Chronic laryngitis is a sluggish infectious inflammation of the larynx with a prolonged course and periodic relapses. The disease rarely develops in isolation and is more often diagnosed against the background of chronic inflammation of the upper respiratory tract - the nasal cavity, paranasal sinuses, throat, etc. Sometimes damage to the larynx is observed in the case of the spread of an ascending infection with pneumonia, bronchitis or tuberculosis.
Hoarseness and discomfort in the throat are typical signs of inflammation of the laryngeal mucosa. Overheating, hypothermia, mechanical damage to mucous membranes, inhalation of gassed or dusty air can provoke damage to the ENT organs. Due to the active development of pathogenic agents in the respiratory tract, an allergic reaction occurs and, accordingly, severe tissue edema. Subsequently, this can lead to difficulty breathing and stenosing laryngotracheitis, which is often the cause of asthma attacks.
General description
What is chronic laryngitis? Laryngitis is called inflammation of the mucous membranes of the larynx, which in 97% of cases is preceded by infectious diseases - influenza, SARS, scarlet fever, tonsillitis, tracheobronchitis, pneumonia, etc. If inflammation is not stopped in time in the acute course of the disease, over time, laryngitis will turn into a chronic form.
It should be noted that chronic laryngitis is an occupational disease that often occurs among teachers, lecturers, singers, theater actors, television and radio hosts. One of the basic rules that must be followed when treating a disease is complete vocal rest. It is known that even with whispering speech, the vocal cords experience considerable stress. This can negatively affect the dynamics of recovery and generally lead to the chronicization of the inflammatory process.
Inadequate therapy or inaction can spread the infection through the respiratory tract. In patients with sluggish laryngitis, laryngotracheitis can subsequently be diagnosed, in which the mucous membranes of not only the larynx, but also the trachea are affected. The greatest danger to humans is the so-called stenosing laryngotracheitis. With the disease, there is a strong narrowing of the lumen of the respiratory tract, which as a result leads to attacks of suffocation and asphyxiation.
Launched laryngitis can cause false croup, in which breathing stops completely.
The causes of chronic laryngitis
Why does chronic laryngitis appear? Sluggish inflammation of the larynx is formed against the background of frequently recurring acute laryngitis. Insufficient or inadequate treatment can also cause chronic inflammation in the ENT organs.
The key reason for the development of pathology is the activation of opportunistic microorganisms. Decreased immune defense, frequent colds, hypothermia, cold drinks can provoke the multiplication of pathogenic agents - fungi, viruses, protozoa, microbes, etc. Chronic inflammation of the larynx is more often diagnosed in men, who are more prone to household and occupational hazards than women.
In the mechanism of development of the disease, a very important role is played by descending (adenoiditis, periodontitis, rhinosinusitis) and ascending (bronchiectasis, bronchitis, pneumonia) infections. Slow inflammation of the ENT organs most often occurs against the background of respiratory infections - scarlet fever, measles, tonsillitis, flu, pharyngitis, etc. The defeat of the laryngeal mucosa, which is represented by ciliated epithelium and lymphoid tissues, entails a decrease in local immunity. As a result, the body cannot cope with the onslaught of opportunistic viruses and microbes, as a result of which inflammation occurs.
Provoking factors
Exogenous and endogenous provoking factors play an important role in the infection of the larynx. Before starting treatment of the disease, it is necessary to eliminate the immediate cause of its occurrence. Chronic laryngitis can be provoked by:
- unfavorable ecology;
- work in hazardous industries;
- tobacco smoking;
- overstrain of the vocal cords;
- decreased general immunity;
- tendency to allergic reactions;
- overgrowth of polyps in the nose;
- disturbances in the digestive tract;
- foci of chronic inflammation in the nasopharynx;
- inhalation of dry and dusty air;
- lack of vitamins and minerals in the body;
- constant stress and psycho-emotional instability.
It has been clinically proven that people with a hereditary predisposition and pathological narrowness of the respiratory tract in the larynx are more susceptible to laryngitis.
In addition, colds and infectious diseases are more common in persons prone to irritation and depression. The psychosomatic reasons for the development of chronic laryngitis are not fully understood, but one thing is clear - the disease "loves" those who keep silent about their grievances.
Clinical picture
How is the disease diagnosed? It is worth noting that the symptoms of chronic laryngitis depend on the form of the disease and the characteristics of the pathological processes in the larynx. As a rule, patients complain of a deterioration in voice quality, a decrease in timbre and the appearance of hoarseness. Common manifestations of sluggish inflammation of the larynx include:
- rapid fatigue of the voice;
- dry and raw throat;
- "Scratching" in the larynx when talking;
- feeling of a coma in the Adam's apple;
- decreased voice power;
- labored breathing;
- coughing in the morning;
- hoarseness.
Swelling of the mucous membranes can lead to respiratory failure and cyanosis, i.e. bluish color of the lips and skin. Despite the fact that the symptoms of the disease are relatively mild, constant inflammation of the soft tissues in the future can lead to complications. Therefore, if pathological manifestations are detected, it is still desirable to be examined by an ENT doctor or therapist.
Types of chronic laryngitis
In otolaryngology, it is customary to distinguish several forms of sluggish laryngitis. Depending on the nature of the inflammatory reactions, the clinical manifestations of the disease may differ slightly. According to the generally accepted classification, chronic laryngitis can be:
- catarrhal - superficial inflammation of the laryngeal mucosa with fairly frequent exacerbations; symptoms differ little from the manifestations of acute laryngitis - fever (up to 37.5 ° C), moderate sore throat, enlarged submandibular lymph nodes, dry cough;
- atrophic - thinning of the walls of the larynx, followed by the formation of dry crusts on the surface of the mucous membrane; more common in older people and men working in hazardous industries;
- hypertrophic - diffuse (widespread) or limited induration of the laryngeal mucosa in the area of the vocal cords; narrowing of the lumen of the respiratory tract makes breathing difficult, as a result of which oxygen starvation is observed and, as a result, dizziness, lethargy, lack of appetite, etc.
Hypertrophic (hyperplastic) laryngitis is a precancerous pathology that can degenerate into a malignant tumor.
To recognize a specific type of disease, you should familiarize yourself with the features and typical manifestations of each form of chronic laryngitis. However, it should be borne in mind that even with the correct diagnosis of the disease, treatment can only be prescribed by a specialist.Inadequate therapy is a key reason for the deterioration of the patient's well-being and the development of complications. Some of them have to be removed through surgery.
Catarrhal laryngitis
Catarrhal chronic laryngitis is the least dangerous form of the disease that does not cause pathological changes in the tissues of the larynx. Endoscopic examination of the laryngopharynx shows some dilation of blood vessels, loosening of the mucous membrane and a change in its color. The surface of the larynx becomes grayish red with small spots all over the mucous membrane.
Because of the inflammation, the goblet cells in the larynx, which secrete mucus, begin to function vigorously. Hypersecretion of mucus causes irritation and coughing with little sputum production. Over time, tissue edema leads to a change in the elasticity of the vocal cords, therefore, the patient's voice "sits down" and hoarseness appears. In case of exacerbation of inflammation, the cough intensifies and becomes permanent. To eliminate pathological processes in the larynx and speed up recovery, the following types of drugs are used:
- antibacterial agents of the penicillin and macrolide series for the destruction of pathogenic microbes;
- mucolytic (expectorant) drugs to remove excess phlegm from the airways;
- antiseptic lozenges for resorption, which inhibit the activity of infectious agents in the ENT organs;
- anti-inflammatory and disinfecting rinsing solutions that restore the integrity of the tissues in the larynx;
- immunostimulants that increase general and specific immunity.
On an outpatient basis, an otolaryngologist conducts electrophoresis and UHF therapy, due to which the healing process of the mucous membranes is accelerated. As a rule, relief occurs within 3-4 days after the use of complex therapy.
Hypertrophic laryngitis
With hypertrophic laryngitis, the symptoms of inflammation are most pronounced. This is the most dangerous form of respiratory disease in which there is hyperplasia (enlargement) of the mucous membranes. The thickening of the walls of the larynx leads to a strong narrowing of the lumen in the airways, so patients may experience a lack of oxygen. Depending on the degree of tissue hyperplasia, diffuse (diffuse) and limited laryngitis are distinguished. In turn, the limited form of the disease is subdivided into:
- monochondritis - inflammatory processes occur mainly in the vocal cords on only one side of the larynx;
- Reinke's edema is a polypoid enlargement of the mucous membrane, in which there is a strong narrowing of the airway lumen;
- hyperplasia of the false vocal cords - a strong compaction of soft tissues directly above the vocal cords;
- "Singing nodules" - round, dense neoplasms on the vocal cords, which are most often found in people of "vocal" professions;
- areas of pachydermia - replacement of cells of the ciliated epithelium with cells of the integumentary, i.e. squamous epithelium.
Launched hypertrophy of the larynx and vocal cords can be eliminated only by surgery, in which the surgeon resects (excises) cysts, fibroids and other neoplasms.
To prevent the development of malignant tumors, in the treatment of hypertrophic laryngitis, potent decongestants and anti-inflammatory drugs are used - corticosteroids and antihistamines. Of the physiotherapeutic procedures, laser therapy, cryodestruction and radiotherapy are often used.
Atrophic laryngitis
Atrophic laryngitis is more often diagnosed in people working in hazardous industries. Inhalation of volatile chemicals leads to disruptions in the functioning of the mucous membranes of the larynx, as a result of which its walls are greatly thinned. Viscous mucous accumulations form on its surface, which dry out over time and form crusts. The development of atrophic laryngitis is signaled by:
- sore throat;
- periodic cough;
- dry mouth;
- tingling in the throat when swallowing;
- sensation of a foreign object in the throat.
Over time, dense crusts begin to separate from the walls of the larynx, resulting in sores that can bleed. Therefore, when coughing up sputum, blood impurities can be found in the mucus. To eliminate inflammatory processes, inhalations are used, in which wound-healing preparations with trypsin are used as solutions. The proteometric enzyme accelerates cellular metabolism, due to which the laryngeal mucosa is regenerated faster.
To prevent the exacerbation of chronic laryngitis, it is necessary to treat colds, rhinitis and dental pathologies (gingivitis, periodontitis) in time. In addition, you should strengthen the immune system by taking vitamin and mineral complexes and foods with a large amount of nutrients. In case of sore throat, it is recommended to strictly observe vocal rest for 3-4 days. For the duration of the treatment of the disease, it is necessary to stop drinking alcohol and smoking, which negatively affects the state of the vocal cords.
