Laryngitis in children
The content of the article:
- Causes of laryngitis in children and risk factors
- Forms of the disease
- Laryngitis symptoms in children
- Diagnostics
- Laryngitis treatment in children
- Possible complications and consequences
- Forecast
- Prevention
Laryngitis in children is an inflammatory disease of the larynx, which is accompanied by respiratory distress and damage to the vocal cords.
The disease is more susceptible to children of the first years of life and preschool age. According to statistics, laryngitis is recorded in approximately 34% of children under two years of age suffering from acute respiratory diseases. Seasonality is characteristic of laryngitis, the peak incidence occurs in the autumn-winter and winter-spring periods. Laryngitis in children rarely occurs in isolation, in most cases it is accompanied by tracheitis and bronchitis.
Causes of laryngitis in children and risk factors
Laryngitis in children usually develops against the background of acute respiratory diseases or childhood infections (measles, whooping cough, scarlet fever). The most common infectious agents are viruses - influenza virus, parainfluenza, herpes simplex, adenovirus. Laryngitis in children of bacterial etiology is much less common, while the causative agents are staphylococci, streptococci (in particular, hemolytic group A streptococcus), haemophilus influenzae. In even more rare cases, laryngitis is caused by a chlamydial infection and microscopic fungi. Diphtheria laryngitis in children is now rarely diagnosed due to the massive vaccination against diphtheria.
Also, laryngitis in children can also occur against the background of allergic processes in the body. More than others, children with lymphatic-hypoplastic diathesis are predisposed to it. Laryngitis in older children can be caused by overstrain of the vocal cords.
Risk factors include:
- metabolic disorders (with diabetes mellitus, diseases of the gastrointestinal tract, hypothyroidism);
- immunodeficiency states;
- psycho-emotional disorders;
- taking some medications in the form of an aerosol;
- laryngeal injury;
- aspiration of foreign bodies;
- hypothermia;
- violation of nasal breathing;
- poor nutrition;
- inhalation of vapors of paints, varnishes, household chemicals, house dust;
- throwing stomach contents into the respiratory tract in gastroesophageal reflux disease.
The chronic form of laryngitis in children, as a rule, occurs with repeated acute laryngitis or against the background of prolonged inflammatory processes in the nasopharynx, paranasal sinuses.
Forms of the disease
Laryngitis can be acute or chronic, as well as complicated or uncomplicated.
Acute laryngitis in children, in turn, is subdivided into:
- catarrhal;
- hydropic;
- phlegmonous.
Chronic laryngitis is of the following types:
- catarrhal;
- atrophic;
- hypertrophic (limited and diffuse).
Depending on the localization of the inflammatory process, laryngitis is divided into subglottic, diffuse, laryngotracheobronchitis.
Laryngitis symptoms in children
Clinical manifestations of laryngitis in children usually occur 2-3 days after the onset of an acute respiratory viral infection. The first symptoms of laryngitis are similar to those in ARVI: the appearance of nasal discharge, general weakness and fatigue, a slight increase in body temperature.
Later, signs specific to inflammation of the larynx join: dry ("barking") cough, voice changes (it becomes hoarse, deaf, it may disappear altogether). Breathing is rapid, with acute laryngitis it can be somewhat difficult, periodically when inhaling air, a characteristic whistle can be heard, which is more often observed at night closer to morning. Difficulty breathing occurs due to the narrowing of the glottis against the background of its spasm or edema. Patients complain of sore throat and dryness, headache. When the pathological process is localized in the region of the epiglottis and / or the posterior wall of the larynx, pain appears when swallowing.
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A few days after the onset of the disease, mucous sputum begins to separate. Uncomplicated acute laryngitis in children lasts 5-10 days.
With the rapid progression of the disease, a spastic narrowing of the larynx may occur, acute stenosing laryngotracheitis develops (more often in children from 6 months to 6 years). In such patients, inspiratory dyspnea, anxiety, agitation, nocturnal awakenings due to severe coughing and choking, tachycardia, and increased sweating are observed. In severe cases, cardiovascular failure and asphyxia may form.
An increase in body temperature to febrile numbers usually indicates the involvement of the lower respiratory tract in the pathological process, this is also indicated by the appearance of cyanosis of the nasolabial triangle.
In acute catarrhal laryngitis, inflammation captures the mucous membrane of the larynx; in the phlegmonous form, the submucosa, muscle layer, as well as the ligaments and perichondrium are involved in the inflammatory process. In the edematous form of acute laryngitis in children, the affected mucous membrane is sharply hyperemic, edema is more pronounced in the area of the vestibule folds. Blood can ooze from dilated blood vessels, resulting in purple-red dots on the mucous membrane.
Chronic laryngitis is more common in older children. In this case, the symptoms of laryngitis in children include transient or persistent voice disturbances, fatigue with vocal stress, and reflex cough. Atrophic laryngitis is often accompanied by a painful cough, in which blood streaks are often found in the sputum. For the atrophic form of the disease, thinning of the mucous membrane is characteristic, with hypertrophic laryngitis, on the contrary, an overgrowth (hyperplasia) of the laryngeal mucosa occurs, while nodules up to 2-3 mm in size can appear on the vocal cords. Chronic laryngitis lasts more than 2 weeks.
Laryngitis against the background of tuberculosis is manifested by lumpy nodular seals in the tissues of the larynx, destruction of the epiglottis and laryngeal cartilage can occur.
The specificity of the clinical picture of laryngitis in children is due to the anatomical and physiological characteristics of the respiratory tract of this age group (narrow lumen of the larynx, looseness of the mucous membrane and connective tissue, their tendency to swelling, weakness of the respiratory muscles, peculiarities of the innervation of the larynx). For this reason, inflammation of the larynx in children often causes acute upper airway obstruction and acute respiratory failure. Narrowing of the lumen of the larynx and breathing disorders, as a rule, occur at night due to a decrease in the frequency and depth of respiratory movements during sleep, as well as changes in blood and lymph circulation in the larynx.
Diagnostics
To make a diagnosis of laryngitis in children, an objective examination of the patient and the data obtained during the collection of complaints and anamnesis may be sufficient. Otorhinolaryngological examination for suspected laryngitis in children includes otorhinolaryngoscopy, pharyngoscopy, indirect laryngoscopy, and palpation of the cervical lymph nodes. In this case, hyperemia, edema, petechial hemorrhages and / or an increase in the vascular pattern of the laryngeal mucosa, incomplete closure and thickening of the vocal cords during phonation are detected.
In the course of a general blood test, an increase in the number of leukocytes, an increase in ESR is determined. Identification of the pathogen in laryngitis in children can be carried out by means of bacteriological, virological examination of washings from the upper respiratory tract, polymerase chain reaction.
With prolonged vocal impairments, the patient is referred for a consultation with a phonopedist and speech therapist, and a study of the voice function is carried out.
Differential diagnosis is carried out with foreign bodies of the larynx, diphtheria, retropharyngeal abscess, congenital stridor, laryngeal papillomatosis, epiglottitis, laryngospasm caused by spasmophilia, as well as tuberculosis, laryngeal cancer, ectopic thyroid gland.
Laryngitis treatment in children
During the treatment of laryngitis, children are advised to minimize the load on the vocal apparatus and avoid breathing through the mouth. The air in the room where the patient is located must be sufficiently humidified. In acute laryngitis, bed rest and plenty of drink are shown (still mineral water, milk with honey, fruit drinks, herbal teas). When the body temperature rises above 38 ° C, an antipyretic from the group of nonsteroidal anti-inflammatory drugs (drugs based on ibuprofen or paracetamol) is prescribed. According to indications, antihistamines are prescribed, in the case of viscous, difficult to expectorate sputum - mucolytics.
For children over three years old, gargling is shown (they can be carried out at the age when the child is already able to rinse the throat and spit out the liquid), inhalation of vapors of oils or medicinal herbs that have anti-inflammatory effects (an excessively hot solution cannot be done, it is necessary to ensure that the child does not burn himself steam), nebulizer therapy.
With laryngitis of bacterial etiology, antibacterial drugs are prescribed.
Treatment of chronic laryngitis is longer. Patients are shown restorative therapy, physiotherapeutic procedures (ultra-high-frequency therapy, electrophoresis in the larynx region, phonophoresis, microwave therapy, ultraviolet irradiation). To correct dysphonia, classes with a speech therapist may be appropriate.
A gentle diet is indicated for patients with laryngitis. Fried, spicy, spicy, sour, cold and hot dishes, carbonated drinks should be excluded from the diet.
With the development of a false croup, the child needs hospitalization. In a hospital, oxygen therapy is carried out, hormonal anti-inflammatory, antispasmodic drugs are prescribed. In severe cases of stenosis of the larynx, they resort to intubation or tracheostomy, artificial ventilation.
Possible complications and consequences
In the absence of timely, correctly selected treatment, the disease can become chronic. Also, laryngitis in children can be complicated by a retropharyngeal abscess, acute obstruction of the upper respiratory tract, which requires emergency medical care.
Forecast
With timely and adequate treatment of uncomplicated acute laryngitis in children, the prognosis is usually favorable. In the case of the transition of the disease to a chronic form, the prognosis worsens. With the development of a false croup, a lethal outcome is possible.
Prevention
Preventive measures aimed at preventing the development of laryngitis in children include:
- timely treatment of diseases that can be complicated by the development of laryngitis;
- routine vaccination;
- avoiding injury to the larynx;
- avoidance of mental stress;
- avoiding exposure to toxic substances;
- avoiding hypothermia;
- balanced diet;
- exclusion of contact with potential allergens.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
