Intended for healthcare professionals

Clinical Review


BMJ 2014; 349 doi: (Published 09 October 2014) Cite this as: BMJ 2014;349:g5827
  1. John M Wood, ENT registrar1,
  2. Theodore Athanasiadis, laryngologist2,
  3. Jacqui Allen, laryngologist3
  1. 1Otolaryngology Head Neck Surgery, Princess Margaret Hospital, Subiaco, WA, Australia
  2. 2Adelaide Voice Specialists, Adelaide, SA 5000, Australia
  3. 3North Shore Hospital, Auckland, New Zealand
  1. Correspondence to: T Athanasiadis theoathans{at}

Summary points

  • The cause of laryngitis is varied and determines appropriate treatment

  • Acute laryngitis is common and generally self limiting

  • Clinicians should re-visit the diagnosis and ensure endoscopic examination has been performed if symptoms persist or red flag symptoms develop

  • Initial assessment must consider airway patency and rule out malignancy

  • Patients with compromised immunity may be at increased risk of infectious causes

  • The impact of laryngopharyngeal reflux is becoming widely recognised, with research focused on improving diagnosis and treatment

Laryngitis describes inflammation of the larynx, and a variety of causes result in the presentation of common symptoms. Laryngitis may be acute or chronic, infective or inflammatory, an isolated disorder, or part of systemic disease, and often includes symptoms such as hoarseness. Commonly, laryngitis is related to an upper respiratory tract infection and can have a major impact on physical health, quality of life, and even psychological wellbeing and occupation if symptoms persist.1 Overall, laryngitis incorporates a cluster of non-specific laryngeal signs and symptoms that can also be caused by other diseases. Consequently diagnosis can be difficult and requires correlation of history, examination, and, if necessary, specialised assessment, including visualisation of the larynx and stroboscopy. Acute laryngitis is typically diagnosed and managed at the primary care level. In at risk populations, or those with persisting symptoms, referral to a specialist otolaryngologist should be considered. The aim of this review is to assist non-specialists in assessing and managing people with laryngitis and to identify the cohort that requires specialist input.

Sources and selection criteria

We searched Medline, PubMed, and the Cochrane Database of Systematic Reviews, using the search terms “laryngitis”, “laryngeal inflammation”, and “dysphonia”. In addition we searched for specific conditions: “laryngopharyngeal reflux”, “sarcoidosis”, “pemphigoid”, and “tuberculosis”. Studies were limited to adult populations and where possible included systematic reviews and randomised controlled trials; we also included case …

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