faculty member Clark A. Rosen, MD (pictured), is director of the UPMC Voice Center and associate professor of otolaryngology, University of Pittsburgh School of Medicine. Dr. Rosen specializes in the treatment and research of voice disorders. One voice disorder, viral laryngitis (inflammation of the voice box), occurs as a result of a viral infection of the larynx. Viruses usually are contracted by inhaling respiratory droplets released into the air by people who are "carrying" the virus.
"It's tough to prevent getting a viral infection, shorten it, or get rid of it," said Dr. Rosen. "We have to learn how to live with it and minimize the impact of viral infections to the throat."
Viral laryngitis usually is characterized by:
- General fatigue
- Low-grade fever
- General body aches
- Sore throat
- Dry throat
Other symptoms of upper respiratory tract infection may also be present, depending on the sites involved with the infection.
The most common patient complaint of laryngitis is hoarseness. Hoarseness is usually a raspy or husky sound of the voice resulting from swelling within the vocal fold. Swelling limits the normal vibratory movement of the vocal fold during phonation, which causes the sound produced to be less harmonic and raspier. If there is significant swelling of the vocal folds, they may not be able to vibrate at all, and no sound or only a whisper is produced.
The voice should not be used excessively during laryngitis in the absence of evaluation by an ear-nose-throat (ENT) specialist (otolaryngologist). In some cases of laryngitis, excessive voice use can cause further and irrevocable injury to the vocal folds, leading to vocal fold hemorrhage, vocal fold scar, and/or vocal fold lesions. Examples of excessive voice use include singing, acting, performing, lecturing, or excessive talking or phone use.
"People keep using or abusing their voice while they're sick," Dr. Rosen said. "The vocal folds are much more prone to permanent injury [polyps, cysts, scar tissue] when they're swollen."
Hydration is an important component of laryngitis treatment. In most cases of laryngitis, either the mucous secretions are excessively thick or the lubrication of the larynx is decreased. Drinking water helps to maintain the thin character of the mucosal lubrication. Steam or mist humidifiers can help to lubricate the vocal folds. Avoiding exposure to drying agents such as caffeine or dehydrating medications can also help to preserve the lubrication of the larynx. Limiting voice use allows the vocal fold tissue to heal without the added trauma and stress caused by trying to phonate with swollen vocal folds. Voice rest can help to accelerate the healing process.
If left untreated, laryngitis is thought by some physicians to lead to the development of hyperfunctional voice disorders such as muscle tension dysphonia, which may contribute to the formation of nodules, polyps, cysts, scarring, hyperkeratosis, and Reinke's edema.
Illustration: McGowan Institute for Regenerative Medicine.
ABC News (10/23/08)
UPMC Voice Center
The Voice Problem Website
Bio: Dr. Clark Rosen