Although acute laryngitis is common, it is often managed by primary physicians. Therefore, video images documenting its signs are scarce. This series includes 7 professional voice users who previously had undergone baseline strobovideolaryngscopy (SVL) during routine examinations or during evaluations for other complaints and who returned with acute laryngitis. Sequential SVL showed not only the expected erythema, edema, cough, and dysphonia, but also new masses in 5 of the 7 subjects. All the signs returned to baseline. This series is reported to highlight the reversible structural changes that can be expected in patients with acute laryngitis and the value of conservative management.
Acute infectious laryngitis is one of the most common disorders of the larynx and is often associated with upper respiratory tract infections (URIs), as reported more than a decade ago in a Cochrane review. (1) Laryngeal inflammation can cause hoarseness, sore throat, and difficulty swallowing. These symptoms usually subside within 3 weeks but may persist much longer (months).
It can be difficult to distinguish between bacterial and viral origins. (1) Viral laryngitis can be caused by many organisms, including but not limited to, influenza virus, adenovirus, and even Varicella zoster virus. Acute bacterial laryngitis presents similarly; however, purulent secretions are observed more commonly in patients with a bacterial infection. (2) Treatment for viral causes remains supportive, with adequate hydration and at least relative voice rest, while the bacterial form may benefit from the addition of an antibiotic.
Most patients with URI symptoms are evaluated and treated by a primary care physician. It is much less common for the otolaryngologist to treat an acute episode unless there is a complicating feature (e.g., protracted course, persistent symptoms after the URI, recurrent episodes, etc.). For this reason, high-quality images of the larynx during an acute infection often are not available. We present a series of patients with acute infectious laryngitis and their coinciding laryngoscopic images to highlight salient features.
Each patient presented here was established within the practice and had had strobovideolaryngoscopy performed before, during, and after an acute episode of infectious laryngitis.
The examinations performed before the current visits often were performed routinely at the patients request, to establish the normal baseline appearance of their vocal folds when they were healthy. In some cases, they were performed incidentally during evaluation for other complaints, but none was performed for laryngitis or any other acute laryngeal problem. These examinations established the "normal" basline laryngoscopic appearance for each of these patients.
Patient 1. A 37-year-old woman presented with a history of cough for 1 week and a gradual onset of hoarseness that began 2 days before the visit. These symptoms progressed to aphonia for 3 days and a sensation of throat swelling. Strobovideolaryngoscopy (SVL) revealed a new right mid-membranous vocal fold mass, moderate erythema and edema of the true vocal folds and arytenoids, and thick mucopurulent secretions (figure 1, A). The proximal trachea also appeared inflamed. Acute laryngotracheitis was diagnosed, and amoxicillin-clavulanate and prednisone were prescribed for 7 days....