Definition

Laryngopharyngitis is a disease of the upper respiratory tract characterized by inflammation of the larynx (laryngitis) and the pharynx (pharyngitis). The larynx, located in the upper neck at the back of the throat, contains the vocal cords. The pharynx is the part of the throat situated behind the mouth. Inflammation of the larynx can cause the vocal cords to swell, leading to muffled, hoarse sounds. When you try to speak, only whispers or squeaks may be heard. Additionally, inflammation of the pharynx can cause itching, discomfort, dryness in the throat, and difficulty swallowing.

Laryngopharyngitis is commonly caused by a viral or bacterial infection. It is a relatively common condition and usually not serious. In acute cases (lasting less than three weeks), symptoms typically resolve on their own, but in some instances, it can develop into a chronic condition (lasting more than three weeks).

Causes

Acute inflammation of the larynx is usually temporary, caused by overuse of the vocal cords or an infection. Common causes of acute laryngitis include:

• Viral infections
• Overuse of the vocal cords from excessive talking or shouting
• Bacterial infections
• Excessive alcohol consumption

Chronic laryngitis occurs due to prolonged exposure to irritants and is generally more severe and has longer-lasting effects than acute laryngitis. Causes of chronic laryngitis include:

• Frequent exposure to harmful chemicals
• Gastroesophageal reflux disease (GERD)
• Frequent and recurrent sinus infections
• Smoking or exposure to secondhand smoke
• Overuse of the vocal cords
• Fungal infections from frequent use of inhaled asthma medications
• Cancer, vocal cord paralysis, or age-related changes in the vocal cords, which can cause persistent hoarseness and throat pain

Pharyngeal inflammation is most often caused by a viral or bacterial infection but can also be triggered by allergies, dry throat, exposure to irritants, acid reflux, or tumors in the throat. Viruses and bacteria that can cause pharyngitis include:

• Influenza and Parainfluenza viruses
• Coxsackievirus
• Epstein-Barr virus
• Measles virus
• Chickenpox virus
• COVID-19 virus
• Adenovirus
• Rhinovirus
• Group A Streptococcus bacteria
• Chlamydia
• Gonorrhea
• Corynebacterium

Risk Factor

Several factors can increase the risk of laryngopharyngitis, including:

• Exposure to upper respiratory tract infections, such as flu, bronchitis (infection of the lung tract), or sinusitis (infection of the sinuses)
• Exposure to irritants such as cigarette smoke, excessive alcohol consumption, acid reflux, or workplace chemicals
• Overuse of the vocal cords through excessive talking, shouting, or singing
• Child or teenager, as they are more frequently exposed to infections
• History of allergies to dust, mold, or pet dander
• Weakened immune system due to conditions like HIV, diabetes, or treatments with steroids or chemotherapy, as well as stress, fatigue, and poor diet

Symptoms

Symptoms of laryngopharyngitis typically combine those of laryngitis and pharyngitis, such as:

• Sore throat, especially when swallowing or speaking
• Throat itching
• Mild fever
• Hoarse voice
• Difficulty speaking
• Difficulty swallowing
• Dry cough
• Runny nose and sneezing
• Body aches
• Headache
• Fatigue
• Frequent throat clearing
• Swollen lymph nodes around the neck

Diagnosis

To diagnose laryngopharyngitis, a doctor will start with an interview to ask about your symptoms, with the most common complaints being sore throat and hoarseness. The doctor will then perform a physical examination of your throat using a headlamp to check for white or gray spots, swelling, and redness. They may also examine the vocal cords using a small mirror, check the ears and nose, gently feel the neck for swollen glands, and listen to your breathing with a stethoscope. Additional tests may include:

• Laryngoscopy examination, using a small camera (endoscope) inserted through the nose or mouth to view the vocal cords more clearly
• Swab and culture test, where a sample from the throat is taken to grow in a lab to identify the bacteria causing the infection
• Biopsy, if there are nodules or lumps on the vocal cords or throat, to examine tissue under a microscope

Management

Most cases of laryngopharyngitis are viral and will resolve on their own within one or two weeks. To aid recovery, rest your voice and drink plenty of fluids. In some cases, the doctor may prescribe medications such as:

• Antibiotics. If laryngopharyngitis is caused by a bacterial infection, your doctor may prescribe antibiotics. Antibiotics are not effective in cases caused by a viral infection.
• Corticosteroids. This medication helps to reduce swelling and inflammation.
• Pain relievers. You can take over-the-counter pain relievers such as Paracetamol, Naproxen, or Ibuprofen to reduce the pain and fever symptoms you are experiencing.

Self-care and home remedies to alleviate symptoms and reduce strain on the vocal cords include:

• Inhaling humidified air, using a humidifier at home or office, or breathing steam from a bowl of hot water or hot shower
• Resting your voice as much as possible, avoiding loud or prolonged talking or singing
• Drinking plenty of fluids to prevent dehydration (avoid alcohol and caffeine)
• Keeping the throat moist by sucking on lozenges, gargling with salt water, or chewing gum
• Avoiding decongestants, which can dry out the throat
• Avoiding whispering, which strains the vocal cords more than normal speaking

Complications

Laryngopharyngitis generally does not cause complications. However, in some cases, the infection can spread to other parts of the respiratory tract, such as the epiglottis, leading to epiglottitis.

Prevention

The best way to prevent laryngopharyngitis is to avoid its causes. Steps to maintain vocal cord health and prevent throat irritation include:

• Avoiding coffee, soda, or caffeinated products that can dry out the throat
• Staying hydrated by drinking plenty of water throughout the day
• Not smoking and avoiding secondhand smoke, which can irritate the vocal cords
• Not frequently clearing your throat, which can cause abnormal vibrations and irritation of the vocal cords
• Washing hands often with soap, especially when around sick individuals

When to See a Doctor?

Most cases of laryngopharyngitis improve within a week. Consult a doctor if symptoms persist beyond a week or if you experience:

• Difficulty swallowing
• Breathing difficulties
• Coughing up blood
• Persistent fever despite medication
• Worsening sore throat