Laryngitis sicca is a condition of severe dryness in the larynx, almost always with crusting of mucus. It often makes the voice hoarse.

Causes of Laryngitis Sicca

One cause is the use of radiation therapy for cancer in the larynx. As the radiation therapy kills the tumor it is targeting, it may also damage or destroy the larynx’s mucus-producing glands. These damaged glands may then produce less mucus, and mucus that is more proteinaceous and consequently more viscous or thick and sticky. This viscous mucus can also be easily colonized by bacteria, and become crusted, especially in winter, when humidity indoors is lower.

A second kind of laryngitis sicca seems to accompany bacterial infection alone, apart from any use of radiation therapy. The mucus crusts become yellow or green, and the mucosa reddens with inflammation.

Treatment for Laryngitis Sicca

Antibiotic therapy may improve or resolve the problem, though some cases seem stubbornly resistant to such treatment, even with several courses of broad-spectrum antibiotics. Improved hydration of the larynx may help somewhat, as may having the patient learn to irrigate his or her larynx and “gargle” in the larynx.

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Laryngitis sicca (1 of 2)

Laryngitis sicca, with crusting of dry, green mucus especially undersurface of the folds. Though a rare long-term complication, may be seen after laryngeal irradiation for cancer (Lab).

Laryngitis sicca (2 of 2)

Same patient, from slightly higher view (Lab).

Pachyderma, caused by laryngitis sicca

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Heaped up Mucosa (1 of 3)

Pachyderma, here referring to the heaped up mucosa in the interarytenoid area, in a patient with laryngitis sicca.

Pachyderma (2 of 3)

Adducted (voicing) position. Note that the pachyderma does not interfere with closure of the cords. In this case, it does not directly affect the patient’s voice, which is typical, but the more generalized inflammatory condition (see the redness of the cords) does.

Stippled Vascular Markings (3 of 3)

Narrow-band lighting. This shows some stippled vascular markings, often seen with chronic inflammation or HPV infection.

Acid reflux and sicca syndrome

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Acid reflux (1 of 4)

This man has obvious clinical symptoms of acid reflux such as heartburn, excessive morning mucus, husky morning voice. Note classic interarytenoid pachyderma, diffuse pinkness.

Prominent capillaries & mucus (2 of 4)

Here we see loss of color differential between true and false cords. Capillaries are prominent (like bloodshot eyes) on the true cords. There is also adherent mucus.

Closer view (3 of 4)

Closer view of the prominent capillaries.

Redness and inflammation (4 of 4)

Even the upper trachea shows evidence of redness and inflammation. This is not seen that often except with truly severe nocturnal acid reflux/ LPR.

Sicca laryngitis with micro-crusts

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Laryngitis (1 of 3)

This 50-something man complains of chronic laryngitis of unknown cause. This distant view shows some small crusts, but closer viewing reveals more detail...

Closer view (2 of 3) this closer view, small crusts are seen more clearly, but an even closer visualization....

"Micro-crusts" (3 of 3)

...shows not just small, but also "micro-crusts" rather than the thin and wet mucus layer that should be slowly streaming upwards from the undersurface of the vocal cords. Tiny dots added to show these micro-crusts.