Cough may cause laryngitis

Laryngitis - Causes & Risks

Acute forms

Acute laryngitis
In most cases, acute laryngitis is accompanied by a cold or a flu-like infection or influenza (catarrhal laryngitis). Accordingly, it is almost always triggered by the typical viruses of the respiratory tract, which are mainly transmitted by droplet infection (coughing or sneezing) or smear infection. Very often the upper airways such as the nose and throat are initially affected (rhinitis), inflammation of the throat (pharyngitis), from where the inflammation then spreads down to the larynx.

In general, a previously damaged larynx mucosa is more susceptible to pathogens, so smokers and people who spend a lot of time in polluted air are particularly affected. The risk of developing cold-related laryngitis is particularly high, of course whenever the immune system is weakened. This is why a particularly large number of patients suffer from it during the typical flu season in winter. Acute laryngitis is more rarely triggered by an additional bacterial infection (superinfection).

Acute laryngitis can develop through excessive use of the voice in dry, smoky rooms even without bacterial or viral triggers. In this case one speaks of a non-inflammatory irritation state.

Pseudo croup
The so-called pseudocroup is an acute laryngitis in which the soft tissues below the vocal folds (subglottis) in particular become inflamed and swell up (stenosis). Like common cold laryngitis, the pseudocroup is mostly caused by parainfluenza viruses (50%), sometimes also by influenza, rhinoceros, RS, adeno or measles viruses. Infection also occurs through droplet or smear infection. The disease occurs particularly frequently in infants and children between the ages of 6 months and 5 years because their larynx is still very narrow and swells up more quickly. There are noticeably many infections in autumn and towards the end of winter. Subglottic laryngitis is very rare in adults.

Inflammation of the epiglottis (epiglottitis)
Epiglottitis is also a disease that occurs predominantly in children between the ages of two and six, but it can also affect adults. In contrast to the common cold-related laryngitis and croup, epiglottitis is caused by bacteria, but Haemophilus influenzae, streptococci, staphylococci, and pneumococci are also found in adults. The pathogen leads to inflammation of the epiglottis with severe swelling (epiglottic edema) or even to an abscess (epiglottic abscess). The severe swelling causes acute shortness of breath and even suffocation.

Diphtheria - also known as "real croup" - is often accompanied by symptoms of inflammation of the larynx (laryngitis) or tonsillitis. This dangerous infectious disease is caused by the bacterium "Corynebacterium diphtheria". Since it was possible to vaccinate against diphtheria, this disease has become much rarer in Germany. In Eastern Europe, however, there are always new cases of illness, i.e. a basic immunization and regular refreshment of the vaccination protection (for adults every 10 years) are important in any case. Due to the lack of booster vaccinations, so-called "childhood diseases", such as diphtheria, occur again and again in adulthood, and recently more frequently.

Chronic forms

Chronic laryngitis
In the vast majority of cases, chronic laryngitis is caused by long-term irritation of the mucous membranes, e.g. from excessive alcohol or nicotine consumption or dry, dusty or smoky air in the workplace. Obstructed nasal breathing and the resulting constant mouth breathing can also have unfavorable effects and lead to chronic laryngitis in the long term. Less common causes are, for example, incorrect voice technique or constantly rising stomach acid (reflux disease).

As a result of all these stimuli, swelling (hyperplasia) and keratinization of the tissue on the larynx and vocal folds can result, which is then expressed in hoarseness. Often edema also forms and the mucous cells increase (chronic hyperplastic laryngitis / Reinke edema). In the rarer chronic atrophic form (atrophy = tissue atrophy), however, the mucous cells decrease.

Local disruptive factors
A local disruptive factor in the larynx can also lead to chronic inflammation. This can be a foreign body that has penetrated, a malformation or a benign tumor (e.g. a fibroma or papilloma).

Systemic causes
Chronic changes in the larynx also occur in certain systemic and infectious diseases such as tuberculosis, advanced syphilis or sarcoid.