Further Outpatient Care
If the patient's laryngitis symptoms have not resolved after approximately 3 weeks, an otolaryngologist should be consulted to evaluate the patient for chronic laryngitis. A patient who has hoarseness and is not following a usual course of acute laryngitis or has risk factors for upper aerodigestive tract carcinoma should be promptly seen by an otolaryngologist.
Inpatient & Outpatient Medications
In addition to conservative treatment of an upper respiratory tract infection and humidification of the airway with vocal rest, antipyretics and decongestants may be administered for the patient's comfort. Mucolytics such as guaifenesin may be used to aid in clearing secretions.
An excellent systematic review attempted to answer the question of whether antibiotics were recommended in cases of acute laryngitis. The authors cite 2 studies by the same research group. In one study, patients received either penicillin V (800 mg for 5 d) or placebo. The 2 groups showed no significant difference in symptoms or blinded voice evaluation findings. The research group published a second study in which erythromycin was administered. Those who received erythromycin showed a small voice benefit after one week and slightly better cough symptoms after 2 weeks. The overall conclusion from the Cochrane Database Systematic Review was that antibiotics are not indicated for most cases of acute laryngitis. [19, 22]
Prognosis
Acute laryngitis is usually self-limited. If the patient adheres to a treatment plan as outlined above, the prognosis for a rapid recovery to a premorbid level of phonation is excellent.
Patient Education
For excellent patient education resources, visit eMedicineHealth's Ear, Nose & Throat Center. Also, see eMedicineHealth's patient education article Laryngitis.
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This view depicts the larynx of a 62-year-old woman with an intermittent history of exudative acute laryngitis that was treated conservatively. Courtesy of Ann Kearney, Palo Alto, Calif.
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This view depicts the larynx of a 53-year-old woman, a sixth-grade science teacher, whose chief symptom was a hoarse and breathy voice. Note the alternating areas of erythema and normal mucosa on the vocal folds. Also note irregularities in the contour of the vocal folds. Courtesy of Ann Kearney, Palo Alto, Calif.