Laryngeal Edema: Symptoms And Treatment In Adults And Children

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2024-01-15 19:51

Laryngeal edema: causes, symptoms, first aid

The content of the article:

Causes of laryngeal edema
Laryngeal edema symptoms
Complication
Diagnostics
When you need emergency help
First aid
Laryngeal edema treatment
Forecast and prevention
Video

Laryngeal edema is a pathological condition caused by edema of the mucous membrane of this organ and resulting from hyperreactivity of the immune system and disorders of the mechanism of neuromuscular regulation.

With the onset of laryngeal edema, a foreign body sensation appears in the throat

Causes of laryngeal edema

The development of mucosal edema can be triggered by various diseases of the larynx and traumatic injuries in the neck. The most common causes of this condition are:

allergic reactions to house dust, pollen, animal dander, food and medicines;
traumatic damage to the larynx by a foreign body, various chemical and physical factors;
acute infectious diseases (flu, scarlet fever, laryngeal sore throat, measles, diphtheria);
diseases of the larynx of an inflammatory nature (infiltrative or phlegmonous laryngitis in adults, lining laryngitis in children);
tumors of the larynx, benign and malignant;
injuries and diseases of tissues and organs located near the larynx (abscesses and phlegmon of the neck, tumors of the mediastinum and thyroid gland).

Depending on the rate of increase in clinical symptoms, edema is:

lightning fast - develops against the background of injuries and allergies, for example, Quincke's edema;
acute - infectious and inflammatory diseases lead to its occurrence;
chronic - due to oncological pathology.

The factors that increase the risk of developing pathology, otolaryngologists include:

hypovitaminosis conditions;
decompensated course of type I and II diabetes mellitus;
general exhaustion;
chronic hepatic and renal failure.

Swelling usually occurs in the area of the arytenoid cartilage and folds, subglottic space, epiglottis and folds of the vestibule. This is due to the presence of well-developed loose connective tissue in these anatomical zones. The consequence is a narrowing of the lumen of the larynx, which provokes the development of stenosis.

Laryngeal edema symptoms

The first sign is the appearance of pain and sore throat, a feeling of the presence of a foreign body. As the vocal cords begin to swell, the timbre of the voice also changes, which becomes hoarse, deaf and lower.

With a further increase in puffiness, the lumen of the larynx begins to decrease, which leads to the development of stridor - noisy breathing caused by the difficulty of air passage through the upper respiratory tract. In severe cases, suffocation develops.

Given that laryngeal edema can be triggered by various pathologies, the clinical picture of this condition may vary. The main differences are presented in the table

Diseases	Viral laryngotracheitis	Allergic edema	Epiglottitis	Foreign body	Laryngospasm
Etiology	Influenza viruses, parainfluenza, RS infection	The presence of allergic diseases	Streptococci, staphylococci	-	Reflex irritation (rough intubation, inhalation of contaminated air), hypocalcemia
Premorbid background	Not complicated	Exudative diathesis, neurodermatitis, various allergic reactions	Not complicated	Not complicated	Spasmophilia, congenital stridor
Frequency of attacks	Rarely, always against the background of ARVI. Usually seen in children between the ages of 3 and 7	Often, usually in the spring and summer	Not typical	No	If the provoking factor is not eliminated, then the attacks can be repeated many times.
Onset of the disease	The increase in symptoms occurs rather slowly (2-5 days)	Fast (a few hours)	Acute, with an increase in body temperature (8-10 hours)	Sudden	Sudden
Intoxication	Moderately expressed, fever up to 38-39 ° С	No	Hyperthermia up to 40 ° C and above	No	No
Voice, cough	Hoarseness, wet cough	Unchanged, dry, rough, barking cough	Not changed	Unchanged, dry, obsessive cough	"Cock's cry", no cough
Dysphagia	No	No	Swallowing any food is difficult and sharply painful	No, vomiting with a coughing fit	No
Other signs	Symptoms of rhinitis, nasopharyngitis	Positive dynamics from taking antihistamines	On examination of the pharynx - edema of the epiglottis, the root of the tongue is cherry red	When breathing, a popping sound is sometimes heard associated with the movement of a foreign body by the air current	Signs of calcium metabolism disorders

Complication

Laryngeal edema is accompanied by gradually increasing respiratory failure. In severe cases and in the absence of timely medical care, the patient may develop asphyxia, which leads to death.

Diagnostics

Diagnosis of laryngeal edema is usually straightforward. To establish the cause of this pathological process, the patient is examined, which includes the following measures:

otolaryngologist consultation with indirect laryngoscopy;
chest x-ray;
computed tomography of the mediastinal organs;
bronchoscopy;
general and biochemical blood test;
Ultrasound of the thyroid gland.

When you need emergency help

Edema of the larynx, especially developing lightning fast or acutely, is a life-threatening condition for a person of any age. Therefore, when the first signs appear, you should consult a doctor. It is especially important to immediately call an ambulance to the patient in the following cases:

cessation of breathing;
an increase in respiratory failure (cyanosis of the skin, bradypnea, participation in the act of breathing of auxiliary muscles, tachycardia);
disturbances of consciousness;
convulsions.

First aid

With rapidly growing signs of edema and stenosis of the larynx, it is necessary to call an ambulance and then proceed with the independent provision of first aid:

Calm down the patient, as fear and panic increase the tissue oxygen demand and respiratory rate.
Provide fresh air by opening a window, removing or loosening tight clothing.
Carry out distracting procedures (foot or sit-down baths with a gradual increase in water temperature from 36 to 43 ° C).
Provide an abundant warm drink.
Inhale with an alkaline solution using a nebulizer, if possible.

As part of first aid, you can perform nebulizer inhalation with an alkaline solution

With laryngospasm, the following procedures help to relieve an attack:

spraying your face with cold water;
pressing with a spatula on the root of the tongue;
irritation with the fingers of the root of the tongue and the back of the pharynx in order to induce vomiting;
irritation of the lower parts of the nasal passages with a cotton turunda, before sneezing.

Never use your fingers to remove a foreign body! With such attempts, there is a high risk of pushing it into the lower respiratory tract with the development of asphyxia.

Laryngeal edema treatment

Medical treatment is carried out only as directed by a doctor and under his supervision. The patient can be prescribed drugs of the following groups:

antihistamines;
corticosteroids;
diuretics;
antispasmodics.

If the ongoing treatment does not lead to the restoration of full breathing, they decide whether to perform tracheal intubation, conicotomy or tracheostomy, followed by transferring the patient to artificial ventilation. The patient is admitted to the intensive care unit and intensive care unit.

Forecast and prevention

The prognosis for laryngeal edema is determined by many factors, primarily:

underlying pathology;
the initial state of health of the patient, the presence or absence of concomitant diseases;
the rate of increase of the phenomena of respiratory failure.

With a fulminant form, the risk of asphyxia and death is quite high. In acute and subacute form, the prognosis is favorable, provided that treatment is started on time.

The chronic form of edema of the laryngeal tissues is usually due to the presence of a tumor process and the prognosis for it is always serious, especially in malignant neoplasms.

Prevention includes the following areas:

timely diagnosis and treatment of infectious and inflammatory diseases of the respiratory system;
preventing foreign bodies from entering the respiratory tract;
when working with substances irritating the respiratory tract, the use of personal protective equipment (respirators, gas masks);
regular dispensary examinations;
systematic observation by an otolaryngologist in the presence of any chronic diseases.