: 108  Stroboscopy may be relatively normal or may reveal asymmetry, aperiodicity, and reduced mucosal wave patterns.Other features of the laryngeal tissues may include
Redness of the laryngeal tissues (acute)
Dilated blood vessels (acute)
Thick, yet dry laryngal tissue (chronic)
Stiff vocal folds
Sticky secretions between the vocal folds and nearby structures (the interarytenoid region)

Referral
Some signs and symptoms indicate the need for early referral. These include

Difficulty swallowing
Vocal stridor
Ear pain
Recent weight loss
History of smoking
Current or recent radiotherapy treatment (in the neck region)
Recent neck surgery or surgery involving endotracheal tubing
Person is a professional voice user (teacher, singer, actor, call center worker, and so on)

Differential diagnosis
Acute epiglottitis: This is more likely in those with stridor, drooling, and painful or trouble swallowing. Spasmodic dysphonia
Reflux laryngitis
Chronic allergic laryngitis
Neoplasm
Croup: This presents with a barking cough, hoarseness of voice, and inspiratory stridor. Treatment
Treatment is often supportive in nature, and depends on the severity and type of laryngitis (acute or chronic). General measures to relieve symptoms of laryngitis include behaviour modification, hydration and humidification.Vocal hygiene (care of the voice) is very important to relieve symptoms of laryngitis. Vocal hygiene involves measures such as: resting the voice, drinking sufficient water, reducing caffeine and alcohol intake, stopping smoking and limiting throat clearing. Acute laryngitis
In general, acute laryngitis treatment involves vocal hygiene, painkillers (analgesics), humidification, and antibiotics. Viral
The suggested treatment for viral laryngitis involves vocal rest, pain medication, and mucolytics for frequent coughing. Home remedies such as tea and honey may also be helpful. Antibiotics are not used for treatment of viral laryngitis.
Imiglucerase is a medication used in the treatment of Gauchers disease.It is a recombinant DNA-produced analogue of the human enzyme β-glucocerebrosidase. Cerezyme is a freeze-dried medicine containing imiglucerase, manufactured by Genzyme Corporation. It is given intravenously after reconstitution as a treatment for Type 1 and Type 3 Gauchers disease. It is available in formulations containing 200 or 400 units per vial. The specific activity of highly purified human enzyme is 890,000 units/mg, meanwhile the enzyme activity produced by recombinant DNA technology is approximately 40 units/mg. A typical dose is 2.5U/kg every two weeks, up to a maximum of 60 U/kg once every two weeks, and safety has been established from ages 2 and up. It is one of more expensive medications, with an annual cost of $200,000 per person in the United States. Imiglucerase has been granted orphan drug status in the United States, Australia, and Japan.Cerezyme was one of the drugs manufactured at Genzymes Allston, Massachusetts plant, for which production was disrupted in 2009 after contamination with Vesivirus 2017. Side effects
The most common side effect is hypersensitivity, which occurs in about 3% of patients. It is associated with symptoms such as cough, shortness of breath, rashes, itching, and angiooedema. Less common side effects include dizziness, headache, nausea, diarrhoea, and reactions at the injection site; they are found in less than 1% of patients. Interactions
No clinical interaction studies have been conducted. Miglustat appears to increase the clearance of imiglucerase by 70%, resulting in decreased enzyme activity.