Laryngitis diagnosis, treatment, and prevention | NCLEX-RN | Khan Academy

- [Voiceover] Diagnosis of
laryngitis, which is "itis,"

swelling, and "larynx," which
refers to the soft tissue

and vocal cords, known
also as the voicebox,

is mostly accomplished clinically

and through good history-taking.

A patient with recent
exposure to a viral illness,

such as the cold or the flu,

may actually develop laryngitis,

but, of course, exposure to
pathogens and viral agents

is not the only cause of laryngitis.

A careful history of the
patient needs to be taken.

For example, they may be exposed

to a lot of different chemicals or smoke,

or they may be a singer
and use their voice often,

or potentially they may have
a nodule on their vocal cords.

Whatever the cause is of
the laryngeal irritation,

or the irritation of the
larynx or the vocal cords,

asking questions is the best way

to diagnose the type of laryngitis.

Of course, laryngitis can
either be acute or chronic,

where acute is more associated
with viral illnesses

and very rarely, bacteria,
and chronic is associated

with irritants such as
smoking or repeated straining

of the voice caused by talking or singing.

Really, clinical is the best
way to diagnose laryngitis

because there are really
no other lab tests

that can be performed.

However, if a physician
or a health practitioner

suspects something other
than a viral illness,

which is the most common
cause of acute laryngitis,

then it might be good to get a direct view

of the larynx to see what's going on,

In fact, there might be a nodule,

or if the patient has
signs of acid reflux,

there might be damage seen to
the soft tissue of the larynx.

This can also help diagnose
bacterial laryngitis.

This could give direct
visualization of any exudate

or white pussy fluid created by bacteria,

and this would give a sign

that it could be a bacterial infection.

Direct visualization of the
larynx, known as laryngoscopy,

so visualization-scopy of the
larynx, can give confirmation

of many different causes of laryngitis.

To do laryngoscopy, a physician
or health practitioner

will insert a long tube-like structure

that has a camera on the end of it.

This camera will allow
a direct view from above

of the larynx and associated structures.

However, laryngoscopy
is usually only pursued

in cases of chronic laryngitis.

Now, in making the
diagnosis of laryngitis,

it's also important to note
that there are other causes

of a horse, raspy voice.

One of the most dangerous causes,

I'll go ahead and scroll
down here, is epiglottitis.

Epiglottitis is a very dangerous illness.

Epiglottitis is swelling
of the epiglottis,

and the epiglottis is this flap of tissue

that sits above the larynx.

It helps protect the airway.

However, when it gets swollen,

it can potentially obstruct the airway,

which can cause serious consequences

such as difficulty breathing.

Epiglottitis also causes
a hoarseness of the voice

just like laryngitis, but
obstruction of the airway

causing difficulty breathing
is the major source

of concern in epiglottitis.

Patients may also have
difficulty swallowing,

which can lead to drooling,
because a patient is unable

to swallow the saliva
that they're producing.

This can actually help in differentiating

between epiglottitis and laryngitis.

Another difference between the two

is in epiglottitis, there's no coughing.

Patients tend not to cough,

and that's because the
vocal cords and the larynx

have a lot of cough
receptors, so when the larynx

gets swollen, this can press
on those cough receptors

and cause a patient to cough.

However, the epiglottis doesn't
have any of these receptors,

and so patients tend
not to cough too much.

Epiglottitis can also cause high fever.

When dealing with a patient
with a hoarse voice,

it's important to look for these symptoms.

If any of these symptoms come up,

a patient should be treated
for epiglottitis right away.

Treatment for epiglottitis
will be antibiotics.

Now, the treatment for
laryngitis is very supportive.

It has to do with general home remedies.

Patients are advised to rest their voice,

drink lots of fluids, and pursue anything

that can help soothe the
pain in their throat.

Patients can use such things
as cough drops or lozenges.

It's also recommended
to gargle with saltwater

because the saltwater can kill

both pathogens and also decrease swelling.

This is just accomplished through osmosis.

Water can be pulled out
of the swollen soft tissue

in the presence of a saltier
environment on the outside.

Treatments for chronic
laryngitis are more focused

on reducing exposure to
the chemical irritant

or whatever is causing
the chronic laryngitis.

For example, quitting smoking

can help resolve chronic laryngitis,

or if the patient is a
singer, they can decrease

the use of their voice and go

through proper speech counseling

to decrease the trauma to their voicebox.

Treatment, again, is home remedies

and also decreasing exposure to irritants.

Last of all, prevention
of laryngitis focuses

on good hygiene to avoid
any viral illnesses

and decreasing exposure
to any noxious substances

such as cigarette smoke.