What is chronic laryngitis symptoms. The chronic course of laryngitis is said when the disease lasts more than three weeks.

If you notice that from time to time it becomes painful for you to swallow, there is a hoarseness of voice and discomfort"something extra" in the throat, perhaps these are signs of a sluggish inflammation of the mucous membrane of the larynx. What is chronic laryngitis, how does it manifest itself, and is it possible to defeat the disease? Everything is in order in our detailed review and video materials.

According to statistics, smoking, including passive smoking, remains the most common cause of laryngitis. Tobacco smoke contains harmful tarry substances and carcinogens that penetrate the mucous membrane of the larynx and provoke inflammation.

In addition, common factors in the development of the disease include:

• living in ecologically unfavorable areas, large industrial centers;
• occupational hazards among miners, metallurgists, etc.;
• constant tension of the vocal cords of singers, teachers;
• frequent acute infectious diseases of the ENT organs;
• GERD is a chronic disease of the esophagus and upper respiratory tract, which is provoked by the pathological throwing of acidic gastric contents into them;
• diabetes mellitus and other metabolic diseases;
• allergic pharyngitis and laryngitis;
• alcohol abuse.

Forms of the disease

Doctors use several classifications of chronic laryngitis:

• Classification according to the nature of inflammation:

1. chronic catarrhal laryngitis (ICD code 10–J37.0) is the mildest form of the disease;
2. chronic hypertrophic laryngitis is manifested by the growth of the inflamed mucous membrane of the inner wall of the larynx and vocal cords. Another name for this form of the disease is laryngitis of singers;
3. chronic atrophic laryngitis - with such a pathology, there is a malnutrition of the mucous membrane of the larynx and its depletion.
4. chronic edematous laryngitis - in this case, swelling of the mucous membrane of the larynx and respiratory failure come to the fore.

• Classification by severity:

1. mild severity;
2. moderate;
3. heavy.

Depending on the form of chronic laryngitis, the doctor determines the diagnostic minimum and further management of the patient.

Clinical signs of the disease

Increasingly, when patients complain of discomfort in the throat, doctors diagnose chronic laryngitis - and the symptoms of this pathology are presented below. In the catarrhal form of the disease, the symptoms resemble acute laryngitis, but are slightly expressed.

Come to the fore:

• dry cough;
• selection is not a large number mucus from the larynx;
• slight changes in voice, hoarseness after long conversations and in the evening.

The hyperplastic form of laryngitis is characterized by hoarseness and pronounced hoarseness in the voice. Sometimes patients complain that they have completely lost their voice.

If a person has developed atrophy of the mucous membrane of the larynx, it is always accompanied by sclerosis of the epithelium of the nasal cavity and pharynx.

With this form of the disease, the following come to the fore:

• severe dryness in the throat;
• persistent painful cough: a thick viscous secret is formed on the walls of the larynx, which the patient hardly expectorates;
• weakness, decreased performance.

The characteristic symptoms of edematous laryngitis include a feeling foreign body in the throat, persistent coughing and shortness of breath on exertion.

The development of a chronic form of the disease in children is rare: it is typical for them acute inflammation larynx. In children, the disease is severe. Due to constant intoxication and hypoxia (lack of oxygen), the shape of the skull in chronic laryngitis in children can be deformed with a change in the shape of the head and bite.

Diagnostics

Diagnosis of chronic laryngitis is based on:

1. Clinical examination.
2. Laryngoscopy is a method of examination of the ENT organs, which allows you to visually assess the condition of the mucous membrane of the larynx and vocal cords.

• with catarrhal laryngitis, the mucosa is slightly hyperemic, there is an expansion of superficial vessels;
• in the hypertrophic form of inflammation, the mucous membrane of the larynx acquires a gray-purple hue, the vocal cords are thickened and look like bright red rollers;
• with atrophic laryngitis, thinning of the mucous layer is observed with the imposition of a viscous secret and crusts;
• edematous laryngitis is manifested on laryngoscopy by mucosal edema, narrowing of the glottis.

Note! Hypertrophic laryngitis in medicine is considered a precancerous condition. Therefore, sometimes for a morphological study of overgrown tissues, CT, MRI, cell biopsy with further microscopy are performed.

Principles of treatment

With an exacerbation of chronic laryngitis, it is important to consult a doctor as soon as possible. In the treatment of this disease, an integrated approach and the implementation of all the recommendations of a specialist are important.

The main principles of treatment are:

1. Gentle voice mode: in order not to strain the inflamed vocal cords, try to be silent more.
2. Warm drink: drink plenty of fluids. It is better if it is heated alkaline mineral water (Borjomi, Essentuki 17), tea with honey and lemon, berry fruit drinks, milk.
3. Avoid irritating action on the larynx (spicy, pickled foods, dry coarse food).
4. Stop smoking;
5. Limit exposure to dust, industrial waste, etc. Use respirators and other protective equipment if necessary.

Medical treatment

The main groups of drugs used to relieve symptoms of exacerbation in chronic laryngitis are presented in the table below.

Note! Taking antitussive drugs is possible only after the recommendation of a doctor. The instruction prohibits their use simultaneously with other cough remedies (expectorants, mucolytics, etc.).

Inhalations

Inhalations are a real salvation for patients with chronic laryngitis (see). The smallest particles of steam with medicinal substances dissolved in it not only have local therapeutic effect, but also moisturize, soften the inflamed mucosa and reduce unpleasant symptoms.

When the disease is effective inhalation with:

• soda solution - the simplest recipe, which you can cook with your own hands by dissolving a teaspoon of soda in a glass of warm boiled water;
• solutions of expectorants - Lazolvan, Ambroxol;
• decoctions of anti-inflammatory herbs.

Physiotherapy procedures

The following physiotherapy procedures are effective in the chronic form of the disease:

• UHF-inductothermia - increases nutrition and blood supply to tissues, reduces inflammation;
• irrigation of the larynx with water and oil solutions with anti-inflammatory, softening effect;
• electrophoresis of the larynx.

In the hypertrophic variant of the disease, it is successfully used surgical method treatment: excision of overgrown inflammatory tissues.

homemade recipes

Chronic laryngitis - how to treat at home? After eliminating the acute period, the doctor will recommend treatment with traditional medicine. He will also recommend the most effective and safe means.

It is dangerous to engage in self-medication, since the wrong remedy can only aggravate the situation. All home remedies are good because they can be prepared with your own hands from the available ingredients.

Here are some effective recipes:

1. Steam inhalations with essential oils of tea tree or eucalyptus, with decoctions medicinal herbs, with soda and honey help well with laryngitis. Hot, humid steam helps to expand the bronchi, relieve swelling and alleviate barking cough.
2. Gargling with red beet juice will soothe sore throat, relieve pain and swelling of the mucosa. To do this, squeeze the juice from the beets. Add 1 teaspoon of apple cider vinegar to a glass of juice (photo). Gargle 3-4 times a day.
3. a remedy is recommended that always works flawlessly. Pour half a glass of anise seeds with two glasses of water and boil for 10-15 minutes. Strain the broth and add 2 tablespoons of honey and 1 tablespoon of cognac to it. Mix everything and drink a tablespoon every 40 minutes.

The combination of all these means will surely give a positive result.

You can avoid the development of exacerbations with the help of preventive measures: healthy lifestyle life, hardening, taking balanced fortified food, quitting smoking and drinking alcohol.

Chronic laryngitis is one of the common causes referral to an otorhinolaryngologist. An integrated approach to treatment, following the doctor's recommendations and attentive attitude to one's health will help to quickly cope with the symptoms of the disease.

Chronic laryngitis is an inflammation of the mucous membrane of the larynx, usually combined with chronic pharyngitis.

Causes of chronic laryngitis

The appearance of an inflammatory reaction on the mucous membrane of the larynx is caused by some reasons: persistent laryngitis, passing in an acute form, chronic inflammatory diseases of the trachea, bronchi, lungs, sinusitis, vasomotor rhinitis, strong and prolonged tension of the vocal cords, smoking (in 100% of smokers the larynx is affected - smoker's laryngitis), drinking alcoholic beverages. Also, chronic laryngitis can be caused by inhalation of dust particles, harmful gas and other harmful factors. Passive smoking (presence in a smoky room) is also quite harmful. All this leads not only to damage to the mucous membrane, it also affects the neuromuscular apparatus of the laryngopharynx.

As a result, a defense reaction immediately appears, which is expressed in a narrowing of the glottis. It is also expressed by coughing, swelling of the larynx is possible. The function that is responsible for the formation of the voice is damaged. Inflammation in a chronic form (rhinitis, tonsillitis, pharyngitis, etc.), which affects the upper respiratory tract, can affect the occurrence of chronic laryngitis.

Varieties and symptoms of chronic laryngitis

1. catarrhal
2. hyperplastic
3. atrophic

For catarrhal laryngitis in the chronic form, the symptoms are not as pronounced as they are characteristic of the acute form of laryngitis. Mainly, it is a feeling of tickling in the throat, coughing, which is accompanied by the secretion of mucus. There is a change in the voice, which may be clear, but gradually become hoarse from long conversations. Quite often, the voice becomes hoarse in the evening. A strong cough is rare, in most cases with inflammation of the back wall. Much more often, the cough is not strong. During laryngoscopy, hyperemia is observed. Hyperemia of the larynx is not too active than during acute form laryngitis. The mucous membrane of the larynx takes on a gray-red color. These symptoms are noted both over the entire surface and localized. Quite often, vessels that are dilated can be seen on the surface of the mucous membrane.

All symptoms appear evenly on one and the other side of the mucous membrane of the larynx. Patients who suffer from chronic laryngitis try to compensate for the strength of their voice by forcing it, which leads to more irritation. During the observation of catarrhal manifestations, neuritis, myositis are observed. The chronic form of laryngitis can occur with complications and periods of acute symptoms.

Signs of hyperplastic laryngitis in the chronic form, the same symptoms can be called as with catarrhal laryngitis, the color of the mucous membrane of the larynx may become blue-red, or gray-red. With hyperplastic laryngitis, the voice may become more hoarse. The vocal cords in hyperplastic laryngitis become thicker and resemble red rollers.

In some cases, hyperplasia is not affected by the mucous membrane of the ligaments, but by the areas under the ligaments. Patients who do not protect the voice by amplifying it, including children who are not able to control this process, may face the problem of the formation of calluses on the vocal cords. They appear at the intersection of the middle and anterior parts of the ligaments. For the first time, these formations were identified in people who are engaged in singing. In honor of this, the name singing knots was coined.

Hyperplastic laryngitis, which has become chronic, is classified as a precancerous disease. As a consequence, patients who have been diagnosed with hyperplastic laryngitis should be treated on an outpatient basis. Apply periodic control and dispensary observation.

With atrophic chronic laryngitis atrophy in the larynx takes place along with the processes of atrophy in the pharynx and in the nasal cavity. With this form of laryngitis, patients experience the following symptoms: cough, dry throat, weakness, low ability to work. A viscous secretion can be observed in the larynx, which can dry out and create crusts. It becomes difficult to expectorate. The patient tries to expectorate more mucous secretions and crusts, as a result of which the cough increases, which can negatively affect the inflammatory process in the larynx. Possible bleeding and sputum.

Treatment of chronic laryngitis

The treatment of this disease involves the complex use of medicinal and physiotherapeutic agents that have both local and general effects on the body.

Local treatment involves the infusion into the larynx of various medicines, as well as their lubrication of its mucous membrane. In catarrhal and hyperplastic forms, substances are used that have anti-inflammatory (hydrocortisone suspension, Kalanchoe juice, dioxidin, streptomycin, etc.), astringent (zinc sulfate 0.25 g, tannin 0.5 g, glycerin 15 g, distilled water 100 g, collargol etc.), softening (vegetable oils, etc.) action. The hypertrophied areas of the mucous membrane are quenched with a 1-2% solution of silver nitrate.

With atrophic laryngitis locally used medicinal substances that contribute to the thinning of mucus, crusts, moisturizing the mucous membrane and stimulating the function of its glandular apparatus (chymopsin, proteolytic enzymes, peloidin, lysozyme, etc.). Assign a general course of treatment with iodine preparations, vitamins, biostimulants (aloe, FIBS, gumizol, etc.).

Inhalation therapy

Among the physical methods of treatment, the main place is occupied by inhalation therapy.

When conducting inhalation therapy, it is necessary to follow a certain sequence of application of medicinal substances. The presence of a large amount of sputum, crusts on the surface of the mucous membrane prevents the absorption of inhaled substances. In this regard, treatment should begin with the appointment of thinning mucus and expectorants. And only after that, prescribe aerosols of medicinal substances, followed by inhalation after 20-30 minutes of vegetable oils (rosehip, sea buckthorn, retinol, etc.).

With catarrhal and hypertrophic forms chronic laryngitis, anti-inflammatory drugs are indicated (1% imanin solution, chymotrypsin, hydrocortisone, prednisolone). Positive results are seen with combined application aerosol suspension of hydrocortisone 1 ml, Kalanchoe juice 1 ml, 2% solution of aethonium 1 ml, 1% solution of chinosol 1 ml.

To reduce swelling of the mucous membrane and secretion of mucus, as well as anti-inflammatory action, astringents and weakly cauterizing agents are prescribed (tannin 2 g, glycerin 10 ml, distilled water 100 ml; zinc sulfate 0.25 g, glycerin 15 ml, distilled water 100 ml; infusion of herb St. John's wort, immortelle flowers at 10.0: 200.0; decoction of oak bark 20.0: 200.0; water infusion of chamomile 10.0: 200.0; sage 5-25% solution, etc.).

Patients with chronic hypertrophic laryngitis in the presence of an inflammatory component, aerosols of steroid preparations (hydrocortisone suspension 25 mg) are also indicated in combination with broad-spectrum antibiotics (250,000 units each). Positive results are observed with the use of biological stimulants (peloidin, gumizol, Kalanchoe juice, 0.5% lysozyme solution, etc.), as well as drugs that regulate tissue metabolism (vitamins B, C, etc.). In order to reduce edema and inflammation, it is recommended to include heparin in combination with other drugs, which has a vasodilating effect, promotes oxygenation, and inhibits inflammation.

With atrophic laryngitis coarse-dispersed heat-moist inhalations are prescribed, alkali-calcium, salt-alkaline (not higher than 2% solution), alkaline mixtures, mineral waters (kemeri).

Physical Therapies

Simultaneously with inhalation therapy are shown physical methods that improve blood circulation, trophic and metabolic processes in the tissues of the larynx. For this purpose, UHF inductothermy is prescribed. Apply darsonvalization of the larynx. Mud applications are shown (temperature 38-42 C, duration 8-10 minutes) on the larynx area, for a course of 12-15.

In order to increase the efficiency of drug electrophoresis in diseases of the larynx, a special electrode was proposed for electrophoresis by the intralaryngeal method.

Treatment of patients with chronic hypertrophic laryngitis should be carried out in stages: first eliminate inflammatory changes, and then apply methods aimed at restoring the functions of the larynx. Patients with this form of the disease are contraindicated in the use of high-frequency therapy (e. p. UHF, microwave, etc.), as well as phototherapy factors (sollux, etc.), even during an exacerbation of the disease.

Laryngitis - clinical syndrome lesions of the larynx, caused by inflammatory changes in the mucous membrane due to the development of an infection of a viral or bacterial etiology or other causes, manifested in the form of an acute or chronic form. Development is facilitated by hypothermia, breathing through the mouth, dusty air, overexertion of the larynx, smoking and drinking alcohol.

The course of the disease depends on a number of conditions (age, body resistance, the adequacy of the therapy, etc.). How to treat laryngitis, what are the symptoms and first signs in adults, as well as about the main methods of prevention - we will talk in more detail in this article.

What is laryngitis?

Laryngitis is a disease respiratory system, in which the mucous membrane of the larynx is affected. In adults, the disease is accompanied by a change in voice, up to its complete loss, cough, and respiratory failure. It is able to proceed independently or be a continuation of inflammation of the mucous membranes of the pharynx, nasopharynx or nasal cavity in cases of acute respiratory diseases.

The fact is that when we talk, our vocal cords begin to vibrate, due to this, sound appears. But with this disease, the vocal cords swell and completely lose this unique property. At the same time, the airways also narrow, it becomes a little difficult to breathe, another characteristic of the disease may be the so-called barking cough.

It is important to realize in time that silence is gold in the literal sense of the word. It is better to talk in whispers for a few days than to suffer for weeks afterwards.

Types of disease

There are two forms of laryngitis: acute, which lasts only a few days, and chronic, which persists for weeks or months.

Acute laryngitis

Acute laryngitis relatively rarely develops as an independent disease. Usually it is a symptom of SARS (influenza, adenovirus infection, parainfluenza), in which the mucous membrane of the nose and pharynx, and sometimes the lower respiratory tract (bronchi, lungs) is also involved in the inflammatory process. Acute laryngitis can result from excessive strain on the vocal cords, such as shouting, cheering, singing, or making speeches.

Chronic laryngitis in adults

The chronic form follows from an acute manifestation in the absence of treatment or becomes the result of infection from chronic sources of the pathogen (inflammatory diseases in the nasopharynx). It is often diagnosed in smokers, since the tobacco house negatively affects the state of the epithelial layer and leads to its depletion, as a result of which the mucosa becomes susceptible to negative factors.

The outcome of chronic laryngitis in adults depends on its form. With hypertrophic and atrophic chronic laryngitis, complete recovery does not occur. Prevention is aimed at eliminating the causative factors.

Sometimes, in view of the similarity of the clinical picture, this pathology is confused with pharyngitis, however, how to treat laryngitis in an adult and what to do with pharyngitis are very different. Therefore, until the doctor makes an accurate diagnosis, you should not take any medication.

Also distinguished:

• Catarrhal laryngitis - the patient has perspiration, hoarseness, a feeling of soreness in the throat, cough is unstable, dry and slightly pronounced. The course is favorable and easy. Characteristic symptoms of laryngitis in adults: most often, patients complain of dysphonia, hoarseness, itching, soreness and dryness in the throat with normal or subfebrile temperature. Sometimes there is a dry cough, which is later accompanied by expectoration of sputum.
• The atrophic variety of laryngitis is characterized by a decrease in the thickness of the mucous membrane. Given this feature, coughs with bloody traces are often noted in the cough. characteristic feature- the formation of yellow-green or dirty brown crusts on the mucous membrane is a hallmark.
• Allergic laryngitis occurs in a patient with allergic reaction(allergic rhinitis, pharyngitis and others).
• Hypertrophic laryngitis, unlike atrophic laryngitis, is characterized by thickening of the mucous membrane of the larynx. Excessively thickened areas of the larynx in the form of whitish or transparent elevations may increase so much that they interfere with the closure of the vocal cords.
• In the case of the diphtheria form, the development of the disease occurs due to the spread of infection into the larynx from the tonsils. The mucous membrane becomes covered with a white membrane, which can detach and cause blockage of the airways at the level of the vocal cords. A similar membrane can also form during streptococcal infections.

Causes in adults

The causative agents of laryngitis are divided into two groups:

• viruses (flu virus, parainfluenza, measles and others);
• bacteria (the causative agent of scarlet fever, diphtheria, whooping cough, streptococci, staphylococci, mycobacteria, treponema and others).

The main causes of laryngitis:

• General and local hypothermia, ingestion of irritating food (usually very cold), cold drinking, mouth breathing, excessive vocal load (long, loud conversation, singing, screaming) - all this leads to disruption of local defense systems, damage to the cellular structures of the mucous membrane and development inflammatory process. In the future, infection may follow.
• Contacts with patients - whooping cough, chicken pox, flu or other SARS. Incubation period laryngitis of infectious origin can range from several hours to several days, depending on the pathogen.
• Spread of infections from the paranasal sinuses in sinusitis, oral cavity and other nearby areas.
• Inhalation of various irritants - air polluted with dust, soot, chemicals.
• Constant or one-time strong tension of the vocal cords - a long loud conversation, as well as a cry, especially in the case of adverse conditions indicated in the previous paragraph.
• Damage to the surface of the mucous membrane of the larynx - surgical intervention, mechanical (fish bone, an attempt to swallow poorly chewed food, crackers).
• Abuse of alcoholic beverages, smoking.
• Laryngitis can develop if stomach contents enter the larynx (gastroesophageal reflux). This condition can develop in case of weakness of the esophageal sphincters, which normally prevent the entry of gastric contents into the esophagus, pharynx, larynx.

Symptoms of laryngitis

Signs of inflammation of the larynx in adults can be suspected independently. The following symptoms may indicate the development of laryngitis:

• The appearance of a dry cough;
• Hoarseness of voice;
• Sore and sore throat;
• Severe pain when swallowing;
• General malaise;
• Rise in body temperature;
• An increased number of leukocytes in the blood.

Laryngitis in adults usually lasts from a few days to 2 weeks. Usually, after 2-3 days, body temperature returns to normal and general well-being improves. Then the voice is restored and gradually the dry cough turns into a wet one and stops.

Throat in the photo with laryngitis

In the first seven to ten days, the disease has an acute course. If the inflammatory process lasts longer, then doctors diagnose chronic laryngitis.

Complications

The most common complication of laryngitis is chronic bronchitis and tonsillitis. Often in the acute phase there is a danger of developing laryngeal edema and the occurrence of false croup. In this state, a person begins to suffocate, skin turn pale, cyanosis of the nasolabial triangle appears. If, in this condition, a person is not urgently helped, then he may die.

Chronic laryngitis can also lead to the development of complications in the form of:

• the formation of a tumor in the larynx of a benign nature;
• proliferation of polyps, formation of cysts or granulomas;
• development of cancer of the larynx;
• stenosis of the larynx;
• laryngeal mobility disorders.

Diagnostics

Symptoms and treatment of laryngitis in adults should be under the supervision of a physician

In the process of diagnosis, the doctor initially studies the history, conducts a physical examination and asks the patient about the nature of the onset and development of the disease. A thorough study of the sound of the voice, as well as the vocal cords, contributes to the selection of the correct approach to the treatment of the disease.

In addition to a general medical examination, the doctor may also apply additional methods research, especially in chronic laryngitis or protracted course acute:

• laryngoscopy;
• blood analysis;
• fluorography of a difficult cell;
• bacteriological examination of swabs, swabs from the larynx, etc.

A person who does not have medical education, it is possible to diagnose laryngitis on your own, but the probability of error is very high. Pathology, although it has characteristic symptoms, but in some cases it can take a "blurred" course. Some signs may be absent altogether.

You should see an otolaryngologist if:

• Your symptoms do not improve within 2 weeks;
• You have sudden severe pain (especially in the ear), difficulty swallowing or coughing up blood;
• You suspect the presence of another disease;
• There is a suspicion that laryngitis may become chronic.

Treatment of laryngitis in adults

Treatment of laryngitis involves compliance with a sparing regimen (the patient needs rest) and the elimination of factors whose action can increase inflammation (cessation of smoking, spicy, cold and hot foods).

General treatment regimen:

• elimination possible causes- reducing the load on the larynx and vocal cords (silence);
• exclusion of food that irritates the mucous membrane - carbonated drinks, salty, spicy foods;
• complete cessation of smoking, taking alcoholic beverages, including beer, alcoholic cocktails;
• plentiful warm drink - teas, infusions, decoctions, milk, kissels, juices.

If laryngitis has developed, treatment in adults can be carried out by prescribing the following drugs for local and systemic therapy:

• external medicines for basic treatment: aerosols - Camphomen, Ingalipt, Tera-Flu; lozenges and absorbable tablets - Isla, Strepsils, Neo-Angin;
• providing expectoration: Mukaltin, Prospan, Gedelix, Evkabal, Gerbion;
• medicines that can alleviate the manifestation of cough: Kofeks, Sinekod;
• antiallergic drugs (antihistamines): Loratadin, Zodak, Suprastin;
• antibacterial antibiotic: Bioparox spray;
• targeted antibiotics: Ampicillin, Amoxicillin, Oxacillin and cephalosporins;
• antiviral drugs: Fusafungin, Fenspiride;
• improving immune defense and strengthening the body - compounds based on radiola, aralia, pantocrine, eleutherococcus.

Antibacterial drugs (antibiotics) are prescribed for laryngitis only if the bacterial nature of the pathology is confirmed. For this, bacterial culture is performed and the causative agent of the infection is detected. If this is not done, the treatment may be ineffective due to the lack of sensitivity of some strains of bacteria to certain types of antibiotics.

A good result is the use of physiotherapeutic methods of treatment. Adult patients may be prescribed the following procedures:

• electrophoresis with novocaine;
• microwave therapy;

How to treat an acute form of laryngitis?

In adults, the treatment of acute laryngitis should first of all be aimed at eliminating the problem that provoked the disease.

• Apply local antibacterial drugs in the form of lozenges, aerosols, sprays, such as Strepsils, Hexoral, Tantum Verde, etc.
• At severe pain NSAIDs are prescribed in the throat - non-steroidal anti-inflammatory drugs: Nimesil, Nise, Nurofen. They effectively eliminate all the symptoms associated with inflammation - pain, voice disturbance, etc.
• To stimulate the activity of metabolic processes and increase the activity of the immune system, adaptogens are prescribed (tinctures of eleutherococcus, pantocrine, ginseng, pink radiola).
• An excellent remedy for laryngitis is to lubricate the throat with Lugol's solution. This tool helps protect the mucous membrane of the larynx from the effects of pathogenic flora. On the 3rd-4th day of illness, lubrication with Lugol's solution can be replaced with sea buckthorn oil. This substance contributes to the rapid restoration of the mucous membrane.

To ensure complete rest of the larynx, a person is not recommended to talk for about a week. If this is not possible, you need to talk as quietly and softly as possible.

Before restoring the mucous membrane of the larynx, the doctor must prescribe a strict diet, during which only sparing food should be consumed. However, it should not be too cold or hot.

How to treat chronic laryngitis in adults?

It is almost impossible to completely get rid of the chronic form of laryngitis, but remission can be achieved and its manifestations reduced to a minimum. It should be noted that with a particularly pronounced inflammatory process and the development of complications, treatment in a hospital may be required. In the treatment of exacerbations of chronic laryngitis Special attention worth the therapy chronic infections contributing to this exacerbation.

Too long its course can disrupt the voice function and completely change the voice of the patient. And people suffering from chronic laryngitis are at risk for laryngeal cancer. Therefore, it is necessary to treat this disease comprehensively and without fail until complete recovery.

For adults, laryngitis therapy will consist of the following procedures:

• Taking medicines and vitamins;
• Alkaline and antibiotic inhalations;
• Physiotherapy;
• Methods of traditional medicine.

• to give up smoking;
• voice rest;

Inhalations

Effective with laryngitis inhalation. It is better if it is an ultrasonic inhaler, and the patient will breathe infusion medicinal herb like chamomile.

Inhalation therapy can be with the help of steam inhalations with herbs (chamomile, oregano, sage and others), potato steam, alkaline inhalations. These can be inhalations using a nebulizer (with mineral water or medicines prescribed by a doctor). Inhalations are carried out from 3 to 7 times a day.

But know that steam inhalation cannot be carried out in the following cases:

• at elevated temperature,
• at purulent processes in the nasopharynx
• intolerance to drugs used for inhalation,
• adults with an exacerbation bronchial asthma and other respiratory disorders
• tendency to nosebleeds,

Food

Proper therapy means an integrated approach to the treatment of the disease, it is impossible to do with medication alone. It is important to follow a certain diet. With laryngitis, adults are strictly forbidden to use:

• all alcoholic drinks;
• carbonated water;
• seeds, nuts;
• garlic, pepper, mustard, onion, horseradish;
• seasonings, spices, spices.

Food should be liquid or grated, not too hot and not cold. It is advisable to exclude fried, fatty foods, and steam meat, fish.

In the fight against inflammation and irritation of the larynx, vegetable oils will help, which can be instilled a few drops into the nose or lubricated with them in the throat. Fresh fruits, vegetables, juices will be of great benefit in the treatment of laryngitis, but they should be eaten in the form of puree.

Drinking with laryngitis should be warm (not hot) and plentiful enough. All remedies should be drunk in small sips. Borjomi, milk and sage will help to cope with the disease.

Folk remedies

Before use folk remedies from laryngitis, it is recommended to consult with your doctor.

1. At the first manifestations of laryngitis, it is advisable to drink more warm drinks. Tea should be decaffeinated, as caffeine has a dehydrating effect.
2. Two teaspoons of calamus are poured with a glass of boiling water, infused for 5 hours, used to gargle. 3 teaspoons of chopped onion peel pour 0.5 liters of water, let it boil and insist for 4 hours, filter and use to gargle.
3. For the treatment of laryngitis at home, gargling with blueberry decoctions, beetroot juice and a homemade apple cider vinegar solution are great. At false croup the child is shown hot foot baths (duration of the procedure - 3-5 minutes).
4. Mogul. To prepare, beat two yolks with a tablespoon of sugar, then add a tablespoon of ghee and mix thoroughly. It is believed that the use of this remedy for 4-5 days twice a day helps to restore the voice.
5. Adults from laryngitis are recommended to use the following recipe: 3 finely chopped carrots are boiled in 1 liter of milk until cooked, the broth can be rinsed and taken orally.
6. Add egg white to 100 ml of vegetable oil, mix thoroughly. Drink in small sips throughout the day.
7. Vitamin teas from linden, mountain ash, black elderberry, which can be drunk twice a day. Frozen viburnum is indispensable, which is also added to tea or eaten in its pure form.
8. Another good folk remedy is tea with ginger and honey - the root is rubbed on a fine grater and added to tea, about 2 teaspoons of freshly grated ginger per 200 ml of boiling water, we eat honey, but only as a bite, do not add to boiling water.

During treatment, and especially at home, it is important to listen to your body! If you feel significant inconvenience and worsening of the symptoms of laryngitis, it is better not to tempt fate and change the treatment method to a more proven one.

Prevention of laryngitis

Prevention of laryngitis in adults implies the prevention of factors leading to the development of the disease.

• Remember that even some drugs can cause the mucous membrane to dry out, so read the instructions before drinking.
• Timely treatment of colds and chronic bacterial foci.
• In the event of acute respiratory infections or acute respiratory viral infections, adherence to the regime (home regimen, warm, plentiful drink, sparing the voice - speak softly or in a whisper, do not be nervous, do not walk, exclude physical exercise).
• Combat bad habits (smoking, alcohol).
• You should also not forget about simple things, such as wet cleaning of premises: dust is paramount, which can irritate absolutely any mucous membrane.
• Sports.

Laryngitis is not serious illnesses, but its neglected cases sometimes require surgical intervention. To prevent this, it needs to be treated in a timely manner and to the end. To do this, we recommend that at the first sign, contact an otolaryngologist.

Chronic laryngitis- this is an inflammation of the mucous membrane of the larynx, lasting a long period of time with periodic exacerbations. The disease often occurs in combination with chronic pharyngitis. Chronic laryngitis affects about 10% of the population. Adults get sick more often than children.

Basically, the disease occurs in smokers, people engaged in hazardous production, teachers, singers, artists. In children, the development of the disease occurs against the background of chronic tonsillitis, adenoiditis, rhinosinusitis.

The main reason is the activation and growth of the number of opportunistic bacteria. Frequent infections and their exacerbation reduce local immunity and lead to damage to the pharyngeal mucosa.

Mostly children and adults who are prone to lesions of the pharynx and organs of the upper respiratory tract, as well as people with a narrowed larynx, are ill.

Causes predisposing to the development of chronic laryngitis:

• poor environmental conditions;
• inappropriate working conditions;
• bad habits (smoking, alcohol);
• deviated nasal septum;
• the presence of polyps in the nose;
• inhalation of dry air;
• decreased immunity;
• diseases of the heart and blood vessels;
• pathology of the gastrointestinal tract and abdominal organs;
• exposure to allergens;
• diseases of the endocrine system;
• unbalanced diet with vitamin deficiency;
• chronic infectious diseases;
• the presence of opportunistic bacteria in the oral cavity;
• frequent manifestation of acute laryngitis;
• regular strong tension of the ligaments;
• a sharp fluctuation in temperature;
• consumption of alcoholic beverages.

Types, symptoms and characteristics of chronic laryngitis

It is usually divided into the following types:

• atrophic;
• catarrhal (banal);
• hyperplastic (hypertrophic).

Atrophic chronic laryngitis

With this type of disease that develops over a long period of time, the laryngeal tissues and tissues of the nasal cavities lose their functions, and are also unable to humidify the air while inhaling and retain viruses.

Symptoms:

• the mucous surface of the larynx becomes thinner, in connection with which there is a cough, dry throat, feeling unwell;
• thick secretion formations are poorly expectorated and accumulate in the nasopharynx, where they form yellowish crusts when dried;
• erosions appear at the place of separation of the crusts;
• mucous membranes become reddish-blue;
• there are hyperemic areas on the vocal cords;
• there may be areas with slight bleeding.

Chronic catarrhal laryngitis occurs with mild symptoms:

• perspiration;
• slight cough;
• dryness in the throat and its redness;
• hoarseness of the voice with a load on the ligaments.

With an exacerbation of the disease, signs of acute laryngitis appear, accompanied by:

• increased cough;
• aphonia (loss of sonority of voice);
• the appearance of mucus during coughing.

Hypertrophic chronic laryngitis subdivided into two forms:

• local;
• diffuse.

In the first case, the pathology covers a small area of ​​the mucosa, in the second case, it extends to almost the entire larynx.

Symptoms:

• in the throat there is a feeling of abrasion and a foreign object;
• pain during a conversation;
• voice becomes hoarse;
• exacerbation of a sharp dry cough.
• the mucous membranes of the larynx become gray-red;
• vocal cords thicken;
• nodules appear on the mucous membrane of the larynx.

This form of the disease is the most dangerous, since prolonged progression can lead to cancer of the larynx.

Diagnosis

If signs of the disease appear, you should seek advice from an otolaryngologist.

Diagnostics is as follows:

• initial inspection;
• clarification of the features of the development of the disease;
• identification of factors contributing to the development of pathology;
• laryngoscopy;
• biopsy of nodules, tubercles and areas of thickening of the throat mucosa;
• computed or magnetic resonance imaging.

If there are suspicions about malignancy, the patient is sent for examination to the oncologist.

Ways to treat pathology

When choosing a method for treating chronic laryngitis, the type of disease should be taken into account.

At catarrhal laryngitis treatment is associated with the therapy of respiratory diseases, influenza, measles, diphtheria. Required compliance with the drinking regimen, exclusion from the diet fatty foods, hot and cold food, smoking cessation.

For local treatment, moisturizing and therapeutic inhalations are used two or more times a day. Gargles are carried out with soda, sea salt, herbal solutions.

In chronic laryngitis in children under 3 years of age, the use of anti-inflammatory drugs in the form of sprays is not recommended due to the strong pressure of the jet, which can provoke laryngospasm.

Chronic hyperplastic laryngitis treated similarly to catarrhal.

The therapy is based on:

• use of funds local action for cauterization;
• prevention of tissue growth;
• fight against an infectious agent.

Treatment steps atrophic chronic laryngitis designed to soften and gently moisturize fabrics.

In the period of exacerbation of the disease, antibacterial drugs are used. Physiotherapeutic procedures (electrophoresis, laser therapy) are often used.

During the period of remission, treatment of the present foci of the nasopharynx and oral cavity is required. Be sure to stimulate the immune system with immunomodulatory drugs and vitamins.

With hypertrophic and atrophic form of chronic laryngitis of the larynx, in some cases, it is required surgery, which consists in removing overgrown tissues and restoring the vocal cords. After surgical intervention, specialist supervision and remedial measures are required.

Antibacterial agents that are prescribed for exacerbations:

To normalize the microflora in chronic catarrhal laryngitis, the following drugs are recommended:

With an exacerbation of the chronic form of laryngitis, the following local antiseptics are recommended:

Treatment of chronic laryngitis with a nebulizer. For these purposes, use:

• lazolvan;
• mineral water;
• saline.

Features of the treatment of atrophic laryngitis.

In this case, inhalations with the following drugs are indicated:

A positive effect of treatment is observed when using:

• laser therapy;
• vitamin therapy;
• electrophoresis.

Hypertrophic laryngitis

For its treatment, all of the above drugs are used, as well as agents that prevent tissue growth:

• hormonal drugs;
• zinc sulfate;
• collargol;
• sea ​​buckthorn oil.

If a conservative treatment did not lead to the desired result, further treatment of hypertrophic laryngitis is carried out by an operative method, usually with a laser.

Correct and effective treatment can only be prescribed by an otolaryngologist. Self-medication can aggravate the situation.

Complications of the disease

With improper treatment of the disease or the absence of therapeutic actions, complications may occur:

• loss of voice
• paresis of ligaments;
• manifestation of shortness of breath;
• the occurrence of suffocation;
• the formation of fibroids and polyps;
• development of a false cyst;
• the formation of a contact ulcer;
• development of cancer of the larynx.

To the main preventive measures aimed at preventing the development of chronic forms of the disease include:

• timely proper treatment infectious diseases;
• avoidance of vocal loads;
• people whose work is connected with stress on the voice require regular monitoring by a phoniatrist;
• quitting smoking and alcohol;
• strengthening immunity (hardening, exercise physical culture and other).

Timely diagnosis of acute and chronic laryngitis, as well as its correct treatment, will avoid serious complications. It is important not to miss the first signs of the development of the disease.

Chronic laryngitis is called inflammation of the mucous membrane of the larynx lasting more than 3 weeks. Timely diagnosis and adequate treatment of this pathology are extremely important, since it is social problem leading to disability of persons of voice-speech professions - vocalists, actors, teachers, guides. There may be a malignancy of the inflamed cells of the larynx, i.e., their degeneration into a cancerous tumor.

Causes of chronic laryngitis

The role in the development of a chronic inflammatory process in the larynx is played by:

• frequent acute laryngitis;
• chronic foci of infection of other localization (sinusitis, pharyngitis, tonsillitis, otitis media, caries);
• conditionally pathogenic microflora of the oral cavity;
• concomitant somatic pathology, in particular GERD (with this disease, the acidic contents of the patient's stomach are thrown into the esophagus, burning the mucous membrane, which creates favorable conditions for reproduction in the given area of ​​microorganisms);
• metabolic diseases (in particular, diabetes mellitus);
• dust, food, chemical allergens;
• regular excessive load on the vocal apparatus;
• work or living in conditions of severe air pollution with dust or chemicals;
• sudden changes in temperature;
• smoking and drinking alcohol;
• decrease in the overall resistance of the body.

Chronic laryngitis: symptoms and diagnosis

Chronic laryngitis may be accompanied by symptoms such as constant discomfort, sensation of a foreign body, coma in the throat.

Leading symptom chronic inflammation larynx is a change in the timbre of the voice, its hoarseness. The disease can be manifested by a constant feeling of dryness, itching, discomfort in the throat, a feeling of having a foreign body or a coma in it. Patients are concerned about coughing of varying intensity - from constant coughing to paroxysmal excruciating coughing. During the period of remission, the above symptoms are slightly expressed, and during exacerbation their intensity increases, the body temperature rises to subfebrile figures, complaints of weakness, fatigue and headache may appear.

The diagnosis of acute laryngitis is made on the basis of the patient's complaints, taking into account the history of the disease and life, and is confirmed during laryngoscopy or video endoscopy - a simple examination of the larynx or its examination using a video endoscope device. In some cases, for the purpose of accurate diagnosis, microlaryngoscopy is used (examination of the mucous membrane of the larynx under a microscope). If malignancy of the process is suspected during a laryngoscopy examination, a puncture biopsy is performed - sampling of affected cells with a special needle for subsequent histological examination.

Depending on the morphological changes in the mucous membrane of the larynx and the prevailing symptoms of the disease, acute laryngitis is usually divided into 3 forms: catarrhal, hypertrophic and atrophic.

In the catarrhal form of chronic laryngitis, the mucous membrane of the larynx is diffusely thickened, moderately hyperemic, blood vessels are visualized on the edematous vocal folds. During phonation, the glottis does not close completely. This form of the disease is manifested by constant hoarseness, a feeling of sore throat, and rapid fatigue of the voice. In addition, patients are occasionally concerned about a moderate cough with clear or whitish sputum.

Chronic hypertrophic laryngitis may be diffuse or limited. diffuse form the mucous membrane of the larynx is evenly edematous, with a limited area vocal folds symmetrically located connective tissue tubercles are visualized (nodules of singers - in adults, nodules of screamers - in children). characteristic clinical sign hypertrophic laryngitis is a pronounced hoarseness of the voice, up to its complete absence - aphonia.

In the atrophic form of chronic inflammation of the larynx, its mucous membrane is dry, thinned, covered with thick mucus and crusts. Clinically, the disease is manifested by a constant sensation of soreness and dryness in the throat, a hacking dry cough, in which crusts with streaks of blood come off. Hoarseness of the voice during the day is expressed in different ways: in the morning it is stronger, after coughing it decreases.

Chronic laryngitis: treatment

Unfortunately, get rid of this disease impossible, therefore, the treatment of chronic laryngitis in adults should be aimed at reducing its manifestations and improving the quality of life of the patient.

Of great importance in the treatment of chronic inflammation of the larynx are non-drug methods:

• to give up smoking;
• voice rest;
• sparing nutrition (warm, soft, neutral in taste food, exclusion of spicy, hot and cold dishes, carbonated drinks);
• plentiful drink (alkaline mineral waters ("Naftusya", Borjomi), warm milk with honey);
• prevention of hypothermia;
• airing the room in which the patient lives for 10 minutes every hour;
• adequate microclimate (temperature and humidity) in the room.

An important component of the treatment of chronic laryngitis is the timely treatment of its accompanying pathology (sanation of chronic foci of infection, correction of blood glucose levels, treatment of GERD).

Further aspects of therapy are different for different forms of the disease, so we will consider each of them separately.

Treatment of chronic catarrhal laryngitis

The healing air of the coniferous forest contributes to the recovery of patients with chronic laryngitis and prevents the development of exacerbations of this pathology.

This form of the disease is very well treatable. In addition to the above non-drug measures, drug therapy is also used:

• antiviral drugs (interferon inducers, Groprinosin);
• if necessary - systemic antibiotics (Amoxiclav, Moexipril);
• oil and alkaline inhalations;
• antitussives (Codeine);
• expectorants (preparations of marshmallow, ivy, plantain) and mucolytic (Acetyl-, Carbocysteine, Ambroxol, Bromhexine) agents;
• local anti-inflammatory and analgesic drugs (Isla lozenges, Neo-angin, Decatilene, Angilex, Tera-flu, Ingalipt sprays);
• local antibacterial drugs (Bioparox);
• multivitamin preparations (Duovit, Multitabs);
• immunomodulators (Respibron, Ribomunil);
• preparations containing bacterial lysates (IRS-19).

In a hospital setting, infusions into the larynx of medicines are also prescribed using a special laryngeal syringe - the so-called instillations.

When the symptoms of exacerbation regress, the use of physiotherapeutic methods of treatment is recommended:

• novocaine electrophoresis;

Treatment of chronic atrophic laryngitis

In the presence of appropriate symptoms, the same remedies are used that are recommended for the treatment of the catarrhal form of the disease. A feature of the treatment of atrophic laryngitis are inhalations of proteolytic enzymes (Chymotrypsin, Trypsin) in the form of aerosols.

Treatment of chronic hypertrophic laryngitis

Depending on the patient's condition, treatment can be conservative (include all or some of the drugs from the above groups) or surgical. The essence of the latter is that local anesthesia Under the control of a microscope, an ENT surgeon removes hyperplastic tissues. No less popular method of surgical intervention is the removal of growths from the vocal folds using a beam of cold plasma - coblation.

After the operation, the patient must follow the following recommendations:

• do not eat for 2 hours after leaving the operating room;
• do not cough (to avoid mechanical trauma to the postoperative wound);
• complete voice rest for the next 5-7 days;
• a sharp restriction of physical activity in the next 7-8 days.
• sparing diet;
• avoid contact with tobacco smoke, stop smoking.

Prevention of chronic laryngitis

The main preventive measures are:

• timely and adequate treatment of acute and chronic infectious diseases and somatic pathology;
• compliance with an adequate voice mode (avoiding overload of the vocal apparatus);
• regular observation of persons of voice-speech professions by a phoniatrist;
• refusal of active and passive smoking, alcohol intake;
• strengthening the general defenses of the body (walking in the fresh air, dosed physical activity, wiping cold water, foot baths and other activities).

About the treatment of laryngitis and how to distinguish it from similar diseases in the program "School of Dr. Komarovsky":

Laryngitis and croup - School of Dr. Komarovsky

Chronic laryngitis is an inflammation of the mucous membrane of the larynx, which is characterized by the appearance of hoarseness, itching, sore throat and coughing. The disease is promoted by frequent viral or bacterial infections, overexertion of the vocal cords and hypothermia.

Chronic laryngitis is widespread throughout the world and occurs in 8-10% of cases of all diseases of the upper respiratory tract (ear, throat and nose). Gender does not affect the incidence of the disease, average age patients with this pathology 45 - 60 years.

The prognosis for life and health is generally favorable. Chronic laryngitis with a hypertrophic component can subsequently lead to the development of a tumor of the larynx. In order to prevent such severe consequences, it is necessary to undergo laboratory and instrumental examination methods in a timely manner and take medicines.

Causes of the disease

The emergence of chronic laryngitis contributes to many reasons, among which the most significant are:

• frequent diseases of adults with acute respiratory viral infections(ARVI) with damage to the mucous membrane of the nasal cavity (rhinitis), the mucous membrane of the nasal sinuses (sinusitis, sinusitis), throat (pharyngitis), ear (otitis) and trachea (tracheitis);
• diphtheria;
• tuberculosis;
• syphilis;
• frequent, early transferred acute laryngitis;
• individual predisposition - anatomical features of the structure of the larynx, which contribute to the occurrence of inflammatory processes;
• excessive constant load on the vocal cords (teachers, teachers, kindergarten workers, commentators, event hosts, singers);
• dental reasons:
  • carious teeth;
  • pulpitis;
  • frequent stomatitis (ulcerative lesions of the oral mucosa);
• GERD (gastro-esophageal reflux disease) is the reflux of acidic contents from the stomach into oral cavity, larynx and trachea. The acidic environment in the larynx contributes to the creation of a favorable flora for the growth and reproduction of pathogenic bacteria;
• metabolic diseases (hypothyroidism, diabetes mellitus);
• diseases that lead to impaired immunity (mononucleosis, HIV (human immunodeficiency virus));
• allergic diseases (hay fever, bronchial asthma);
• working or living in areas with polluted air;
• smoking, drug addiction, alcohol abuse;
• sudden changes in temperature.

Classification of chronic laryngitis

Depending on the manifestations of the disease, chronic laryngitis is divided into:

1. catarrhal.
2. Hypertrophic.
3. atrophic.
4. Professional.

According to the severity of chronic laryngitis is divided into:

1. Light.
2. Medium severity.
3. Heavy.

Depending on the presence of complications, chronic laryngitis is:

1. Complicated.
2. Uncomplicated.

Symptomatic picture of chronic laryngitis

General manifestations of the disease

• increase in body temperature;
• general weakness;
• increased fatigue;
• decrease in working capacity;
• dizziness;
• headache;
• difficult nasal breathing;
• often - the occurrence of shortness of breath.

Manifestations of various forms of the disease

With catarrhal laryngitis observed:

• sore throat;
• hoarseness of voice;
• unproductive cough with scanty sputum.

This type of laryngitis with minor symptoms is the most mild form and responds quite well to treatment without any complications.

With hypertrophic laryngitis, there is:

• sharp pain, aggravated by stress on the vocal cords;
• hoarseness of voice;
• pain when swallowing.

Symptoms in this form of the disease are pronounced, and persist during exacerbation of the process. long time(10 - 14 days). Same way distinctive feature This form of the disease is the appearance on the vocal cords of growths of connective tissue - "singer's nodes", the size of which affects the degree of hoarseness of the voice.

With atrophic laryngitis, there is:

• sore throat;
• slight hoarseness of voice;
• paroxysmal cough with frequent discharge of blood crusts, which are formed due to the thinning of the mucous membrane of the larynx.

Symptoms of this form of the disease persist constantly. The cause of the occurrence is considered to be the frequent use of very spicy foods, which, along with the larynx, also affects the back surface of the pharynx. The disease occurs in adult residents of the mountainous regions of the Caucasus, Mongolia.

With professional laryngitis, there is:

• hoarseness of voice until its complete loss;
• sharp pain in the larynx;
• dry paroxysmal cough;
• "Singer's knots" on the vocal cords.

Symptoms of the disease with adequate treatment disappear in 3 to 7 days.

Specific forms of chronic laryngitis, which are often found among the adult population:

1. Diphtheria laryngitis is caused by the bacterium diphtheria, which affects the tonsils and spreads to the larynx. The main distinguishing symptom of the disease is the appearance of a whitish film that covers the larynx and can lead to suffocation.
2. Tuberculous laryngitis - occurs as a secondary disease in patients with tuberculosis. The mucous membrane of the larynx becomes tuberculous, destruction of the epiglottis can be observed.
3. Syphilitic laryngitis - occurs in patients with syphilis, starting from the second period of the disease. Dense plaques form in the larynx, which later become scars. This deformation of the vocal cords leads to a complete loss of voice.

Diagnosis of chronic laryngitis

1. Examination by a general practitioner or family doctor, with the further appointment of tests and the passage of narrow specialists.

2. Laboratory examinations:

Complete blood count: increase in leukocytes and ESR (erythrocyte sedimentation rate).

Urinalysis: an increase in squamous epithelium, leukocytes in the field of view, the appearance of slight traces of protein.

These changes in general analyzes indicate an inflammatory process in the body.

If diphtheria is suspected, flush from the oropharynx to the flora.

If tuberculosis is suspected - sputum analysis.

If syphilis is suspected - the Waserman reaction.

3. Instrumental Methods examinations:

Laryngoscopy - examination of the mucous membrane of the larynx and vocal cords in adults using an endoscope (a hollow tube made of optical fiber).

Video laryngoscopy is a study of the larynx in dynamics, which allows you to track the vibration of the vocal cords during a conversation.

Depending on the form of the disease, the data obtained during the examination will differ.

Catarrhal laryngitis - the mucous membrane of the larynx is edematous, pink. Blood vessels are visualized on the vocal folds. The glottis does not close completely.

catarrhal laryngitis

Hypertrophic laryngitis - the mucous membrane is bright red, thickened, edematous. Nodular growths of connective tissue are visualized on the vocal cords.

Hypertrophic laryngitis

Atrophic laryngitis - the mucous membrane is thinned, dry, covered with bloody crusts and thick mucus. The glottis does not close.

Atrophic laryngitis

4. Examination by an otorhinolaryngologist (ENT doctor) and appointment of treatment.

Treatment methods for chronic laryngitis

The volume of treatment, doses and frequency of taking drugs in each case are individual and are prescribed by your doctor.

Complications of chronic laryngitis

• laryngotracheitis (lesions of the larynx and trachea);
• ulcers of the larynx;
• polyps of the larynx (growth of the mucous membrane, more common in hypertrophic
  laryngitis);
• false croup (intense inflammation of the mucous membrane of the larynx, which makes breathing difficult);
• cancer of the larynx (occurs with atrophic laryngitis).

Prevention of chronic laryngitis

• active lifestyle;
• playing sports;
• hardening of the body;
• rejection bad habits;
• balanced diet;
• timely diagnosis and treatment of diseases of the upper respiratory tract and ENT organs;
• vaccination against diphtheria, tuberculosis;
• protected sex.

Chronic laryngitis treatment requires time-consuming and painstaking. Therefore, in order to avoid it, you need to monitor your health. As you know, any chronic disease preceded by its initial stage. If laryngitis is not treated in time, then chronic laryngitis appears over time.

Laryngitis is viral disease larynx, more precisely, its mucous membrane, and vocal cords. The patient feels stabbing dryness, irritation, sore throat. Over time, severe itching appears. The resulting hoarseness leads to a partial, and possibly complete, loss of voice. Another symptom of laryngitis is a barking cough.

What causes chronic laryngitis?

It was previously noted that with laryngitis, the mucous membrane of the throat becomes inflamed. What are the reasons for this? There may be several reasons for this:

• frequent relapses of the disease;
• professional costs (singers, teachers);
• smoking;
• excessive alcohol consumption;
• the presence of diseases of the nasopharynx, diabetes, allergies, heart or lung.

Taken together or individually, all these causes are conducive to damage to the mucous membrane due to the narrowing of the glottis.

Further, an edematous condition of the larynx appears, damaging the vocal cords. These painful symptoms can cause pharyngitis, tonsillitis, or rhinitis. With a disease of the upper respiratory tract, a diagnosis of chronic laryngitis is made.

The main cause of the disease in adults is smoking. According to statistics, for example, in our country, smoking men make up 65%, and women - 50%.

Types of chronic laryngitis

There are three types of this disease:

• catarrhal chronic;
• atrophic chronic;
• hyperplastic chronic.

With catarrhal chronic laryngitis, the manifestations of the disease are not very pronounced, compared with acute. There is a slight tickling in the throat, a weak cough, accompanied by the release of mucus. This mucus prevents the vocal cords from closing, resulting in a hoarse voice. The mucous membrane of the larynx has a gray-red color and spreads either over its entire part, or in a certain area. The vessels of the larynx dilate.

As the disease worsens, the symptoms worsen. To determine the diagnosis, a laryngoscopy is performed in a hospital facility. The patient has a cough, dryness in the larynx, reduced efficiency, weakness, and most importantly, discharge in the form of blood and sputum. This means that the disease has turned into chronic atrophic laryngitis. Atrophy occurs both in the larynx and in the nasopharynx. Often prominent lumps in the throat increase the inflammatory process. Trying to expectorate them, the sick person causes a stronger cough, worsening the situation. After the accumulation of a large number of traffic jams, hoarseness increases, breathing becomes difficult, the voice changes.

Hyperplastic chronic laryngitis is similar in symptoms to chronic catarrhal. Only the voice at the same time has a great hoarseness, because the vocal cords are greatly thickened. Sometimes with an exacerbation of the disease, calloused areas appear under the ligaments, causing pain. Without treatment, it can turn into cancer. Mostly this disease affects children and singers who do not protect their voice.

With exacerbation of laryngitis, to reduce the load on the ligaments, it is necessary to talk in a whisper. To avoid overdrying of the mucosa, breathing should be nasal.

Prevention of chronic laryngitis

Treatment of chronic laryngitis should be carried out in clean, ventilated areas. During illness, one should not be in a building where there is evaporation from caustic chemical substances: paints, varnish, etc. Inhaling these chemicals will aggravate the situation.

You need to eliminate certain foods from your diet. It includes spicy-salty, sour dishes, all kinds of seasonings and spices. All these products delay the healing process, as they negatively affect the throat.

Before going outside, it is recommended to stay indoors for 15 minutes: cold air can provoke illness in people who intensively load their voice.

An important condition for the prevention of the treatment of laryngitis is the maintenance of air humidity. required level. To do this, do not forget about airing the room and regular wet cleaning.

To strengthen the immune system, all doctors prescribe a systematic hardening of the body. This method gives excellent results, especially in children. But first you need to consult a pediatrician. Indeed, in young children, laryngitis can give various complications. After examining a small patient, the doctor will find the cause of the inflammation. It is he who will select the hardening system for your child. It is important to avoid hypothermia. Parents should not forget that the child must wash their hands, use wet wipes, that is, observe personal hygiene.

And adults need to give up bad habits. It is they who delay the course of treatment, and sometimes prevent complete recovery.

How to treat chronic laryngitis?

Depending on the type of disease, the attending physician prescribes a course of treatment. Patients diagnosed with atrophic and catarrhal chronic laryngitis are cured better and faster. Using in this case, inhalations from oils and alkalis, you can relieve pain in the larynx and its inflammation. Aerosol antibiotics are also used in the treatment of chronic laryngitis. With a strong cough, the doctor prescribes a warm drink with alkalis and cough medicines, supplementing the treatment with physiotherapy procedures.

It is advisable to talk less, especially in cold air.

In the room, you need to talk calmly, without straining your vocal cords, in normal mode.

A special conversation concerns hyperplastic chronic laryngitis, the treatment of which should be carried out under the strict supervision of a physician. It is dangerous because it can cause cancer.

Most often, this disease affects men over 40 years of age. At long-term treatment antibiotics, certain enzymes, and astringents are prescribed.

If medicines do not help, then surgery is performed.

Treatment of chronic laryngitis with folk remedies

Many have heard about the treatment of diseases with folk remedies. It did not pass by and laryngitis. Applying traditional medicine, you can improve your condition by gargling using various solutions (saline, alkaline). Medicinal sucking lozenges also help. Such a remedy relieves pain well.

Lemon and honey are very beneficial for a sore throat. Lemon juice helps produce acidic saliva to fight infection. For this purpose, squeezed juice is consumed repeatedly during the day, 1 tbsp. spoon. A teaspoon of honey is also added there and washed down with warm tea. Instead of lemon juice it is good to use cranberry juice.

A popular way to treat laryngitis is inhalation. Covering your head with a warm cloth, bending over the pan, you need to inhale the moist hot steam. Decoctions of herbs or potatoes perfectly help get rid of this ailment. From herbs, plantain, raspberry, sage are used.

For the treatment of adults, you can use warm beer. It is drunk in small sips, preheated. It is believed that with its help you can restore the voice. This tool is popular with singers, artists. And although alcohol is not recommended for laryngitis, it is used in small doses as a folk remedy. Here is another recipe. A drop of cognac is added to the eggnog to get rid of sore throats. Patients should eat no more than one serving daily.

If chronic laryngitis is treated with various warming compresses, then the disease will pass faster. For these purposes, you can use warm vegetable oil, badger fat, lard.

In each case, the use of folk remedies is an additional technique in the treatment of chronic laryngitis. It is taken as a basis drug treatment, which is carried out by an ENT doctor or a phthisiatrician.

Catad_tema Diseases of ENT organs - articles

ICD 10: J37.0, J37.1

Year of approval (revision frequency): 2016 (review every 3 years)

ID: KR321

Professional associations:

• National Medical Association of Otorhinolaryngologists

Approved

Chief Freelance Specialist Otorhinolaryngologist of the Ministry of Health of Russia Doctor of Medical Sciences, Professor N.A. DaikhesPresident of the National Medical Association of Otorhinolaryngologists Honored Doctor of Russia, Corresponding Member of the Russian Academy of Sciences Professor Yu.K. Yanov

Agreed

Scientific Council of the Ministry of Health Russian Federation __ __________201_

chronic hyperplastic laryngitis

chronic edematous-polypous laryngitis

List of abbreviations

GERD is gastroesophageal reflux disease.

CHL - chronic hyperplastic laryngitis

CL - chronic laryngitis

COPD - chronic edematous-polypous laryngitis

Terms and Definitions

Chronic hyperplastic laryngitis (CHL) (l. chronica hyperplastica) - a type of chronic laryngitis, characterized by diffuse hyperplasia of the mucous membrane of the larynx or limited hyperplasia in the form of nodules, mushroom-shaped elevations, folds or ridges.

Chronic edematous-polypous laryngitis (COPL) - Reinke-Gayek's disease (Reinkae edema)- chronic laryngitis, characterized by a polypoid proliferation of the mucous membrane of the vocal folds.

Gastroesophageal reflux disease (GERD) - morphological changes and a symptom complex that develop as a result of the reflux of the contents of the stomach and duodenum into the esophagus.

1. Brief information

1.1. Definition

Chronic laryngitis (CL) - chronic inflammatory disease mucous membrane of the larynx lasting more than 3 weeks.

1.2. Etiology and pathogenesis

Almost all chronic laryngitis are precancerous diseases. Chronic hyperplastic laryngitis (CHL) is characterized by hyperplasia of the epithelium of the mucous membrane of the larynx. The pathogenesis of the disease is not fully known. The pathogenesis of chronic edematous polypous laryngitis (COPL) is better known. The course of the disease is associated with anatomical features Reinke spaces. Immunohistochemical examination and electron microscopy of remote areas of the mucous membrane of the vocal folds in patients with Reinecke's disease reveal increased subepithelial vascularization with a large number of dilated vessels. The walls of the vessels are thinned, fragility of capillaries is noted. Fragility and change in the vascular pattern in the Reinecke's space is the cause of edema in this area, contributes to the progression of the disease. This can also explain the occurrence of hemorrhages in the vocal folds in the initial stage of the disease with a sharp increase in vocal loads. Besides, great importance has impaired lymph flow.

1.3. Epidemiology

Chronic laryngitis accounts for 8.4% - 10% of the total pathology of the ENT organs. COPD Reinke-Hajek accounts for 5.5 - 7.7% of all diseases of the larynx, leading to voice impairment. CHL is more common in men aged 40-60 years, and Reinke-Gajek COPD is more common in women.

1.4. ICD-10 coding

J37.0- Chronic laryngitis;

J37.1- Chronic laryngotracheitis.

1.5. Classification

Chronic laryngitis is divided into catarrhal, hyperplastic, atrophic and edematous-polyposis (Reinke-Gayek disease). Separately, specific laryngitis is isolated and, by some authors, pachydermia of the larynx is separately determined. Allocate a limited and diffuse form of hyperplastic laryngitis. Vocal fold nodules, according to some authors, are a form of hyperplastic laryngitis, but most authors tend to define this pathology as an independent one. Also, chronic laryngitis is divided into specific and nonspecific.

2. Diagnostics

2.1. Complaints and anamnesis

In CL, the leading complaint is a persistent violation of the voice function, sometimes cough, sore throat during vocal load, paresthesia in the projection of the larynx, and sometimes shortness of breath. Changes in voice function are different with different forms laryngitis. Chronic hyperplastic laryngitis is characterized by constant hoarseness with coarsening of the voice, the presence of many overtones. In chronic edematous-polypous laryngitis, the leading symptom is persistent hoarseness, which is characterized by a gradual shift in the timbre of the voice to the low frequencies of the male timbre. For atrophic laryngitis, a decrease in tolerance to voice loads, the appearance of cough and pain when trying to improve the volume of the voice, and hoarseness are more characteristic. In patients with catarrhal laryngitis, complaints of various paresthesias in the projection of the larynx and hoarseness, which increases during the vocal load, and a decrease in voice endurance come to the fore. With edematous-polypous laryngitis, respiratory failure may develop up to grade 3 stenosis of the larynx. The appearance of patients suffering from Reinecke's edema is characteristic: symptoms of hirsutism in women, a tendency to swelling of the face. With long-term laryngitis, in some cases, hypertrophy of the vestibular larynx develops due to the formation of vestibular-fold phonation. Cough is not a constant symptom of laryngitis. If the patient complains of coughing, an additional examination is necessary to determine the cause of the cough.

When collecting anamnesis, attention is paid to the screening of etiopathogenetic factors in the development of the disease, the frequency of relapses. The anamnesis of the voice disorder is important (the nature of the violation of the voice function, its duration, the patient's need for voice loads), as this allows not only to carry out the initial differential diagnosis of the disease and determine its duration, but also to build the correct system of staged voice restoration treatment.

2.2. Physical examination

During a physical examination of a patient with chronic laryngitis, attention should be paid to the external contours of the neck and larynx, the mobility of the skeleton of the larynx by palpation and during swallowing, and the participation of the neck muscles in phonation. With tense phonation, the tension of the external muscles of the neck is clearly visible. Regional lymph nodes are evaluated, their increase may indicate the degeneration of the precancerous process. Determine the size of the thyroid gland, which is especially important for patients with COPD. At the same time, a subjective assessment of voice quality, articulation and individual speech characteristics is carried out.

2.3. Laboratory diagnostics

A comprehensive general clinical examination of a patient with CL is recommended with the involvement of doctors of other specialties (gastroenterologist, endocrinologist, pulmonologist, neurologist, rheumatologist, infectious disease specialist, dermatologist, etc.).

Comments: is carried out to determine the etiological factors in the development of the inflammatory process and concomitant pathology.

Comments: Cultures should preferably be taken from the laryngopharyngeal mucosa without anesthesia or from the vocal folds under local anesthesia. The most common causative agents of laryngitis are: Streptococcus pneumonia, Haemophilus influenza, S. aureus, Mycoplasma spp., Actinomycesdiphteriae, Mycoplasma pneumonia, Chlamiophila pneumonia. Chronic hyperplastic laryngitis is characterized by associations of microorganisms, among which the most common are Staphylococcus aureus, epidermidis. It has been established that the causative agents of laryngomycosis in 97% of cases are yeast-like fungi of the genus Candida, most often Candida albicans and Candida spp., other species are less common - C.tropicalis, C.krusei, C.pseudotropicalis, C.glabrata.

Comments: Taking a biopsy in the larynx can be carried out with fibrolaryngoscopy, with indirect microlaryngoscopy, with direct microlaryngoscopy by an otorhinolaryngologist or endoscopist or oncologist who has the necessary surgical skills.

The microscopic picture in CHL is a combination of reactive changes in the surface epithelium and inflammatory, reparative, and sclerotic changes in the lamina propria. The inflammatory infiltrate is characterized by the predominance of mononuclear elements and plasma cells over segmented leukocytes. The predominance of cells of the productive phase of inflammation is the main distinguishing feature of chronic inflammation. The second morphological component is reactive changes in the integumentary and glandular epithelium in the form of its hyperplasia, acanthosis and impaired keratinization, dysplasia of the respiratory type epithelium - in the form of basal cell hyperplasia, an increase in the number of goblet cells and squamous metaplasia. Pronounced acanthosis of the stratified squamous epithelium is the underlying pachydermia. In COPD, it is not the signs of inflammatory infiltration that come to the fore, but a pronounced interstitial edema, often with stromal myxomatosis, a violation of the vascular wall, and a thickening of the basement membrane of the integumentary epithelium. Morphological examination in specific laryngitis and laryngomycosis, although it has its own characteristics, is only part of the diagnosis, the whole is of great importance. clinical picture diseases, data from other methods of examination. Histological examination in these cases - not always informative.

2.4. Instrumental diagnostics

Comments: It is optimal if the examination is recorded on video, as this will make it possible to fully monitor the patient with a precancerous process. If there is no opportunity to conduct microlaryngoscopy, the patient should be sent for a consultation to those institutions where this method of diagnosis exists. Microlaryngoscopy picture of CL varied. In the vast majority of cases, the pathology is bilateral. Chronic catarrhal laryngitis is characterized by an increase in the vascular pattern of the vocal folds, their hyperemia, and dryness of the mucous membrane. In chronic edematous-polypous laryngitis, polypoid degeneration of the mucous membrane can be different: from a mild fusiform-vitreous tumor that looks like an "abdomen" to a severe floating, polypoid, translucent or gray, gray-pink gelatinous thickening stenosing the lumen of the larynx. With atrophic laryngitis, the mucous membrane of the vocal folds looks dull, there may be viscous sputum, hypotonia of the vocal folds and non-closure during phonation.

In the diffuse form of CHL, infiltration of the vocal folds is noted, foci of keratosis are visible, hyperemia of the mucous membrane of the larynx, there may be fibrinous deposits, accumulation of viscous or purulent sputum. Keratosis is a pathological keratinization of the epithelium of the mucous membrane of the larynx, which can manifest itself in the form of pachydermia (thickening of the mucous membrane in the interarytenoid region), leukoplakia (white smoky formation), hyperkeratosis (hilly formation) located on the vocal folds.

In all forms of laryngomycosis, a common microlaringoscopic symptom was noted - the presence of whitish deposits or accumulation of thick sputum in various parts of the larynx in all patients. The diagnosis of laryngomycosis can only be made after verification of the pathogen.

The endovideolaringostroboscopic picture in the catarrhal form of laryngitis shows minor changes in the vibratory cycle, there is a decrease in the amplitude of the oscillation of the vocal folds and mucous waves. The subatrophic form of chronic laryngitis is characterized by a symmetrical decrease in the amplitude of the vocal folds, a decrease in the mucous wave and the absence of a closing phase. With edematous-polypous laryngitis, the closing phase is complete, the vocal folds fluctuations are asymmetric and irregular, the amplitude of the vocal folds fluctuations is reduced, and the mucous wave, on the contrary, is sharply increased. In the hyperplastic form of laryngitis, pronounced violations of the vibratory cycle are determined. They are determined by a decrease in the amplitude of oscillations of the vocal folds (along the entire length or in a separate area), the mucous wave is reduced or absent, non-vibrating sections of the mucous membrane are determined, an asymmetric and uneven change in the amplitude of oscillations and the mucous wave is noted. Video laryngoscopy is indicated for patients with limited keratosis. There are superficially located keratosis and soldered to the underlying layers. Adhesive keratosis is especially suspicious for cancer and is an absolute indication for surgical treatment.

Comments: at hastily used and other , based on the analysis of the vascular pattern of the affected areas of the mucous membrane, it is also possible to use contact endoscopy, which is an intravital morphological study of the mucous membrane.

Comments: the study helps at later stages of therapy to determine the quality and nature of the phonation of each individual patient in order to build the correct system of voice restoration treatment.

Recommended CT scan neck organs, if differential diagnosis is necessary, and a study of the function of external respiration is indicated for patients with COPD to verify the symptoms of latent respiratory failure in laryngeal stenosis.

Comments: consultation is indicated to identify etiopathogenetic factors in the development of the inflammatory process in the larynx.

2.5. Differential Diagnosis

Comments: The differential diagnosis of CHL and laryngeal cancer is often difficult. With indirect microlaryngoscopy, attention is paid to the nature of the vascular pattern. Laryngeal cancer is characterized by atypia of capillaries: an increase in their number, their convoluted shape in the form of a corkscrew and uneven expansion of blood vessels, petechial hemorrhages. In general, the vascular pattern of the vocal fold is chaotic. Violation of the mobility of the vocal fold, the unilateral nature of the process is alarming in terms of malignancy of chronic laryngitis. Other changes in the vocal fold are also noteworthy: severe dysplasia, mucosal infiltration, foci of dense keratosis, soldered to the underlying tissues, and others. The final differential diagnosis in CL is based on histological examination.

Comments: involvement in the pathological process of the larynx with Wegener's granulomatosis occurs in 6-25% of cases in the form of subglottic laryngitis, accompanied by subglottic stenosis. Isolated damage to the larynx with scleroma is observed in 4.5% of cases, more often the nose, nasopharynx and larynx are involved in the process. Pale pink bumpy infiltrates form in the subglottic space. The process can spread into the trachea or up to other parts of the larynx. Primary amylodiosis of the larynx occurs, nodular or diffuse-infiltrative forms, and secondary - against the background of chronic inflammatory systemic diseases (Crohn's disease, rheumatoid arthritis, tuberculosis, etc.). Most often, the lesion is diffuse in nature with an intact mucosa, sometimes with spread to the tracheobronchial tree. Amyloid deposits are localized mainly in the supraglottic region of the larynx, sometimes in the form of subglottic laryngitis. Sarcoidosis occurs in the larynx in 6% of cases in the form of epiglotitis and granulomas. The vocal folds are rarely affected. With rheumatoid arthritis, laryngeal pathology is diagnosed in 25-30% of patients. Clinically, the disease manifests itself in the form of arthritis of the cricoarytenoid joint. Differential Diagnosis is carried out on the basis of general clinical, serological examination and biopsy. Tuberculosis of the larynx is characterized by polymorphism of changes. The formation of miliary nodules, infiltrates, which undergo decay with the formation of granulations, ulcers and scarring, is noted. Tuberculomas and chondroperichondritis are often formed. Syphilis of the larynx manifests itself in the form of erythema, papules and warts. Ulcers are often formed, covered with a grayish-white coating.

3. Treatment

The goal of treatment is the elimination of the inflammatory process in the larynx, the restoration of a sonorous voice, the prevention of the degeneration of the inflammatory process into a malignant formation.

Indications for hospitalization. Patients who are scheduled for surgical treatment are hospitalized.

3.1. Conservative treatment

Antibacterial therapy is recommended for exacerbation of CL, while it is prescribed empirically with the use of broad-spectrum drugs (amoxicillin + clavulanic acid, respiratory fluoroquinolones, macrolides).

Comments: with severe inflammatory phenomena with the addition of purulent exudation. Perioperative antibiotic therapy is prescribed during surgical intervention with direct microlaryngoscopy, with implant methods of surgical correction, and a large amount of surgical intervention. When diagnosing a fungal infection, antimycotic drugs are prescribed. The use of specific therapy in the diagnosis of specific laryngitis does not exclude the use of local and general anti-inflammatory therapy.

Comments: indicated for exacerbation of hyperplastic and edematous-polypous laryngitis, with a history of allergies and, in some cases, laryngomycosis. Use should be avoided antihistamines with catarrhal and subatrophic form of laryngitis, since these drugs cause dryness of the mucous membrane of the larynx.

Anti-edematous therapy with systemic corticosteroids is recommended, which is indicated for patients after surgical interventions, if decortication of the vocal folds has not been performed, as well as for stenosis of the upper respiratory tract caused by an exacerbation of a chronic inflammatory process, and cannot be monotherapy.

Comments: locally - in the form of inhalations. You can prescribe local and systemic mucolytics at the same time. An indication for the use of mucolytics is the visualization of sputum and crusts in various parts of the larynx. It is possible to use long-term courses (up to 14 days) of drugs plant origin or containing essential oils in the presence of dry crusts, including patients with laryngomycosis. When choosing a mucolytic, it should be remembered that one of the etiological factors of CL is the pathology of the gastrointestinal tract, and therefore preference should be given to medicines without side effects that affect the function of the stomach.

Good clinical effect in patients with hyperplastic and edematous-polypous laryngitis, it is achieved with the use of complex enzyme preparations for a period of at least 14 days. These drugs can reduce inflammatory infiltration, local edema, affect cellular and humoral immunity.

Comments: For inhalations, antibacterial drugs, mucolytic, hormonal agents, herbal preparations with anti-inflammatory and antiseptic effects, as well as mineral water are used. The choice of the drug for inhalation depends on the form of inflammation: with the predominance of edema - inhalation with corticosteroids; with severe inflammation - inhalation with antiseptics, antimycotic drugs. Antibiotic inhalations are currently not available. Exceptions are the drug Tiamphenicol glycinate acetylcysteinate, which contains an antibiotic and a mucolytic and an antimicrobial drug hydroxymethylquinoxaline dioxide. It is better to start the inhalation procedure with inhalation of mucolytic agents and only after that, after 20 minutes, prescribe aerosols of other drugs. After inhalation of a corticosteroid and / or antiseptic, inhalation can be carried out after 20 minutes mineral water to moisturize the mucous membrane. Such inhalation procedures are carried out 1-2 times a day. The course of treatment - no more than 10 days.

Comments: in order to create conditions for physiological phonation and moistening of the mucous membrane, inhalations with mineral water can be prescribed for long periods, for example, for 1 month.

The use of physiotherapeutic methods of treatment is recommended: electrophoresis of 1% potassium iodide, hyaluronidase or calcium chloride on the larynx, therapeutic laser, microwaves; phonophoresis, including endolaryngeal.

Comments: For the treatment of patients with chronic edematous-polypous laryngitis, especially in the initial stages of the disease, injections of corticosteroid preparations into the vocal folds are also used. This procedure is performed with indirect, less often with direct microlaryngoscopy.

3.2 Surgical treatment

Comments: When performing a biopsy, it is necessary to take a sufficient amount of material for examination. The main errors in the diagnosis of laryngeal cancer are associated with an incorrectly chosen site for biopsy and insufficient material for research. Despite the fact that the main goal of surgical intervention is to verify the diagnosis and remove areas of hyperplastic mucous membrane, the mucous membrane of the vocal folds should be treated sparingly, avoiding, if possible, additional deterioration of the voice function. It is better to plan a surgical intervention after anti-inflammatory therapy, so that you can more accurately determine the place for a biopsy. The goal of surgery for COPD is to improve voice function and prevent complications - laryngeal stenosis. Histological examination of the removed mucous membrane is mandatory. Two surgical techniques are mainly used in COPD: the Kleinsasser vocal cord decortication and the Hirano technique. When decorticating the vocal folds, they try to preserve the epithelium in the commissure area on both sides, in order to avoid subsequent fusion and the formation of a scar membrane or adhesion. The essence of the M. Hirano technique is that an incision is made along the lateral edge of the vocal folds, the gelatinous mass is aspirated, the excess epithelial tissue is excised with scissors, and the rest is placed on the vocal fold. Laser techniques are also used. In the initial stages of the disease, a small area of ​​the altered mucosa can be removed. A complication of surgical intervention may be gross scarring of the vocal folds, the formation of a scar membrane.

3.3 Other treatment