Chronic Laryngitis Treatment in Singapore

Living with a persistently hoarse voice or recurring throat discomfort can impact your personal and professional life. Chronic laryngitis, a condition that may develop gradually and persist for extended periods without appropriate treatment. Our ENT specialist provides evaluation and treatment approaches that aim to address the underlying causes of voice problems. Understanding this condition and available treatment options can be a step towards managing your voice health.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

What is Chronic Laryngitis?

Chronic laryngitis is persistent inflammation of the larynx (voice box) lasting more than three weeks. Unlike acute laryngitis which typically resolves within days, chronic laryngitis develops gradually and may require medical intervention. The condition affects the vocal cords, causing them to become swollen and irritated, which alters voice quality and may cause discomfort.

In Singapore’s humid climate and urban environment, chronic laryngitis can affect adults, with teachers, singers, and professionals who use their voice extensively being commonly affected. The condition can result from various factors including environmental irritants, acid reflux, and vocal strain. Early recognition and appropriate treatment may help prevent permanent vocal cord damage and support normal voice function.

*Individual results and timelines may vary.*

Types of Chronic Laryngitis

Irritant-Induced Laryngitis: This form develops from prolonged exposure to environmental irritants such as cigarette smoke, chemical fumes, or air pollution. Singapore’s occasional haze episodes can worsen this type. The vocal cords may become chronically inflamed due to continuous irritation, potentially leading to persistent hoarseness and throat discomfort.
Reflux Laryngitis: Also known as laryngopharyngeal reflux (LPR), this occurs when stomach acid repeatedly backs up into the throat and larynx. Unlike typical heartburn, patients may not experience chest burning. The acid can irritate the delicate tissues of the vocal cords, potentially causing chronic inflammation and voice changes.
Infectious Laryngitis: Though less common in chronic cases, persistent fungal infections (particularly in immunocompromised patients) or recurring bacterial infections can cause ongoing laryngeal inflammation. This type may require specific antimicrobial treatment alongside voice therapy.
Mechanical/Traumatic Laryngitis: Results from chronic voice abuse or misuse, common amongst professional voice users. Repeated vocal trauma may lead to swelling, nodules, or polyps on the vocal cords. This type often requires both medical treatment and voice rehabilitation therapy.

Causes & Risk Factors

Causes

Gastro-oesophageal reflux disease (GORD): Stomach acid may repeatedly irritate laryngeal tissues
Chronic sinusitis: Post-nasal drip may continuously irritate the throat and vocal cords
Smoking: Direct chemical irritation and heat damage to vocal cord tissues
Excessive alcohol consumption: May dehydrate and irritate throat tissues
Voice overuse or misuse: Prolonged speaking, shouting, or incorrect vocal technique
Environmental irritants: Chemical fumes, dust, or pollutants in workplace or home
Allergies: Chronic post-nasal drip and throat clearing may irritate the larynx

Risk Factors

Occupation requiring extensive voice use: Teachers, singers, call centre workers
Age: Natural ageing may affect vocal cord elasticity and healing
Weakened immune system: May increase susceptibility to infections and slower healing
Chronic respiratory conditions: Asthma or COPD requiring inhaled medications
Dehydration: Insufficient water intake may affect vocal cord lubrication
Stress and anxiety: Can lead to muscle tension affecting voice production
Previous intubation or throat surgery: May cause scarring or structural changes

Signs & Symptoms

Mild Symptoms

Persistent hoarseness lasting over three weeks
Slight voice fatigue after moderate speaking
Occasional throat clearing or mild cough
Sensation of throat dryness or mild irritation
Voice sounds slightly breathy or rough
Minor difficulty projecting voice in noisy environments

Moderate Symptoms

Significant voice changes throughout the day
Voice fatigue after minimal speaking
Persistent dry cough without other cold symptoms
Feeling of lump or foreign body in throat
Frequent throat clearing becomes habitual
Difficulty singing or reaching higher pitches
Throat pain or discomfort when speaking

Severe Symptoms

Complete voice loss (aphonia) episodes
Severe pain when speaking or swallowing
Breathing difficulties or noisy breathing (stridor)
Coughing up blood-tinged sputum
Significant unintentional weight loss
Persistent fever without other infection signs
Neck swelling or enlarged lymph nodes

Symptoms may develop gradually over time. Patients may adapt to their changing voice quality, which can delay seeking treatment until symptoms significantly impact daily activities.

Experiencing these symptoms? Consider seeking medical evaluation.

Consult with an ENT specialist for an assessment and to discuss treatment options.

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When to See a Doctor

Seek immediate medical attention if you experience breathing difficulties, coughing up blood, or severe throat pain with fever. These symptoms may indicate serious complications requiring urgent evaluation.

Schedule a consultation if hoarseness persists beyond three weeks, especially if you’re a smoker or have risk factors for throat cancer. Professional voice users should seek evaluation sooner, ideally within two weeks of voice changes. Early intervention may help prevent permanent vocal cord damage and can help identify any underlying serious conditions.

During your consultation, an ENT specialist will discuss your symptoms, voice use patterns, and medical history. The examination includes a thorough throat evaluation and typically a laryngoscopy to visualise your vocal cords directly. This assessment aims to support accurate diagnosis and appropriate treatment planning tailored to your specific condition and voice demands.

Diagnosis & Testing Methods

Video Laryngoscopy: This diagnostic tool involves inserting a thin, flexible scope through the nose to visualise the vocal cords in real-time. The procedure provides visual assessment of vocal cord movement, swelling, and any structural abnormalities. Video recording allows analysis and treatment monitoring.
Stroboscopy: This examination uses synchronised strobe lighting to create slow-motion visualisation of vocal cord vibration. It can reveal abnormalities in vocal cord movement not visible during regular examination. The test may help identify lesions, scarring, or asymmetric vibrations affecting voice quality.
Voice Analysis: Acoustic analysis measures various voice parameters including pitch, volume, and quality using specialised software. This assessment documents baseline voice characteristics and can monitor treatment progress. The non-invasive test is performed as part of comprehensive evaluation.
pH Monitoring: For suspected reflux laryngitis, pH monitoring measures acid levels in the throat. A thin probe placed through the nose records acid exposure patterns. Results may guide anti-reflux therapy decisions and treatment modifications.
Imaging Studies: CT or MRI scans may be recommended if structural abnormalities or masses are suspected. These images can reveal tissue changes, tumours, or anatomical variations affecting the larynx. Preparation requirements vary depending on the imaging type ordered.

Treatment Options Overview

Medical Management

Anti-Reflux Medications: Proton pump inhibitors (PPIs) may help reduce stomach acid production, potentially addressing laryngopharyngeal reflux that can contribute to chronic laryngitis. Treatment duration varies based on individual response and clinical assessment. Medications are typically taken before meals as directed by your healthcare provider.
Corticosteroid Therapy: Inhaled or oral corticosteroids may help reduce vocal cord inflammation in selected cases. Short courses of oral steroids might provide relief for inflammation, while inhaled forms offer localised treatment. Duration and dosage are determined based on individual clinical assessment and response to treatment.
Antihistamines and Decongestants: For allergy-related laryngitis, these medications may help reduce post-nasal drip and throat irritation. Second-generation antihistamines can provide symptom management while minimising drowsiness. Nasal corticosteroid sprays may complement oral medications for allergy management.
Mucolytics and Throat Moisturisers: Medications that thin mucus secretions may help ease throat clearing and reduce vocal cord irritation. Throat lozenges and sprays can provide temporary symptom relief and help maintain throat moisture. Regular use may support healing while other treatments address underlying causes.

In-Office Procedures

Vocal Cord Injections: Injectable treatments can deliver medications or bulking agents directly to vocal cords. Steroid injections may help reduce inflammation in specific areas, while hyaluronic acid injections might improve vocal cord closure. Procedures are performed under local anaesthesia with voice rest typically recommended post-treatment.
Laser Therapy: Office-based laser treatments can remove small lesions or reduce swelling without general anaesthesia. KTP or PDL lasers target specific abnormalities while aiming to preserve healthy tissue. Multiple sessions may be necessary depending on individual clinical factors.
Voice Therapy: Structured rehabilitation with a speech therapist addresses vocal behaviours and teaches voice technique. Sessions may include breathing exercises, vocal hygiene education, and resonance training. Treatment duration varies based on individual needs and response to therapy.

Surgical Interventions

Microlaryngoscopy: Performed under general anaesthesia, this procedure allows removal of vocal cord lesions using microscopic visualisation. Instruments can remove polyps, nodules, or other growths while aiming to preserve normal tissue. Recovery typically involves voice rest followed by gradual voice rehabilitation. *Individual recovery times may vary.*
Injection Laryngoplasty: For vocal cords with gaps or weakness, injectable materials may help improve closure and voice quality. Temporary fillers and permanent options are available with varying durations. The procedure can be performed in-office or operating theatre depending on individual clinical factors.

Every patient’s condition is unique.

Our ENT specialist will assess your specific situation and recommend the most suitable treatment approach for you.

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Complications if Left Untreated

Untreated chronic laryngitis may progressively affect vocal cord tissues, potentially leading to voice changes. Continued inflammation can cause vocal cord thickening and scarring, which may result in hoarseness or voice alterations. Professional singers and speakers might experience changes to their vocal abilities, which could impact their career prospects.

Chronic inflammation may increase the risk of developing vocal cord lesions including nodules, polyps, or cysts. These benign growths can further affect voice quality and may require surgical removal. Some patients may develop contact ulcers or granulomas, lesions that require treatment.

Long-term untreated laryngitis can affect quality of life beyond voice changes. Communication difficulties may impact personal relationships and social interactions. Professional limitations might necessitate career adjustments. Chronic laryngitis symptoms can potentially mask early signs of laryngeal conditions, which could delay diagnosis and treatment.

*Individual outcomes and timelines may vary. This information is provided for educational purposes and should not replace professional medical consultation.*

Prevention

Voice Hygiene Practices: Maintain adequate hydration by drinking water daily to help keep vocal cords lubricated. Avoid excessive throat clearing and coughing, which may traumatise vocal cords. Use amplification devices when speaking to large groups rather than straining your voice. Take regular voice breaks during extended speaking periods.
Environmental Modifications: Minimise exposure to cigarette smoke, including second-hand smoke, which may irritate vocal cords. Use a humidifier to maintain air moisture, particularly in air-conditioned environments. Wear appropriate protective equipment when exposed to chemical irritants or dust.
Lifestyle Adjustments: Manage acid reflux through dietary modifications, such as avoiding late-night meals, spicy foods, and caffeine. Maintain healthy weight to help reduce reflux pressure. Limit alcohol consumption which may dehydrate and irritate throat tissues. Practise stress management techniques as tension can affect voice production.
Regular Health Monitoring: Address allergies and sinus conditions promptly to help prevent post-nasal drip complications. Treat respiratory infections completely to help avoid chronic inflammation. Professional voice users may benefit from periodic voice evaluations to help detect problems early.

*Individual results and experiences may vary. These preventive measures should be discussed with a healthcare professional.*

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Frequently Asked Questions (FAQ)

How long does chronic laryngitis treatment typically take?

Treatment duration varies depending on the underlying cause and severity. Individual results and timelines may vary. Voice therapy sessions are typically conducted over several weeks. Complete resolution depends on addressing causative factors and adherence to treatment recommendations. Some patients may require ongoing maintenance therapy to prevent recurrence.

Can chronic laryngitis permanently damage my voice?

While chronic laryngitis can cause permanent changes if left untreated for extended periods, many cases respond well to appropriate treatment. Early intervention may help prevent irreversible scarring and structural changes. Vocal cord scarring from prolonged inflammation may cause permanent hoarseness. However, modern treatments including voice therapy and surgical options can help improve voice quality even in advanced cases.

Will I need surgery for chronic laryngitis?

Many chronic laryngitis cases may resolve with conservative treatment including medications and voice therapy. Surgery is typically reserved for cases with structural abnormalities like polyps, cysts, or severe scarring not responding to medical management. Your ENT specialist will recommend surgery only when necessary and after exhausting conservative options. When required, modern minimally invasive techniques are available with shorter recovery periods.

Can I continue working while undergoing treatment?

Many patients continue normal activities during treatment, though voice rest recommendations vary by severity. Professional voice users may need modified duties initially. Teachers might require amplification devices or reduced speaking responsibilities. Complete voice rest is rarely necessary except after certain procedures. Your specialist will provide specific activity guidelines based on your occupation and treatment plan.

Is chronic laryngitis related to throat cancer?

While chronic laryngitis itself doesn’t cause cancer, similar symptoms can occur with both conditions. Persistent hoarseness lasting over three weeks requires medical evaluation to rule out serious conditions. Risk factors like smoking increase concern for malignancy. Comprehensive evaluation includes thorough visualisation to identify any suspicious lesions. Early detection of throat cancer can improve treatment outcomes.

How can I prevent chronic laryngitis from recurring?

Prevention focuses on addressing underlying causes and maintaining good vocal hygiene. Continue prescribed medications as directed, particularly for reflux management. Implement voice conservation techniques learned during therapy. Avoid known irritants including smoke and excessive alcohol. Maintain adequate hydration and humidification. Regular follow-up appointments help monitor for early recurrence signs. Patients may successfully prevent recurrence through lifestyle modifications and proper voice use.

What’s the difference between acute and chronic laryngitis treatment?

Acute laryngitis typically resolves with voice rest and symptomatic treatment. Chronic laryngitis requires identifying and treating underlying causes through comprehensive evaluation. Treatment is more extensive, often combining medications, voice therapy, and lifestyle modifications. Chronic cases need longer treatment periods and may require procedural interventions. Follow-up monitoring is important for chronic laryngitis to help ensure complete resolution and prevent recurrence.

Are there any new treatments for chronic laryngitis available in Singapore?

Singapore’s ENT specialists have access to modern treatment options including office-based laser procedures and injection therapies. Voice therapy techniques continue evolving with computer-assisted biofeedback systems. Newer reflux medications offer improved symptom control. Regenerative medicine approaches using growth factors show promise for vocal cord healing. Specialists stay current with evidence-based treatments to offer patients appropriate care options.

Conclusion

Chronic laryngitis can respond to appropriate medical intervention when diagnosed and treated promptly. Understanding the condition’s causes and recognising symptoms early enables timely treatment that may help prevent permanent vocal damage. Our ENT specialist combines modern diagnostic techniques with comprehensive treatment approaches tailored to each patient’s specific needs.

Recovery from chronic laryngitis requires patience and commitment to treatment recommendations. Patients may experience voice improvement with proper medical management, voice therapy, and lifestyle modifications. The approach focuses on addressing underlying causes whilst protecting your voice during the healing process.

*Individual results and timelines may vary.*

Take the First Step Towards Better Voice Health

Living with chronic laryngitis can be challenging, but persistent voice problems may be manageable with appropriate medical care. Our ENT specialist has experience diagnosing and treating chronic laryngitis using current evidence-based approaches.

Book Your Consultation Today

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.

Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
2016 – Best Educator Award (Eastern Health Alliance)
2016 – “Wow” Award (Patient Compliment)

2014 – Eastern Health Alliance Caring Award – Silver
2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
2012 – Human Manpower Development Award (Ministry of Health, Singapore)
2007 – Singhealth Best Doctor Award

Qualifications

MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
FAMS – Fellow of the Academy of Medicine Singapore

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