How is laryngitis diagnosed?
The health-care professional often can make the diagnosis of laryngitis in the doctor’s office with little testing required. The history of upper respiratory tract infection associated with loss of voice is reinforced by the patient answering questions in a hoarse voice. The examination is often brief and limited to the ears, nose, and throat, looking for other potential causes of the cold-like symptoms. If the throat is red and there is a concern about a streptococcal throat infection (strep throat) a throat swab for a rapid strep test may be ordered.
If the hoarse voice becomes chronic, the health care professional may want to take a more detailed history, trying to learn why the larynx has remained inflamed for such a long time.
The following questions may be asked:
- Diet, use of alcohol, aspirin, ibuprofen, and smoking, all of which may cause gastroesophageal reflux disease. Alcohol and smoking can irritate the vocal cords.
- Work and hobbies may reveal evidence of repeated chemical inhalation and exposure to air pollution.
- Repeated use of asthma inhalers may cause chronic inflammation of the vocal cords.
- Any signs or symptoms that suggest the potential of thyroid disease, stroke, or cancers of the head and neck will be explored.
Most cases of laryngitis need no testing to confirm the diagnosis. In those patients with chronic laryngitis, the necessity for blood tests, X-rays and other diagnostic tests will depend upon the patient presentation and the potential concerns that the health care professional has regarding the cause of the hoarseness.
Laryngoscopy is the most common test performed to look directly at the vocal cords and evaluate their function. This procedure uses a thin tube containing a lighted fiber optic camera that is inserted through the nose into the back of the throat. The health care practitioner performing the procedure can see whether the vocal cords are inflamed, if there are any polyps or nodules growing on them, and if the vocal cords move appropriately with breathing and speaking. This test is often performed by an otolaryngologist (ear, nose, and throat specialist), but many other physicians and specialists are trained to perform direct laryngoscopy. Indirect laryngoscopy may be attempted using a mirror placed in the back of the throat to visualize the vocal cords.
What kinds of doctors treat laryngitis?
Laryngitis most is often first evaluated by a primary care provider including internists, pediatricians, and family medicine specialists. Since most often the illness is self-limited, no further treatment is usually required. When laryngitis persists, otolaryngologists (ear, nose and throat (ENT) specialist), gastroenterologists, or emergency department doctors may be consulted.