Stenosing laryngitis: causes, symptoms, diagnosis and treatment

An acute inflammatory process that occurs in the larynx is called stenosing laryngitis. Usually this pathology is observed in ARVI, but it can be a complication of bacterial infection, as well as with allergy. In children, inflammation causes the closure of the larynx lumen, which makes breathing difficult.

Why does

Most commonly, stenosing laryngitis occurs when a virus of influenza, parainfluenza, rhinovirus or enterovirus enters the body. Less often, pathology arises as a complication in herpes, measles, chicken pox and some other infectious diseases.

Stenosing laryngitis in each case develops as follows: the mucosa becomes edematous, there is a muscle spasm. Then in the lumen of the larynx appears mucus. The body tries to remove it, reflexively strengthening the spasm. As a result, hypoxia develops.

The following factors can lead to the development of laryngitis:

1. Excessive tension of the vocal cords.
2. Reception of food, drinks irritating throat.
3. Mechanical damage to mucous throat.
4. Subcooling.
5. Decreased immunity.
6. Allergic reaction.

Noisy breathing with laryngitis can be caused by the appearance of abscesses of the pharyngeal or paratonsillar type. Also, the pathology can be caused by diphtheria, epiglottitis, aspiration by foreign body, traumatization of the larynx, burns.

In some cases, stenosing laryngitis is caused by:

• Laryngospasm as a result of hypocalcemia in rickets, hypothyroidism, renal insufficiency;
• Congenital stridor;
• Allergic edema;
• Hypertrophy of the tonsils;
• Papillomatosis;
• Cysts;
• Hemangiomas of the larynx.

After determining the cause, the doctor selects the method of treatment. He can prescribe medication or recommend surgical treatment.

Risk of development

Because of the peculiarities of the structure of the larynx, children up to six years old most often suffer from stenosis. Before this age, the child's body is characterized by:

• Thin shell of the larynx;
• Submucosal layer loose, strongly development of vascular mesh;
• Epiglottis cartilage soft, elongated;
• The respiratory muscles are weak.

From the onset of the development of acute respiratory viral infection, stenosing laryngitis may appear on the second day. Most often, the infection manifests itself at night. In the development of the disease, the presence of allergies and the increased sensitivity of the respiratory tract to irritants play an important role.

Clinical manifestations

Stenosing laryngitis in the early stages of development is often mistaken for SARS. Intensified spasms usually appear at night. There is a feeling of pressure in the larynx.

With the development of the disease appears dry, barking cough, during which in the sore throat soreness is felt. The nasolabial triangle acquires a bluish tint, the skin pales. Appears shortness of breath, the patient begins to breathe deeply, trying to grasp something with his mouth, then with a little air. As a result, the mucous membranes of the mouth, throat and nose begin to dry out. On the larynx form crusts that block the airways.

In children, the stenosing laryngitis quickly changes into choking due to the peculiarity of the larynx structure: a narrow lumen in the inflammation quickly overlaps, and the child begins to choke. To prevent this, it is necessary to be able to quickly identify a dangerous pathology and distinguish it from influenza and other infectious pathologies.

The inflammatory process in the larynx takes place in several stages, each of which is manifested by certain symptoms.

With inflammation of the larynx, croup syndrome is manifested. This is a clinical condition characterized by hoarseness, a barking cough, stenotic breathing. In another way, croup of croup is called stenosing laryngitis.

Stages of pathology

Inflammation of the larynx occurs in four stages.

1. Stage of compensated breathing. At the initial stage of manifestation of pathology begins barking cough in a child with a temperature. Then the hoarseness of the voice joins, slight attacks of dyspnea may be noted.
2. Subcompensation. At this stage, breathing becomes rapid, noisy. The nasolabial triangle acquires a pronounced blue hue. The general condition of the patient worsens, anxiety arises, sleep is disturbed.
3. Decompensation. The entire body becomes covered with a sticky sweat. Mixed or inspiratory dyspnea is noted. If the inflammation of the larynx in children reaches the third stage, then there is a sharp excitement, the breathing is weakened, the pupils are dilated. Sometimes children become confused.
4. Asphyxia. Stenosing laryngitis in children seldom passes into the fourth stage. If this happens, then a hypoxic coma develops with a pronounced impairment of all body functions. Children become sluggish, sleepy, their breathing slows down, until it stops.

In isolated cases, the fourth stage can be manifested by involuntary urination and defecation, seizures and a gray tinge of the skin.

Possible complications

If the stenosing laryngitis is correctly diagnosed, the treatment is started on time, then the prognosis is favorable. Otherwise, the pathology leaves serious consequences. Most often, inflammation is complicated by obstructive bronchitis. Less often the ailment passes into the following pathologies:

• sinusitis;
• otitis;
• tonsillitis;
• meningitis;
• conjunctivitis.

The most dangerous complication is pneumonia. If she joins the laryngitis, a fatal outcome is possible.

Diagnostics

Laryngitis is suggested at the appearance of hoarseness of voice, barking coughing, shortness of breath. Also the doctor takes into account the anamnesis, the data of laboratory and instrumental examination. They help confirm or deny the diagnosis.

In a number of cases, a virological examination is carried out with suspicion of the viral etiology of the disease. A bacterial infection is also examined. Bacteriological diagnosis of mucus on diphtheria from the oral and nasal cavities is mandatory.

Treatment

If there is a barking cough in a child with a temperature, then it's worth to see a doctor right away.

At the first stage of the disease, the doctor prescribes copious drinking, inhalation with medicinal herbs (sage, chamomile, etc.). The doctor selects vitamins and drugs that increase immunity. If the treatment does not give a positive result, then a novocaine blockade is performed to relieve the swelling of the respiratory passages and spasm. At the first stage, the doctor can prescribe a course of antibiotics and antiviral drugs.

In the second stage of the disease, moistened oxygen, cardiovascular strengthening agents, diuretics are added to the above agents.

The third stage requires special treatment. Her therapy includes hormonal drugs. If the treatment does not give positive results, then the mucus is removed with a catheter, after which the mucous membrane is heavily oiled.

When the effectiveness of therapy is low, the patient is tracheotomized, intubated.

First aid

Before the arrival of an ambulance, it is necessary to alleviate the condition of the patient, in whom stenosing laryngitis is manifested. First aid is as follows:

1. Provide access to oxygen. For this, the upper buttons of the clothes are unbuttoned.
2. Put the patient in bed and lift the head of the bed.
3. Provide abundant warm drink. For this you can use tea, warm milk.
4. In winter it is recommended to increase the humidity in the room.
5. Give an antihistamine.

If no improvement is observed, then an intramuscular or intravenous injection of Prednisolone should be done: 4 mg per kilogram of the child's weight.

After examining the patient, the doctor will inject an antispasmodic drug.

Prevention

The rules for the prevention of laryngitis include:

• Observance of personal hygiene;
• Proper nutrition;
• Limiting contacts with viral and bacterial infections.

To avoid the development of ailment, you should constantly monitor the health, improve immunity, take vitamins, do exercises.