[Inflammation and laryngitis].

1. DISTINCT ENTITIES: Unlike inflammation or the middle ear or nasal or sinus cavities, there is no direct link between acute and chronic inflammation of the larynx. Chronic laryngitis is a distinct nosological entity. Patients with recurrent allergic laryngitis do not necessarily develop chronic laryngitis as is observed in patients with nasal allergy. 2. RESEARCH: There is no research data on infections of the larynx comparable to that available for the middle ear or the nasal cavities. This is probably related to the difficulty of accessing the laryngeal mucosa and the risks related with this condition. 3. CLINICAL TRIALS: While fundamental research remains to be conducted, their is a large body of clinical trials on the topic, although one must be prudent concerning the terms used. 4. NOSOLOGOGY: In French the term "croup" designates diphtheritic croup and must be distinguished from the more general term used in English. Clinical trials must be interpreted with caution since it is often difficult to ascertain which type of laryngitis is concerned. 5. GRAVITY SCORES: Widely used in the English literature, gravity scores are not generally used in French pediatric ENT units and have no real equivalent in French. 6. DYSPHONIA AND DYSPNEA: Dysphonia is the leading sign of chronic laryngitis. Dyspnea is the leading sign of acute laryngitis. Dyspnea is more frequent in children and is related to disease severity. 7. BACTERIA AND VIRUSES: Epiglottitis (supraglottic laryngitis) is related to bacterial infections while subglottic laryngitis is related to viral infections requiring antibiotics in combination with corticosteroids. 8. H. INFLUENZAE: The most common causal agent of epiglottitis, type B Haemophilus influenzae, is not the only culprit. 9. ADULTS: Epiglottitis can also occur in adults where it is as severe as in children. 10. SYSTEMIC CORTICOSTEROIDS: Emergency administration of systemic and inhaled glucocorticoids in the hospital setting is the basic treatment for glotto-subglottic laryngitis. Dosage must be high, more than 0.3 mg/kg dexamethasone for 48 hours, followed by oral corticosteroids.