (London, England), 5, 4. https://doi.org/10.1186/1745-9974-5-4[]
  8. Hartley, N. A., Petty, B. E., Johnson, B., & Thibeault, S. L. (2015). Comparative analysis of clinical profile: Chronic cough vs paradoxical vocal fold motion. Respiratory Medicine, 109(12), 1516–1520. https://doi.org/10.1016/j.rmed.2015.10.007[]
  9. Kahrilas, P. J., Smith, J. A., & Dicpinigaitis, P. V. (2013). A Causal Relationship Between Cough and Gastroesophageal Reflux Disease (GERD) has been Established: A Pro/Con Debate. Lung, 192(1), 39–46). https://doi.org/10.1007/s00408-013-9528-7[]
  10. Caserta M. T. (2015). Acute Laryngitis. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 760–761.e1. https://doi.org/10.1016/B978-1-4557-4801-3.00060-6[]
  11. Jones, M. W., Catling, S., Evans, E., Green, D. H., & Green, J. R. (1992). Hoarseness after tracheal intubation. Anaesthesia, 47(3), 213–216). Wiley. https://doi.org/10.1111/j.1365-2044.1992.tb02121.x[]
  12. Fuchs, M., & Bücheler, M. (2004). Chronisch-hyperplastische Laryngitis. Nach antihypertensiver Therapie mit einem ACE-Inhibitor [Chronic hyperplastic laryngitis following treatment of hypertension with angiotensin-converting enzyme inhibitor]. HNO, 52(11), 998–1000. https://doi.org/10.1007/s00106-003-1016-6[]
  13. Za'im, N. A. N., & Azman, M. (2021). Alarming triad of progressive hoarseness in a male smoker. Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia, 16(3), 119–122. https://doi.org/10.51866/cr1163[]
  14. Campagnolo, A., & Benninger, M. S. (2019). Allergic laryngitis: chronic laryngitis and allergic sensitization. Brazilian Journal of Otorhinolaryngology, 85(3), 263–266. https://doi.org/10.1016/j.bjorl.2019.02.001[]
  15. Silva, C. E., Niedermeier, B. T., & Portinho, F. (2015). Reflux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy. International archives of otorhinolaryngology, 19(3), 234–237. https://doi.org/10.1055/s-0034-1399794[]
  16. Ramalingam, S., Graham, C., Dove, J., Morrice, L., & Sheikh, A. (2019). A pilot, open-labeled, randomized controlled trial of hypertonic saline nasal irrigation and gargling for the common cold. Scientific reports, 9(1), 1015. https://doi.org/10.1038/s41598-018-37703-3[]
  17. Banjara, H., Mungutwar, V., Singh, D., & Gupta, A. (2014). Objective and subjective evaluation of larynx in smokers and nonsmokers: a comparative study. Indian Journal of Otolaryngology and Head and neck surgery: official publication of the Association of Otolaryngologists of India, 66(Suppl 1), 99–109. https://doi.org/10.1007/s12070-011-0342-3[]
  18. McBroom, D. (2017). Empowering Musicians: Teaching, Performing, Living: Why Should I Care About Vocal Health? American Music Teacher, 67(2), 32–35. https://www.jstor.org/stable/26385833[][]
  19. Pedersen, M., & McGlashan, J. (2012). Surgical versus non-surgical interventions for vocal cord nodules. The Cochrane Database of systematic reviews, 2012(6), CD001934. https://doi.org/10.1002/14651858.CD001934.pub2[][]
  20. Ryan, N. M., Vertigan, A. E., & Gibson, P. G. (2009). Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement. Cough (London, England), 5, 4. https://doi.org/10.1186/1745-9974-5-4[]
  21. Adeel, M., Faisal, M., Rashid, A., Usman, S., Khaleeq, U., Abbas, T., Rehman, A., Malik, K., Hussain, R., & Jamshed, A. (2018). An Overview of Laryngeal Cancer Treatment at a Tertiary Care Oncological Center in a Developing Country. Cureus, 10(6), e2730. https://doi.org/10.7759/cureus.2730[]

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