Last updated: October 23, 2023

Summarytoggle arrow icon

Laryngitis is inflammation of the larynx. The main symptom is an altered voice (e.g., hoarseness). Acute laryngitis is commonly caused by viral upper respiratory tract infection (URTI) or vocal strain and is typically self-limited, with complete resolution within three weeks. Laryngitis is considered chronic if symptoms last longer than three weeks. Common causes of chronic laryngitis include gastroesophageal or laryngopharyngeal reflux, smoking, and postnasal drip. Acute laryngitis with no red flags of hoarseness is diagnosed clinically without any further evaluation, especially if the patient's history is consistent with viral URTI or vocal strain. Individuals with red flags of any duration and individuals with dysphonia and/or hoarseness that lasts for four weeks or longer require laryngoscopy to evaluate for alternative diagnoses. Further evaluation is guided by history, physical examination, and laryngoscopy. Laryngitis is treated with supportive measures (e.g., voice rest, hydration, and avoidance of airway irritants) and, in the case of chronic laryngitis, treatment of the underlying cause.

Definitiontoggle arrow icon

  • Acute laryngitis: inflammation of the larynx, which contains the vocal fold mucosa, for < 3 weeks
  • Chronic laryngitis: inflammation of the larynx for ≥ 3 weeks

Etiologytoggle arrow icon

Etiology of acute laryngitis [1][2]

Etiology of chronic laryngitis [1]

Clinical featurestoggle arrow icon

Managementtoggle arrow icon


The majority of patients with acute laryngitis can be diagnosed clinically and do not require diagnostic studies. [6]

Supportive care for laryngitis

  • Vocal rest: Avoid shouting, using a loud voice, and forced whispering.
  • Analgesia as needed
  • Mucosal hydration
    • Drink water.
    • Increase humidity (e.g., cool mist humidifier) in dry environments.
    • Avoid medications that dry the airway mucosa. [6]
  • Avoid exposure to airway irritants, e.g., via smoking cessation.

Management of acute laryngitis [6]

  • Acute laryngitis is primarily a clinical diagnosis; consider diagnostic studies only: [6]
  • Typically self-limited and resolves in 1–3 weeks with supportive care only [5][6][10]
  • Follow up within a few weeks to ensure resolution.

Antibiotics are ineffective in improving symptoms in adults with acute laryngitis. [10]

Management of chronic laryngitis [6]

Do not initiate treatment with proton pump inhibitors, antibiotics, or corticosteroids without first confirming the cause of chronic laryngitis. [6]

Diagnostic studies for laryngitis

Diagnostic studies are usually performed by otolaryngology.

Laryngoscopy [1]

  • Laryngoscopy is used to assess for characteristic changes of laryngitis.
  • Biopsy can be performed on lesions or for tissue culture. [11]
  • Consider laryngeal swabs in chronic laryngitis. [11][12]


Children with inspiratory stridor consistent with typical croup do not require laryngoscopy or referral to otolaryngology. [13]


Potential findings in laryngitis [9]

Imaging [6][16]

Differential diagnosestoggle arrow icon

The differential diagnoses listed here are not exhaustive.

Referencestoggle arrow icon

  1. Stachler RJ, Francis DO, Schwartz SR, et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018; 158 (1_suppl): p.S1-S42.doi: 10.1177/0194599817751030 . | Open in Read by QxMD
  2. Walls R, Hockberger R, Gausche-Hill M, Erickson TB, Wilcox SR. Rosen's Emergency Medicine 10th edition- Concepts and Clinical Practice E-Book. Elsevier Health Sciences ; 2022
  3. House SA, Fisher EL. Hoarseness in Adults. Am Fam Physician. 2017; 96 (11): p.720-728.
  4. Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2). McGraw-Hill Education / Medical ; 2018
  5. Wood JM, Athanasiadis T, Allen J. Laryngitis. BMJ. 2014; 349: p.g5827.doi: 10.1136/bmj.g5827 . | Open in Read by QxMD
  6. Reveiz L, Cardona AF. Antibiotics for acute laryngitis in adults. Cochrane Database Syst Rev. 2015.doi: 10.1002/14651858.cd004783.pub5 . | Open in Read by QxMD
  7. Thomas CM, Jetté ME, Clary MS. Factors Associated With Infectious Laryngitis: A Retrospective Review of 15 Cases. Ann Otol Rhinol Laryngol. 2017; 126 (5): p.388-395.doi: 10.1177/0003489417694911 . | Open in Read by QxMD
  8. Conti KR, Zhao A, Hunt E, Jaworek AJ. Practical Application of Culture‐Directed Treatment for Chronic Bacterial Laryngitis. Laryngoscope. 2023.doi: 10.1002/lary.30906 . | Open in Read by QxMD
  9. Smith DK, McDermott AJ, Sullivan JF. Croup: Diagnosis and Management. Am Fam Physician. 2018; 97 (9): p.575-580.
  10. Lechien JR, Akst LM, Hamdan AL, et al. Evaluation and Management of Laryngopharyngeal Reflux Disease: State of the Art Review. Otolaryngol Head Neck Surg .. 2019; 160 (5): p.762-782.doi: 10.1177/0194599819827488 . | Open in Read by QxMD
  11. Stachler RJ, Dworkin-Valenti JP. Allergic laryngitis: unraveling the myths. Curr Opin Otolaryngol Head Neck Surg. 2017; 25 (3): p.242-246.doi: 10.1097/moo.0000000000000354 . | Open in Read by QxMD
  12. Kenn K, Balkissoon R. Vocal cord dysfunction: what do we know?. Eur Respir J. 2010; 37 (1): p.194-200.doi: 10.1183/09031936.00192809 . | Open in Read by QxMD
  13. The AAO-HNSF, as Part of the Choosing Wisely® Campaign, Identifies Five Commonly Used Tests and Treatments to Question. Updated: February 21, 2013. Accessed: August 2, 2023.
  14. ACR Appropriateness Criteria: Staging and Post-Therapy Assessment of Head and Neck Cancer. . Accessed: January 1, 2023.
  15. Dankbaar JW, Pameijer FA. Vocal cord paralysis: anatomy, imaging and pathology. Insights Imaging. 2014; 5 (6): p.743-751.doi: 10.1007/s13244-014-0364-y . | Open in Read by QxMD
  16. Caserta MT. Acute Laryngitis. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 2015: p.760-761.e1.doi: 10.1016/b978-1-4557-4801-3.00060-6 . | Open in Read by QxMD
  17. Jetté M. Toward an Understanding of the Pathophysiology of Chronic Laryngitis. Perspect ASHA Spec Interest Groups. 2016; 1 (3): p.14-25.doi: 10.1044/persp1.sig3.14 . | Open in Read by QxMD
  18. Zhukhovitskaya A, Verma SP. Identification and Management of Chronic Laryngitis. Otolaryngol Clin North Am. 2019; 52 (4): p.607-616.doi: 10.1016/j.otc.2019.03.004 . | Open in Read by QxMD

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