Laryngitis is inflammation and swelling of the larynx and vocal cords that leaves the voice hoarse, weak or absent, along with dryness and burning in the throat, a repeated urge to clear it, and a dry cough. The acute form is the most common; it is usually viral, accompanies a cold or sore throat, and settles on its own within days to about two weeks with voice rest and hydration. The chronic form has other causes that need investigation: occupational voice strain in teachers, muezzins, singers and call centre staff; smoking and exposure to smoke; gastro-oesophageal reflux that irritates the larynx overnight; nasal allergy and postnasal drip; dry air and air conditioning; incorrect use of inhaled sprays without rinsing the mouth afterwards; and sometimes fungal infection or nodules and cysts on the vocal cords. Treatment starts from the cause rather than from silencing the symptom. **Antibiotics do not treat viral laryngitis and do not shorten it**, and using them without indication causes harm and breeds bacterial resistance. Voice rest is the foundation of care, but note carefully: **whispering is not voice rest and actually increases strain on the vocal cords.** Rest means talking less and more softly in a relaxed natural voice, neither whispering nor shouting. To this are added hydration and water, avoiding smoking and excess caffeine, treating reflux by adjusting evening meals and raising the head during sleep, treating allergy, and voice therapy for anyone whose work depends on their voice. The limits are explicit: treatment relieves symptoms and addresses the cause, but it cannot repair a nodule, a cyst, a papilloma or a paralysed vocal cord. Those require laryngoscopy to watch the cords while speaking, and may need microsurgery or structured voice rehabilitation. No treatment works while smoking or vocal misuse continues. **Hoarseness lasting more than two weeks calls for laryngoscopy, especially in smokers or when there is a neck lump, persistent ear pain, difficulty swallowing or weight loss, in order to exclude serious causes whose course early diagnosis changes completely.** **Seek emergency care immediately for difficulty breathing, a high-pitched noise on breathing in, inability to swallow or drooling, particularly in children, or for coughing blood, rapid neck swelling, or high fever with severe pain.**
Procedure steps
- 1
History and voice assessment
The doctor asks when hoarseness began and whether it followed a cold or vocal strain, and about smoking, heartburn, allergy, occupation and how much the voice is used each day. Voice quality and stamina are assessed, and the throat, neck and lymph nodes are examined.
- 2
Laryngoscopy when indicated
For persistent hoarseness or when risk factors are present, laryngoscopy is performed with a flexible scope or mirror to see the vocal cords and their movement during speech. It is a quick clinic procedure using topical anaesthesia, and it reveals inflammation, nodules, cysts and impaired mobility.
- 3
Identifying and treating the cause
The doctor distinguishes acute viral inflammation managed by rest and hydration, reflux treated with lifestyle and dietary change plus medicines the physician decides, allergy treated on its own terms, vocal strain needing behavioural change, and fungal or bacterial infection treated only when actually proven.
- 4
Voice rest and voice retraining
You are shown how to rest the voice without whispering: talk less, avoid shouting, speaking over noise and long phone calls, drink water regularly, and drop the habit of throat clearing. Anyone whose work depends on their voice is referred to a speech and language therapist for breathing and correct vocal support.
- 5
Follow-up and the decision to intervene
The patient is reviewed after two to four weeks; if the voice has not improved, laryngoscopy is repeated and the need is assessed for microsurgery of nodules or cysts, a longer voice rehabilitation programme, or broader investigation when worrying signs are present.
Before the procedure
Before the visit, note when the hoarseness began, whether it changes through the day, and what makes it worse, such as long conversations, air conditioning or a heavy late meal. Record how many hours a day you speak and what your work involves, and tell the doctor if you are a teacher, muezzin, singer or call centre worker. Bring a list of your medicines and do not forget inhaled sprays, a frequent cause of hoarseness, along with allergy and blood pressure medicines. Record a voice note on your phone when your voice is at its worst so it can be compared later. Do not smoke before the visit, and avoid straining your voice that day, since it distorts assessment of the cords. If laryngoscopy is planned, ask how long to avoid food and drink beforehand, and tell the doctor if you react to local anaesthetics or take blood thinners.
After the procedure
Rest your voice by speaking less rather than whispering, and avoid shouting, talking in noisy places and long phone calls. Drink water regularly and humidify the room, and avoid smoking, sitting with smokers, direct air conditioning, dust and excess caffeine. If you have reflux, eat a light early dinner, raise the head of the bed a little, and avoid lying down after eating. Give up throat clearing and replace it with a sip of water or a gentle swallow. Rinse your mouth with water after any inhaled spray. Do not take antibiotics without a prescription and do not rely on cough medicines without advice. **Seek emergency care immediately for difficulty breathing or a high-pitched noise on breathing in, inability to swallow or drooling, rapid neck swelling, coughing blood, or high fever with severe pain; and in children for any breathing difficulty or stridor.** See your doctor if hoarseness lasts beyond two weeks, or if a neck lump appears or you lose weight.
Expected duration
The assessment visit usually takes 15 to 30 minutes, with viral cases typically improving within days to two weeks
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