When does laryngitis get to the point of requiring surgery? I have chronic laryngitis from smoking and acid reflux. I am not having luck quitting smoking and I'm concerned I may one day need surgery to fix this problem. What should I be on the lookout for

You . You should seek an evaluation from an ENT physician who can diagnose and manage your problem. Both smoking and reflux take a toll on the upper airway causing damage to the structure around the vocal cords. Of more concern is the possibility of a benign or malignant growth in the region. The ENT can use a television probe to visual the area and perform a biopsy if required.
There is no surgery. For laryngitis per se, which just means inflammation of the larynx. If a person develops nodules or tumors on their cords, that is a surgical condition, and it can cause the same symptoms as laryngitis (hoarseness or loss of voice). Stop smoking and treat your acid reflux adequately! see an ENT doctor for direct evaluation of your vocal cords if this is a chronic problem; they can advise you.