Acute laryngitis causes. Treatment of acute laryngitis. How is the disease treated?

Acute laryngitis is a disease based on inflammation of the mucous membrane of the larynx. Usually the acute process lasts for seven to ten days. The disease is accompanied by coughing, breathing problems, voice changes, and even loss of voice. The most serious complication of laryngitis that occurs in children is occlusion respiratory tract.

There are a number of reasons that can cause inflammation in the pharynx. They can be infectious, physical, allergic, autoimmune in nature. Effective treatment acute laryngitis is associated with the elimination of the main etiological factor. The disease causes great discomfort and can cause serious complications. An acute process in the absence of timely treatment easily turns into chronic form, which is much more difficult to get rid of. Before considering the symptoms and treatment of acute laryngitis, let's talk about the provoking causes.

What causes acute laryngitis

Main etiological reasons diseases are:

• respiratory viruses;
• bacterial and fungal infection;
• injuries;
• burns.

The prerequisites for the development of acute laryngitis are the following factors:

• hypothermia;
• dirty dry air, chemical pollution;
• eating irritating foods or cold drinks;
• autoimmune processes in which the immune system fights own tissues body;
• professional activities associated with increased load on the vocal apparatus: teachers, singers;
• allergens of various origins;
• gastroesophageal reflux, in which the contents of the stomach are thrown into the esophagus;
• avitaminosis;
• metabolic disorders;
• chronic foci of infection;
• bad habits: alcoholism and smoking;
• deviated nasal septum.

Symptoms

An acute process is characterized by a sudden onset. Patients complain of general weakness, increased fatigue, irritability. There is a slight increase in body temperature. There is discomfort, dryness, and soreness in the throat. Patients note a sensation of a foreign body. The voice becomes rough, with a low timbre, and sometimes disappears completely.

As for coughing, attacks of dry, debilitating cough first appear. With adequate medical therapy, a nonproductive cough becomes wet with the release of mucous sputum.

If we talk about children, laryngitis most often appears before the age of six. Due to the peculiarity of the structure child's body, in particular, narrowness of the glottis, a high percentage of allergic reactions and instability of work immune system, the child’s body is vulnerable.

Children's laryngitis has a number of its own characteristics:

• most often occurs as a secondary process against the background of respiratory diseases;
• present;
• high risks of occurrence;
• the likelihood of shortness of breath, up to the occurrence of respiratory failure;
• there are swallowing disorders;
• an attack occurs at night;
• the child wakes up from an attack of suffocation and lack of air; the attack can last fifteen minutes;
• a dry barking cough may appear;
• It is possible for the attack to stop on its own, although in most cases immediate hospitalization is required.

Children suffer acute laryngitis much more severely than adults

Acute catarrhal laryngitis

The catarrhal form of laryngitis is considered one of the mildest, as it manifests itself with mild clinical symptoms and rarely causes complications. However, this does not mean that the disease can be left to chance, because in the absence of treatment, an acute process can develop into a chronic one.

Treatment of catarrhal laryngitis includes achieving the following goals:

• symptomatic therapy;
• fighting the root cause;
• therapeutic therapy should not only be effective, but also as painless and safe as possible;
• prevention of relapse and transition of the process to a chronic form.

For treatment, specialists use the following methods:

• photodynamic therapy relieves inflammation in a short time, fights pathogens and restores the functional activity of the damaged mucous membrane;
• mineral therapy includes irrigation of the oropharynx, which allows you to wash away pathogenic microflora from the surface of the mucous membrane;
• Ozone therapy increases the internal strength of the body.

Obstructive laryngitis is whole group diseases based on narrowing of the lumen of the larynx

What is obstructive laryngitis

Most often, obstructive laryngitis occurs in preschool children, this is due to physiological and anatomical features:

• the larynx has a small opening, and its cartilaginous base is pliable and soft;
• the larynx has a funnel shape;
• vocal cords are short and thick;
• the muscles near the glottis are easily excitable;
• hypertonicity of the sympathetic nervous system.

Viruses and bacteria provoke the development of an inflammatory process in the larynx. Allergies to drugs, prematurity, damage to the central nervous system - these and other factors contribute to the development of the obstructive form. One of the dangerous types of obstructive laryngitis is stenotic laryngitis.

The source of obstructive laryngitis is a sick person. The disease can be transmitted through airborne droplets

The obstructive form is based on stenosis, or narrowing, of the larynx. The pathological process is characterized by a change in voice, shortness of breath, and in severe cases - complete loss of voice and asphyxia.

Experts distinguish four stages of obstructive laryngitis:

1. Compensation stage. Usually at night the child has an attack barking cough. Usually the attack is preceded by symptoms characteristic of colds: aches, hyperthermia, general weakness, headache. A new coughing attack can be triggered by some kind of stress or movement. At this stage, the cough goes away on its own. Typically, shortness of breath occurs during inhalation during physical activity. The child's breathing is noisy and intermittent.
2. Subcompensation stage. Not in all cases the compensation stage progresses to the next phase. In some cases, the process either on its own or after treatment, the disease may stop. At this stage, shortness of breath also appears at rest. Noisy breathing can be heard in the distance. The child is capricious, refuses food, and sleeps poorly. The skin becomes pale. When you cry, the skin around your nose and mouth turns blue. The subcompensation stage can persist for three to five days.
3. Stage of decompensation. The child's condition is serious, he is apathetic and drowsy. It is superficial and severe. Shortness of breath is constantly present. The cough is rough and barking at first, and then becomes quiet. The voice becomes hoarse and then disappears completely. This stage is characterized by the appearance of a forced posture, in which the child sits down and holds his knees with his hands.
4. Terminal stage. Most often the child is unconscious. Respiratory and heart failure increases. In the absence of proper treatment, respiratory arrest, asystole and death occur.

Treatment of obstructive laryngitis depends on the stage of stenosis and severity

Let's consider treatment depending on the stage of the pathological process:

• in case of stage 1 stenosis, rest, distraction procedures and, if necessary, antipyretics are indicated. Constant monitoring of body temperature and breathing. If the condition worsens, inhalation procedures with Pulmicort are carried out; if after twenty minutes nothing has changed, then an ambulance must be called. Children under one year of age are hospitalized even at the first stage;
• the second stage is absolute reading to hospitalization. Every half hour the child is given inhalations until the symptoms disappear;
• in the third and fourth stages, the child is taken to intensive care, where he is given steroid drugs. In severe cases, intubation and tracheostomy are required.

Complications

Laryngitis can lead to conditions that require immediate hospitalization and are life-threatening:

• infiltration of the epiglottis;
• abscess formation of the epiglottis.

Prevention

Laryngitis is easier to prevent than to treat! There is no specific prevention, but there are recommendations that can help prevent the onset of the disease:

• do not contact with infected people;
• timely treatment chronic lesions infections;
• refusal bad habits, in particular, smoking;
• prevention of injuries and burns of the larynx.

Treatment of laryngitis begins with diagnosis

Diagnostics

The diagnosis is made by a therapist or otolaryngologist based on the following data:

• patient complaints;
• collection of anamnestic data;
• inspection;
• laryngoscopy.

During an appointment, an experienced specialist may suspect the presence of one or another form of laryngitis:

• the diffuse form of laryngitis is indicated by swelling and hyperemia of the laryngeal mucosa;
• in a limited form, the inflammatory focus is localized in one part of the organ;
• O hemorrhagic form you can talk if you have it pinpoint hemorrhages;
• with fibrous laryngitis, white or yellow plaques, and with diphtheria - gray or even brown.

How to treat acute laryngitis in adults

• compliance with bed rest;
• voice rest;
• maintaining an optimal indoor microclimate: humidity, temperature;
• regular wet cleaning and ventilation of the room;
• quitting active and passive smoking.

During treatment and at least a week after recovery, you should stop smoking

Drug therapy

Treatment is prescribed depending on clinical signs laryngitis:

• for sore throat and sore throat, antimicrobial and anti-inflammatory drugs are prescribed in the form of sprays and lozenges;
• for dry, painful paroxysmal cough, antitussives containing codeine are used;
• for a non-productive cough, herbal expectorants are prescribed;
• for a wet cough, mucolytic drugs are prescribed to thin the sputum;
• if a bacterial infection is suspected, Bioparox is prescribed, a local antibiotic;
• in case of swelling of the mucous membrane of the larynx, antihistamines cannot be avoided;
• multivitamins and immunomodulators are prescribed to strengthen the immune system.

Treatment at home

Compliance plays an important role in the treatment of laryngitis. correct mode. Talk as little as possible, or better yet remain silent. Remember, dry air makes the mucous membrane of the respiratory tract vulnerable, so care should be taken to maintain optimal air humidity.

Keep your throat warm by wrapping it in a warm scarf. You should not go outside, especially in the cold season. In order to remove toxic substances from the body and thin phlegm, drink plenty of fluids. As an alternative to plain water, you can use herbal infusions, rosehip decoction, warm milk with mineral waters.

Plays an important role in the treatment of laryngitis dietary food. Cold, hot, spicy, salty - all this injures the already vulnerable mucous membrane and reduces local immunity.

Gargling is another effective way to get rid of laryngitis. Procedures should be carried out five to seven times a day. Rinsing promotes healing of the mucous membrane, relieving swelling and inflammatory effects. The following solutions can be used as rinses:

• soda solution;
• herbal decoction;
• solution with sea ​​salt and etc.

Inhalations will also help reduce the symptoms of laryngitis. At home for carrying out inhalation procedures You can use a teapot or a regular saucepan. The vapors should be inhaled at least ten minutes after the liquid has boiled, otherwise there is a risk of getting a burn to the mucous membrane. For inhalations, use the following solutions:

• alkaline soda solution;
• mineral water;
• decoctions of medicinal herbs;
• essential oils.

Traditional recipes will help cure laryngitis faster

ethnoscience

Let's consider proven and effective non-traditional methods of getting rid of laryngitis:

• rinsing. Grate the beets and squeeze out the juice. Mix freshly squeezed juice with apple cider vinegar and gargle. You can also use juice raw potatoes or cabbage;
• inhalation. For the procedure, you can use the following herbs: coltsfoot, string, elderberry, string;
• means for oral administration. Drink warmed beer in small sips. For a glass of milk, take two cloves of garlic. Drink the product in small sips.

So, acute laryngitis is an inflammatory disease that affects the larynx. The disease occurs in both adults and children. Most often, the causative agents of the disease are viruses and bacteria. Laryngitis often appears as a complication of other respiratory diseases. In most cases, laryngitis can be treated at home.

Gargling, inhalation, proper nutrition, maintaining the microclimate in the room - all this will help speed up the healing process. The disease, if not properly treated, leads to serious complications, which is why when the first symptoms appear, do not delay in seeing a doctor. A timely and competent approach to treatment is the key to a speedy recovery!

Acute laryngitis has the second name false croup and occurs mainly in childhood. It is important to promptly diagnose and treat this disease. curative measures. The acute form of laryngitis is characterized by the appearance of a paroxysmal barking cough, which is accompanied by loss of voice.

This disease can be treated well, but despite this, the patient must be under the supervision of a specialist, which eliminates the development of possible complications.

Causes of development of acute laryngitis

Acute laryngitis develops in children and adults due to the penetration of viruses into the body, which provoke the development of infectious diseases such as diphtheria, influenza and scarlet fever. The cause of laryngitis is chemical or mechanical irritation of the larynx, as well as overexertion vocal cords.

Along with the vibration created, sound is produced. If there is an inflammatory process in this area, the ligaments swell and harden. This provokes hoarseness of the voice and is the cause of aphonia ( total loss vote).

Reasons for the development of laryngitis:

• ulcerative lesions localized in the area of ​​the vocal cords;
• the appearance of neoplasms on the mucous membrane;
• chronic forms of sinusitis or sinusitis, as well as enlarged adenoids;
• cancer, trauma and stroke.

Laryngitis occurs due to the influence of a number of certain predisposing factors on the body. Among them are hypothermia, abuse of bad habits, poor nutrition and obesity, inhalation of polluted air and excessive strain on the vocal cords.

It is also important to take into account factors such as reduction immune defense body and work in unfavorable working conditions.

Course of acute laryngitis

Acute laryngitis treatment in both adults and children, which should be carried out in a timely manner, is sufficient dangerous disease. The pathogenesis of the disease is as follows:

1. At the very beginning, hyperemia of the laryngeal mucosa develops due to damage pathogenic microorganisms or viruses.
2. During the inflammatory process, blood vessels dilate, which provokes the infiltration of leukocytes and is accompanied by the release of submucosal transudate.
3. Transudate causes the release of purulent or mucous exudate, which may contain an admixture of blood.
4. Due to intoxication caused by the inflammatory process, swelling occurs in the mucous membrane, which is the cause of the development of laryngeal stenosis.

Symptoms of the disease

Acute laryngitis symptoms, which determine the stage of the disease, occur suddenly. General weakness occurs unexpectedly, with irritability and fast fatiguability. In some cases, during the primary stage of development, an increase in body temperature of up to 38 degrees is observed. There is discomfort in the throat, a sensation of a foreign body or lump.

There is soreness, dryness and rapid fatigue of the vocal cords. The voice becomes rough or may be completely absent. Initially, a paroxysmal dry cough appears. With timely treatment, it quickly becomes productive. When expectorating, mucopurulent sputum is released.

Possible complications

Acute laryngitis treatment, which is not started in a timely manner, can provoke the following complications:

• laryngeal stenosis varying degrees;
• abscess formation of the epiglottis;
• infiltration of the epiglottic mucosa.

These conditions pose a serious threat to the patient's life. That is why in case of acute laryngitis it is recommended to hospitalize the patient, which allows timely treatment measures to be taken and, if necessary, assistance to the patient.

Acute laryngitis symptoms and treatment in both adults and children, which are closely related to each other, should be diagnosed in a timely manner. The diagnosis can only be made by a doctor based on the patient’s complaints. The collected medical history and the results of the research procedures performed. The first step is laryngoscopy (examination of the larynx).

In accordance with the clinical picture of the disease, the specialist determines its form:

1. acute catarrhal laryngitis is mild form diseases that are accompanied by an inflammatory process;
2. the diffuse form is accompanied by redness and swelling of the mucous membrane in the larynx area;
3. in a limited form, signs of the inflammatory process are present in only one part of the larynx;
4. the hemorrhagic form is accompanied by the appearance of pinpoint hemorrhages in the mucous membrane;
5. The fibrous form is characterized by the appearance of a whitish coating in the larynx area.

To confirm the diagnosis, general urine and blood tests are prescribed, which makes it possible to determine increase in ESR and leukocytes in the body. X-ray examination is not very informative, but allows you to differentiate the diagnosis.

Therapeutic measures

Acute laryngitis in children, treatment that is started in a timely manner, as a rule, does not produce complications. IN mandatory at the same time, the vocal cords should be kept at rest. Even when whispering, the vocal cords become tense, so you shouldn’t talk at all. It is important to exclude such traumatic factors as tobacco smoke, dust and fumes. The air in the room should be humidified and fresh. It is recommended to follow a diet devoid of spicy, alcoholic and spicy foods.

If laryngitis occurs against the background of ARVI. Then the patient is prescribed antiviral drugs. Local antiseptics such as Dequalie and Timol are suitable for these purposes. If necessary, the doctor prescribes oral antibiotics. Among the most safe drugs Bioparox can be distinguished.

If there is a cough, expectorant medications are prescribed. It is recommended to give the patient mineral water to drink. alkaline water and use potassium iodide.

When carrying out antibacterial therapy, it is important to prescribe drugs intended to restore intestinal microflora(Linex, Bifiform or Lactovit). Paracetamol, Aspirin and Ibuprofen help reduce high fever. Sore throat is relieved with aerosols such as Orasept, Ingalipt, Hexasprey.

Elimination of mucosal edema

In case of false croup, swelling and spasm in the larynx should be eliminated:

1. Oral inhalation using a nebulizer with 5% ephedrine, 0.1% atropine and adrenaline, hydrocortisone, diphenhydramine and chymopsin.
2. Injections of the corticosteroids dexamethasone or prednisolone.
3. Introduction « lytic mixture", which includes an antihistamine (suprastin, diphenhydramine), an antispasmodic (papaverine, drotaverine) and analgin (added for fever).

In case of laryngeal stenosis, the patient must be hospitalized in a hospital where resuscitation measures. In order to prevent the development of laryngitis, you should promptly treat infectious diseases, avoid contact with an infected person, prevent burns and injury to the mucous membrane in the larynx, and control the load on the vocal cords.

Acute laryngitis is the most common inflammatory disease of the larynx. People encounter it different ages and floors. For what reasons can laryngitis occur and how to identify it? Why is he dangerous? How to treat it correctly? You will learn the answers to these and other questions from this article.

Features of the disease

Laryngitis

Laryngitis can appear on its own, but in most cases it occurs against the background of viral diseases of the upper respiratory tract. It is often accompanied by inflammation of the trachea, bronchi and pharynx (,).

Acute laryngitis occurs:

• (the mucous layer becomes inflamed). This form is the most common and easiest;
• edematous (inflammation affects the submucosal layer, the course of the disease is more severe);
• . The most dangerous type of laryngitis occurs in rare cases.

Inflammation begins in the mucous layer, then moves to the submucosal layer, and in severe cases to the muscular layer. This can happen due to improper treatment or lack thereof, as well as due to the body’s weak resistance.

Inflammation of the larynx is accompanied by redness and swelling of the tissue. Laryngitis can be isolated (for example, it affects only the epiglottis) or affect all parts of the organ, which sometimes leads to stenosis, which is life-threatening.

The duration of acute laryngitis is 1-2 weeks. If the disease drags on, then there is a possibility of transition to.
A special form of laryngitis occurs in children, called false croup. This disease is very dangerous and requires immediate medical attention.

Causes of acute laryngitis

What causes laryngitis? The causative agents of this disease are usually various infections. These can be viruses (measles, scarlet fever, diphtheria), bacteria (staphylococci, streptococci, etc.) and, extremely rarely, fungi. Sometimes several infections are present at once.

It is known that the microflora of the larynx contains opportunistic bacteria and microorganisms (pneumococci, Haemophilus influenzae, Moraxella catarrhalis, Neisseria). IN normal conditions our body is able to fight them on its own, but when the immune system is weakened, they begin to actively multiply and cause diseases. That is, the main cause of laryngitis is weak defense body.

There is also a list of factors that influence the development of inflammation in the larynx:

• polluted, dusty air. This problem is faced by people in large cities with poor environmental conditions and those who work in hazardous industries;
• eating food that is too hot or spicy food and drinks that irritate the walls of the throat;
• overstrain of the vocal apparatus (for example, when shouting or working in people of vocal professions);
• drinking alcohol and smoking;
• injuries and tumors of the throat, microcracks in the mucous membrane;
• talking in the cold and hypothermia of the throat;
• chronic diseases of the upper respiratory tract.

At risk are people who, for some reason, have difficulty breathing, increased sensitivity of the mucous membrane of the larynx, metabolic disorders, caries or other dental diseases.

Also, acute laryngitis in adults can occur as a result of allergic reactions, constant heartburn, and in rare cases it becomes a complication of tuberculosis, syphilis, cancer (Wegener's granulomatosis, scleroma) and rheumatoid arthritis.

For coughs, drugs that reduce the excitability of the cough center are prescribed:

1. Kodilak. The tablets contain codeine, a substance that affects the cough center. Sodium hydrocarbon reduces the viscosity of sputum, and licorice root and thermopsis herb help to expectorate it;
2. Glycodin. It contains Dextromethorphan, which reduces the excitability of the cough center, Terpinhydrate (reduces the viscosity of sputum and promotes its release), and Levomenthol (reduces irritation and soothes the mucous membrane). Sold as syrup;
3. Gederin syrup. This is a drug plant origin, which is made from ivy leaf extract. It has an antiseptic, wound-healing, anti-inflammatory, expectorant and tonic effect;
4. Libexin. Its antitussive effect is due to prenoxdiazine. Libexin is available in tablets.

Additionally, gargle 3-4 times a day.

How to gargle for acute laryngitis? For this purpose, decoctions from various medicinal plants: chamomile, sage, calamus root, nettle, St. John's wort, calendula, fennel. Soda and saline solutions not recommended.

In advanced cases, for the treatment of acute laryngitis in adults, steam inhalations with the addition of medications are used. Inhalations with laryngitis have a pronounced anti-inflammatory and anti-edematous effect.

For uniform distribution of medication and enhancement therapeutic action A device called a nebulizer is used. This is an inhalation device that converts liquid drugs into an aerosol. nebulizer helps relieve inflammation and unpleasant symptoms, moisturize the mucous membrane of the larynx and reduce the viscosity of sputum. You can also use a special inhaler or simply breathe in the steam from the medicinal solution.

What products can be used for inhalation:

• miramistin or dioxidin (antibacterial);
• alkaline mineral waters, for example, Essentuki. Help eliminate dry throat;
• mucolytics (chymopsin);
• aromatic oils of mint, menthol, eucalyptus (to relieve irritation, soreness and pain, as well as treat cough);
• herbal decoctions (chamomile, oregano, sage) with antimicrobial, analgesic, soothing, and anti-inflammatory properties.

Inhalations for acute laryngitis are carried out three times a day, their duration is 5-10 minutes.

In addition to treatment, physical procedures may be prescribed, for example, UHF, microwave therapy for the throat area, electrophonophoresis.

Compresses on the throat for laryngitis are not so effective and, according to some reports, can lead to complications, so it is better not to use them.

Antibiotics for acute laryngitis are prescribed if severe swelling of the larynx and severe intoxication of the body are diagnosed. They are also prescribed if, after 4-5 days of treatment with other methods, the disease continues to develop. Antimicrobial therapy is usually carried out in a hospital setting. Used with clavulanic acid (), fluoroquinolones or macrolides (Azithromycin). Antimicrobials for acute laryngitis, they are used together with medicinal installations.

When injections are performed antihistamines: Tavegil, Histidil. And glucocorticosteroids: Dexamethasone, Prednisolone.

Surgical treatment of acute laryngitis in adults is carried out with the development of purulent complications.

During the treatment of acute laryngitis, treatment for diseases of the upper respiratory tract, gastroesophageal reflux and sanitation of the oral cavity should be carried out (if necessary).

Acute laryngitis: treatment with folk remedies

Folk remedies can be used to treat laryngitis as aid. What is used to treat acute laryngitis at home:

• honey. Prepare a solution from warm water and a couple of spoons of honey and gargle with it 2-3 times a day. For greater effectiveness, add a little lemon juice or cranberries - they are also useful;
• gargling with herbal decoctions (chamomile, sage, calamus root, nettle, St. John's wort, calendula, fennel), which are carried out every hour;
• warm milk and eggnog. To prepare the latter, you need to take 2 yolks and grind them with sugar and butter. Some people add honey and milk. This drink coats the throat and eliminates pain, burning, cough;
• vodka compresses. Soak a gauze-cotton bandage in vodka and apply to the throat. Cover the top with plastic and wrap it with a warm scarf. Leave overnight;
• a decoction of anise seeds, which is consumed internally. To prepare it you will need 250 ml of water and 100 g of seeds. Boil water and add anise, wait another 15 minutes, then remove from heat and let cool. You can add honey to the mixture. Drink up to 7 times a day;
• foot baths with mustard.

Important! Before using any product, consult your doctor!

Informative video

Disease prevention

To prevent laryngitis you must:

• promptly treat inflammatory diseases of the upper respiratory tract;
• avoid hypothermia, too cold and hot food;
• to refuse from bad habits;
• take medications to prevent flu and colds;
• avoid straining the throat;
• increase immunity (harden yourself, drink vitamins, eat healthy food);
• ventilate the room in which you live and maintain normal air humidity. Don't forget about wet cleaning.

It is also important to comply elementary rules hygiene, such as washing your hands and brushing your teeth, and to prevent complications - do not self-medicate and do not prescribe antibiotics for yourself!

Catad_tema Diseases of the ENT organs - articles

Acute laryngitis

Acute laryngitis

ICD 10: J04.0, J04.2, J05.0, J05.1, J38.6

Year of approval (revision frequency): 2016 (reviewed every 3 years)

ID: KR309

Professional associations:

• National Medical Association of Otolaryngologists

Approved

Chief freelance specialist otorhinolaryngologist of the Ministry of Health of Russia, Doctor of Medical Sciences, Professor N.A. Daikhes President of the National Medical Association of Otorhinolaryngologists Honored Doctor of Russia, Corresponding Member of the Russian Academy of Sciences Professor Yu.K. Yanov

Agreed

Scientific Council of the Ministry of Health Russian Federation __ __________201_

List of abbreviations

OL - acute laryngitis

ARVI - acute respiratory viral infection

Ultrasound - ultrasound examination

CT - computed tomography

ABP - antibacterial drugs

UHF - ultra high frequency

Terms and Definitions

Acute laryngitis – acute inflammation of the mucous membrane of the larynx.

1. Brief information

1.1 Definition

Acute laryngitis (AL) – acute inflammation of the mucous membrane of the larynx.

Abscess or phlegmonous laryngitis- acute laryngitis with the formation of an abscess, most often on the lingual surface of the epiglottis or on the aryepiglottic folds; manifested by sharp pain when swallowing and phonation, radiating to the ear, increased body temperature, and the presence of a dense infiltrate in the tissues of the larynx.

Acute chondroperichondritis of the larynx- acute inflammation of the cartilage of the larynx, i.e. chondritis, in which the inflammatory process involves the perichondrium and surrounding tissues.

1.2 Etiology and pathogenesis

Acute inflammation of the laryngeal mucosa may be a continuation catarrh mucous membrane of the nose or pharynx or occur with acute catarrh of the upper respiratory tract, respiratory viral infection, flu. Typically, acute laryngitis is a symptom complex of ARVI (influenza, parainfluenza, adenovirus infection), in which the inflammatory process also involves the mucous membrane of the nose and pharynx, and sometimes the lower respiratory tract (bronchi, lungs). It is known that the microflora that colonizes non-sterile parts of the respiratory tract, including the larynx, is represented by saprophytic microorganisms, almost never causing diseases in humans and opportunistic bacteria that can cause purulent inflammation under unfavorable conditions for the microorganism.

In the pathogenesis of the development of acute laryngeal edema, an important role is played by the anatomical features of the structure of the mucous membrane of the larynx. Disruption of lymphatic drainage and local water metabolism is important. Swelling of the mucous membrane can occur in any part of the larynx and quickly spread to others, causing acute laryngeal stenosis and threatening the patient's life. The causes of acute inflammation of the mucous membrane of the larynx are varied: infectious and viral factors, external and internal trauma to the neck and larynx, including inhalation injuries, foreign body entry, allergies, gastroesophageal reflux. A large voice load is also important. The occurrence of inflammatory pathology of the larynx is facilitated by chronic diseases of the bronchopulmonary system, nose, paranasal sinuses, metabolic disorders with diabetes mellitus, hypothyroidism or diseases of the gastrointestinal tract, chronic renal failure, pathology of the secretive function of the larynx, alcohol and tobacco abuse, previous radiation therapy.

Possible development angioedema larynx of hereditary or allergic origin.

Non-inflammatory laryngeal edema can occur as local manifestation general hydrops of the body with various forms heart failure, liver disease, kidney disease, venous congestion, mediastinal tumors.

Specific (secondary laryngitis develops with tuberculosis, syphilis, infectious (diphtheria), systemic diseases (Wegener's granulomatosis, rheumatoid arthritis, amyloidosis, sarcoidosis, polychondritis, etc.), as well as blood diseases).

1.3 Epidemiology

The exact prevalence of acute laryngitis is unknown, as many patients are often self-treated with medications or use traditional remedies to treat laryngitis and do not seek medical help. Most often people from 18 to 40 years old become ill, but the disease can occur at any age.

The highest incidence of acute laryngitis was observed in children aged 6 months to 2 years. At this age, it is observed in 34% of children with acute respiratory disease.

1.4 Coding according to ICD 10

J04.0 - Acute laryngitis.

J04.2 - Acute laryngotracheitis.

J05.0- Acute obstructive laryngitis (croup).

J05.1 - Acute epiglotitis.

J38.6- Acute laryngeal stenosis.

1.5 Classification

1. According to the form of acute laryngitis:

catarrhal;

• phlegmonous (infiltrative-purulent):

Infiltrative;

Abscessing.

1. According to the nature of the pathogen:

bacterial;

viral;

fungal;

specific.

2. Diagnostics

2.1 Zha l customs and anamnesis

The main symptoms of acute laryngitis are sharp pain in the throat, hoarseness, cough, difficulty breathing, deterioration in general health. Acute forms are characterized by a sudden onset of the disease with general satisfactory condition or against the background of a slight malaise. Body temperature remains normal or rises to subfebrile levels with catarrhal acute laryngitis. Febrile temperature, as a rule, reflects the addition of inflammation of the lower respiratory tract or the transition of catarrhal inflammation of the larynx to phlegmonous. Infiltrative and abscess forms of acute laryngitis are characterized by severe pain in the throat, difficulty swallowing, including liquids, severe intoxication, and increasing symptoms of laryngeal stenosis. Expressiveness clinical manifestations directly correlates with the severity of inflammatory changes. General state the patient becomes ill. In the absence of adequate therapy, neck phlegmon, mediastinitis, sepsis, abscess pneumonia and laryngeal stenosis may develop. In these cases, regardless of the cause causing acute laryngeal stenosis, its clinical picture is the same and is determined by the degree of narrowing of the airways. Sharply expressed negative pressure in the mediastinum during intense inspiration and increasing oxygen starvation cause a symptom complex, which consists of the appearance of noisy breathing, a change in the breathing rhythm, retraction of the supraclavicular fossa and retraction intercostal spaces, forced position of the patient with his head thrown back, lowering of the larynx when inhaling and rising when exhaling.

2.2 Physical examination

In a limited form, changes are observed mainly on the vocal folds, in the interarytenoid or subglottic space. Against the background of the hyperemic mucous membrane of the larynx and vocal folds, expanded superficial blood vessels and mucous or mucopurulent secretion. In the diffuse form of acute laryngitis, continuous hyperemia and swelling of the entire mucous membrane of the larynx of varying degrees of severity are determined. During phonation, incomplete closure of the vocal folds is observed, and the glottis has a linear or oval shape. In acute laryngitis developing against the background of influenza or ARVI, laryngoscopy reveals hemorrhages in the mucous membrane of the larynx: from petechial to small sizes hematomas (so-called hemorrhagic laryngitis).

The appearance of white and whitish-yellow fibrinous plaque in the larynx is a sign of the disease transitioning to a more severe form - fibrinous laryngitis, and the plaque is gray or brown color may be a sign of diphtheria.

The main symptom of acute respiratory failure is shortness of breath. Depending on the severity of shortness of breath, the following degrees are distinguished:
I degree of respiratory failure – shortness of breath occurs during physical exertion;
II degree – shortness of breath occurs at small physical activity(slowly walking, washing, dressing);

III degree – shortness of breath at rest.

According to the clinical course and size of the airway lumen, four degrees of laryngeal stenosis are distinguished:

The stage of compensation, which is characterized by slowing and deepening of breathing, shortening or loss of pauses between inhalation and exhalation, and slowing of the heartbeat. The lumen of the glottis is 6-8 mm or the narrowing of the tracheal lumen by 1/3. At rest there is no lack of breathing; shortness of breath appears when walking.

Stage of subcompensation - in this case, inspiratory shortness of breath appears with the inclusion of auxiliary muscles in the act of breathing during physical activity, there is retraction of the intercostal spaces, soft tissues of the jugular and supraclavicular fossae, stridorous (noisy) breathing, pallor of the skin, arterial pressure remains normal or elevated, the glottis is 3-4 mm, the tracheal lumen is narrowed by? and more.

Stage of decompensation. Breathing is shallow, frequent, and stridor is pronounced. Forced position sitting. The larynx makes maximum excursions. The face becomes pale and bluish, there is increased sweating, acrocyanosis, rapid and thready pulse, and decreased blood pressure. The glottis is 2-3 mm, the trachea has a slit-like lumen.

Asphyxia - breathing is intermittent or stops completely. The glottis and/or tracheal lumen is 1 mm. Sharp depression of cardiac activity. The pulse is frequent, thread-like, and often cannot be felt. The skin is pale gray due to spasm of small arteries. There is loss of consciousness, exophthalmos, involuntary urination, defecation, cardiac arrest.

The acute onset of the disease with rapid progression of stenosis symptoms aggravates the severity of the patient’s condition, since compensatory mechanisms do not have time to develop in a short time. This must be taken into account when determining indications for emergency surgical treatment. Narrowing of the lumen of the upper respiratory tract in acute stenosing laryngotracheitis occurs sequentially, stage by stage over a short period of time. With incomplete obstruction of the larynx, noisy breathing occurs - stridor, caused by vibrations of the epiglottis, arytenoid cartilages, and partly the vocal cords with intense turbulent passage of air through the narrowed airways according to Bernoulli's law. When swelling of the laryngeal tissues dominates, a whistling sound is observed; when hypersecretion increases, hoarse, bubbling, noisy breathing is observed. In the terminal stage of stenosis, breathing becomes less and less noisy due to a decrease in tidal volume.

The inspiratory nature of shortness of breath occurs when the larynx narrows in the area of ​​the vocal folds or above them and is characterized by noisy inhalation with retraction of pliable places chest. Stenoses below the level of the vocal folds are characterized by expiratory shortness of breath with the participation of auxiliary muscles in breathing. Laryngeal stenosis in the subglottic area usually manifests as mixed shortness of breath.

In patients with obstruction of the larynx with inflammatory infiltrate due to an abscess of the epiglottis against the background of acute pain symptom the first to appear are complaints about the inability to swallow, which is associated with limited mobility of the epiglottis and swelling back wall larynx, then as the disease progresses, difficulty breathing appears. Obstruction of the glottis can occur very quickly, which requires the doctor to take emergency measures to save the patient’s life.

2.3 Laboratory diagnostics

It is recommended to conduct a general clinical examination, including a clinical blood test, general analysis urine, blood test for RW, HBS and HCV antigens, HIV, biochemical blood test, coagulogram; is performed at the preoperative stage in all patients with OA entering for surgery.

Comments:Standard laboratory examination during hospitalization.

Comments:The ciliated epithelium loses cilia or is rejected, the deeper layers of cells are preserved (they serve as a matrix for epithelial regeneration). With a pronounced inflammatory process, metaplasia of the ciliated columnar epithelium into squamous epithelium can occur. Infiltration of the mucous membrane is unevenly expressed, the blood vessels are tortuous, dilated, and overflowing with blood. In some cases, their subepithelial breaks are determined (usually in the area of ​​the vocal folds).

2.4 Instrumental diagnostics

Comments:The study allows us to determine the nature of the pathological process, its localization, level, extent and degree of narrowing of the airway lumen.

The picture of acute laryngitis is characterized by hyperemia, swelling of the laryngeal mucosa, and increased vascular pattern. The vocal folds are usually pink or bright red, thickened, and the glottis during phonation is oval or linear with accumulation of mucus. In acute laryngitis, the mucous membrane of the subglottic region of the larynx may be involved in the inflammatory process. With subglottic laryngitis, a roller-like thickening of the mucous membrane of the subglottic part of the larynx is diagnosed. If the process is not associated with intubation trauma, its detection in adults requires urgent differential diagnosis with systemic diseases and tuberculosis. With infiltrative laryngitis, significant infiltration, hyperemia, an increase in volume and impaired mobility of the affected part of the larynx are determined. Fibrinous deposits are often visible, and purulent contents are visible at the site of abscess formation. Severe forms of laryngitis and chondroperichondritis of the larynx are characterized by pain on palpation, impaired mobility of the cartilage of the larynx, possible infiltration and hyperemia of the skin in the projection of the larynx, against the background of pain and a clinical picture of a general purulent infection. An epiglottis abscess looks like a spherical formation on its lingual surface with translucent purulent contents with severe pain and difficulty swallowing.

3. Treatment

3.1 Conservative treatment

Systemic antibacterial therapy is recommended for severe intoxication and the presence of significant inflammation in the larynx ( diffuse edema mucous membrane of the larynx, the presence of infiltration) and regional lymphadenitis.

Comments: Systemic antibacterial therapy for acute laryngitis is also prescribed in the absence of effect from local antibacterial and anti-inflammatory therapy for 4–5 days, with the addition of purulent exudation and inflammation of the lower respiratory tract.

Carrying out antibiotic therapy on an outpatient basis is not an easy task, since the irrational choice of the “starting” antibiotic prolongs the course of a purulent infection and leads to the development of purulent complications. Antimicrobial therapy acute laryngitis with severe inflammatory phenomena prescribed empirically - amoxicillin + clavulanic acid**, macrolides, fluoroquinolones.

Comments:Local antimicrobial therapy includes endolaryngeal infusions with hydrocortisone emulsion**, peach oil and an antibacterial drug (you can use erythromycin, gramicidin C, streptomycin, amoxicillin + clavulanic acid**).

Comments:In the allergic form of angioedema of the larynx, it is quite easily removed by injections of antihistamines acting both on H1 receptors (diphenhydramine**, clemastine, chloropyramine**) and on H2 receptors (cimetidine, histodil (not registered in the Russian Federation and not used) 200 ml IV) with the addition of glucocorticosteroids (60-90 mg prednisolone** or 8-16 mg dexamethasone** IV)

Comments:Inhalations with corticosteroids, antibiotics, mucolytics, herbal preparations with anti-inflammatory and antiseptic effects are used, as well as alkaline inhalations to eliminate dryness of the laryngeal mucosa. The duration of inhalation is usually 10 minutes 3 times a day. Alkaline inhalations can be used several times a day to moisten the lining of the respiratory tract.

3.2. Surgery

Comments:In case of complications such as phlegmon of the neck or mediastinitis, combined surgical treatment is performed using external and endolaryngeal access.

It is recommended to perform tracheostomy or instrumental conicotomy in case of clinical picture acute edematous-infiltrative laryngitis, epiglottitis, abscess of the lateral wall of the pharynx, lack of effect from conservative treatment and increasing symptoms of laryngeal stenosis (the tracheostomy technique is presented in Appendix D).

3.3 Other treatment

Comments:Good therapeutic effect gives laser therapy - laser radiation visible red range of the spectrum (0.63-0.65 µm) in continuous mode with a mirror attachment D 50 mm (mirror-contact method of exposure).

Superphonoelectrophoresis according to Kryukov-Podmazov is highly effective.

Comments:It is also necessary to remember that for any inflammatory disease of the larynx it is necessary to create a protective mode (voice mode), recommend that the patient speak a little and in a quiet voice, but not in a whisper, when the tension of the larynx muscles increases. It is also necessary to stop eating spicy, salty, hot, cold foods, alcoholic beverages, and smoking. In the stage of convalescence and in cases where intense phonation is one of the etiopathogenetic factors in the development of hypotonic disorders of vocal function as a result of inflammation, phonopedia and stimulating therapy are indicated.

4. Rehabilitation

Comments:Patients who have undergone surgical interventions are observed until the clinical and functional state of the larynx is completely restored for an average of 3 months, with examinations occurring once a week in the first month and once every 2 weeks, starting from the second month.

The period of incapacity for work depends on the patient’s profession: for people in vocal professions, they are extended until voice function is restored. Uncomplicated acute laryngitis resolves within 7-14 days; infiltrative forms - about 14 days.

5. Prevention and clinical observation

Prevention of chronicity of the inflammatory process of the larynx consists of timely treatment of acute laryngitis, increasing the body's resistance, treatment of gastroesophageal reflux disease, infectious diseases of the upper and lower respiratory tract, quitting smoking, and maintaining a voice regime.

6. Additional information affecting the course and outcome of the disease

In uncomplicated forms of laryngitis, the prognosis is favorable; in complicated forms with the development of laryngeal stenosis, timely specialized care and surgical treatment will help save the patient’s life.

Criteria for assessing the quality of medical care

Bibliography

Vasilenko Yu.S. Diagnosis and treatment of laryngitis associated with gastroesophageal reflux / Ros. otorhinolaryngology. 2002. - No. 1. - P.95-96.

Dainyak L. B. Special forms acute and chronic laryngitis / Bulletin of Otorhinolaryngology. 1997. - No. 5. - P.45.

Vasilenko Yu.S., Pavlikhin O.G., Romanenko S.G. Features of the clinical course and therapeutic tactics for acute laryngitis in voice professionals. / Science and practice in otorhinolaryngology: Materials III Russian scientific and practical conference. M., 2004. - P.122-123.

Otorhinolaryngology. National leadership. Brief edition / ed. V.T. Palchuna. M.: GEOTAR-Media, 2012. 656 p.

Carding P. N., Sellars C., Deary I. J. et al. Characterization of effective primary voice therapy for dysphonia / J. Laryngol. Otol. 2002. - Vol. 116, No. 12. - P. 1014-1018.

Kryukov A.I., Romanenko S.G., Palikhin O.G., Eliseev O.V. The use of inhalation therapy for inflammatory diseases larynx. Guidelines. M., 2007. 19 p.

Romanenko S.G. Spicy and chronic laryngitis", "Otorhinolaryngology. National leadership. Brief edition / ed. V.T. Palchuna. - M. -: GEOTAR-Media, 2012 – P. 541-547.

Strachunsky L.S., Belousov Yu.B., Kozlov S.N. Practical guide to anti-infective chemotherapy. – M.: Borges, 2002: 211-219.

Klassen T.P., Craig W.R., Moher D., Osmond M.H., Pasterkamp H., Sutcliffe T. et al. Nebulized budesonide and oral dexamethasone for treatment of croup: a randomized controlled trial // JAMA. – 1998; 279:1629–1632.

Daikhes N.A., Bykova V.P., Ponomarev A.B., Davudov Kh.Sh. Clinical pathology of the larynx. Atlas Guide. - M. - Medical information agency. 2009.- P.160.

Lesperance M.M. Zaezal G.H. Assessment and management of laryngotracheal stenosis. / Pediatric Clinics of North Amrica.-1996.-Vol.43, No. 6. P. 1413-1427.

Appendix A1. Composition of the working group

Ryazantsev S.V.,

Karneeva O.V., Doctor of Medical Sciences, Professor, member of the National Medical Association of Otorhinolaryngologists, no conflict of interest;

Garashchenko T.I., Doctor of Medical Sciences, Professor, member of the National Medical Association of Otorhinolaryngologists, no conflict of interest;

Gurov A.V.,

Svistushkin V.M., Doctor of Medical Sciences, Professor, Member of the National Medical Association of Otorhinolaryngologists, no conflict of interest;

Abdulkerimov Kh.T., Doctor of Medical Sciences, Professor, Member of the National Medical Association of Otorhinolaryngologists, no conflict of interest;

Polyakov D.P., Candidate of Medical Sciences, member of the National Medical Association of Otolaryngologists, no conflict of interest;

Sapova K.I., Member of the National Medical Association of Otorhinolaryngologists, no conflict of interest;

Otorhinolaryngologists.

General practitioners.

Pediatricians.

Doctors general practice(family doctors).

Table P1. Levels of evidence used

Table P2 - Recommendation strength levels used

Appendix A3. Related documents

Order of the Ministry of Health of the Russian Federation dated November 12, 2012 N 905n “On approval of the procedure for providing medical care to the population in the field of otorhinolaryngology.

Order of the Ministry of Health of the Russian Federation dated December 28, 2012 No. 1654n “On approval of the standard of primary health care for acute nasopharyngitis, laryngitis, tracheitis and acute infections upper respiratory tract mild degree heaviness."

Order of the Ministry of Health of the Russian Federation dated November 9, 2012 No. 798n “On approval of the standard of specialized medical care for children with acute respiratory diseases moderate severity."

Appendix B. Patient management algorithms

Appendix B: Patient Information

With the development of acute laryngitis, it is necessary to limit the vocal load. Eating hot, cold and spicy food, alcoholic beverages, smoking, and steam inhalation is prohibited. Constant humidification of the air in the room using special humidifiers and taking antiviral drugs are recommended.

Appendix D

Urgent tracheostomy should be performed with careful adherence to surgical technique and comply with the principles of maximum preservation of tracheal elements. The operation is performed under local anesthesia with 20-30 ml of 0.5% novocaine or 10-15 ml of 1% lidocaine under the skin of the neck. Standard styling with a cushion under the shoulders is not always possible due to severe difficulty breathing. In these cases, the operation is performed in a semi-sitting position. A median longitudinal incision is used to dissect the skin and subcutaneous fatty tissue from the level of the arch of the cricoid cartilage to the jugular notch of the sternum. Layer by layer strictly according to midline The superficial fascia of the neck is incised. The sternohyoid muscles are pushed apart bluntly along the midline (linea alba of the neck). The cricoid cartilage and isthmus are exposed thyroid gland, which, depending on the size, moves up or down. After this, the anterior wall of the trachea is isolated. The trachea should not be isolated over a large area, especially its side walls, because in this case, there is a possibility of disruption of the blood supply to this section of the trachea and damage to the recurrent nerves. In patients with normal neck anatomy, the thyroid isthmus is usually displaced superiorly. In patients with a thick, short neck and a retrosternal location of the thyroid gland, the isthmus is mobilized and shifted downwards behind the sternum by transversely dissecting the dense fascia at the lower edge of the cricoid cartilage arch. If it is impossible to displace the isthmus of the thyroid gland, it is intersected between two clamps and sutured with synthetic absorbable threads on an atraumatic needle. The trachea is opened with a longitudinal incision from 2 to 4 half rings of the trachea after anesthesia of the tracheal mucosa with 1-2 ml of 10% lidocaine solution and a test with a syringe (free passage of air through the needle). If the situation allows, then a permanent tracheostomy is formed at the level of 2 - 4 half rings of the trachea. The size of the tracheal incision should correspond to the size of the tracheostomy cannula. Increasing the length of the incision can lead to the development of subcutaneous emphysema, and decreasing it can lead to necrosis of the mucous membrane and adjacent tracheal cartilage. A tracheostomy cannula is inserted into the tracheal lumen. It is preferable to use tracheostomy tubes made of thermoplastic materials. The main difference between these tubes is that the anatomical bend of the tube makes it possible to minimize the risk of complications associated with irritation caused by contact of the distal end of the tube with the tracheal wall. The tracheostomy remains until breathing is restored through natural pathways.

Immediately after the end of the operation, sanitary fibrobronchoscopy is performed to avoid obstruction of the lumen of the trachea and bronchi with blood clots that got there during the operation.

In urgent situations, when the stenosis is decompensated, the patient undergoes an emergency conicotomy to ensure breathing. The patient lies on his back, a cushion is placed under the shoulder blades, and the head is tilted back. Palpable is the conical ligament, located between the thyroid and cricoid cartilages. Under aseptic conditions, after local anesthesia, a small skin incision is made above the conical ligament, then the conical ligament is pierced with a conicotome, the mandrin is removed, and the tracheostomy tube remaining in the wound is fixed by any available method.

In the absence of special instruments and severe obstruction of the larynx at the level of the vocal folds, insertion into the palpable part is justified. cervical region trachea 1-2 thick needles with a diameter of about 2 mm (from the infusion system) at the level of 2-3 tracheal rings strictly along the midline. This air gap is enough to save the patient from asphyxia and guarantee his transportation to the hospital.

Acute laryngitis is an inflammation of the mucous membrane of the larynx, submucosal layer, as well as internal muscles, most often of an infectious nature. Typically, acute laryngitis in adults and children occurs in conjunction with a viral or bacterial infection. If the pathology also affects the initial parts of the trachea, the disease is called laryngotracheitis.

In children, the disease often develops in infancy and early preschool age, accompanying up to a third of all inflammatory and infectious diseases. In adults, acute laryngitis can occur in several forms:

1. Catarrhal laryngitis. Light form pathology, causes redness and slight pain in the throat.

2. Hemorrhagic laryngitis. The specificity of the disease is small hemorrhages in the area of ​​the mucous membrane of the larynx and in the vocal folds.

3. Phlegmonous laryngitis. Inflammation of the laryngeal mucosa is purulent in nature. This type of pathology is very rare and is more often associated with trauma to the larynx.

4. Stenosing laryngitis. The disease leads to swelling of the larynx (especially its subglottic region), against which the lumen narrows. In addition to laryngeal stenosis, narrowing of the tracheal lumen may occur, which is fraught with serious complications.

Stenosing (subglottic) laryngitis often develops in children and is called false croup. Obstruction of the larynx in young patients occurs due to its small size and increased looseness of connective tissue. As a result, swelling quickly covers the subglottic space and can lead to a lack of oxygen.

Due to the appearance of acute laryngitis, it occurs:

• Bacterial,
• Viral
• Professional,
• Tuberculosis,
• Diphtheria,
• Syphilitic,

According to the degree of narrowing of the larynx, stenosing laryngitis can be:

• compensated,
• Subcompensated,
• Decompensated
• Terminal stage

At the last stage, it is possible to save the patient in rare cases. All other forms of stenosing laryngitis in adults and children have a favorable prognosis when timely application for help.

Why does acute laryngitis develop?

The causes of the disease may be associated with injury to the mucous membrane of the larynx, for example, due to severe voice strain or due to a cold (hypothermia). This causes increased proliferation of bacteria inhabiting the mucous membrane, resulting in the development of symptoms of pathology. Acute laryngitis may be occupational disease singers and lecturers, but in this case it is often chronic.

And yet, in most cases, acute laryngitis in children and adults is a complication associated with an infectious disease. The disease can be caused by:

• Influenza viruses, adenoviruses, parainfluenza, measles virus, herpes (respiratory viruses cause up to 70% of cases of acute laryngitis);
• Bacteria specific (tuberculosis, diphtheria, chlamydia) and nonspecific (staphylococci, streptococci, hemophilus influenzae)

Symptoms of laryngitis may appear after a burn to the larynx, after the introduction of a foreign body or other damage to the mucous membrane. In addition, there are a number of factors that provoke acute laryngitis, the influence of which is more likely to lead to the development of this disease:

• Frequent hypothermia, for example, working outdoors;
• Unfavorable ecology in the place of residence;
• Smoking;
• The presence of chronic diseases of the pharynx and sinuses;
• Tendency to food or drug allergies;
• Conditions labor activity, involving work with poisons, chemicals, etc.

False croup in children almost always develops as a complication of influenza, nasopharyngitis, measles, chickenpox, etc. In infancy, acute laryngitis is diagnosed much less frequently in babies who have received full breastfeeding.

Clinical picture of acute laryngitis

Typically, symptoms of laryngitis appear 2-5 days after the onset of the primary infectious disease. If you examine the patient's throat, it appears swollen and bright red. Swelling in the folds of the vestibule of the pharynx is especially clearly visible. Sometimes when severe course acute laryngitis causes small hemorrhages from affected and dilated vessels, which look like red or burgundy dots. If inflammation covers the trachea, a cough occurs (dry, later wet, with sputum discharge). Subjective signs of the disease are represented by the following symptom complex:

• Malaise, symptoms of intoxication of the body;
• Increased temperature (in adults it is rarely higher than 37.5 degrees, in children - up to 38.5 degrees);
• Sore throat that gets worse when swallowing;
• Feeling of throat distension, sore throat, presence of a foreign body;
• Severe hoarseness of voice;
• Wheezing when breathing;
• Feelings of difficulty in breathing and swallowing.

If a patient develops laryngotracheitis, symptoms include cough. Usually it is very dry, “barking”, and the patient’s voice may completely disappear. If treatment is started at this stage, the cough quickly turns into a wet one, and the symptoms reduce in intensity.

In children under 7 years of age, acute laryngitis can occur in a completely different scenario. If the disease progresses to false croup, then the swelling covers a significant part of the larynx and is externally manifested by periodic attacks. Symptoms of an attack with false croup:

• Violent, rough cough;
• Blue lips, pale face;
• Increased sweating;
• Hoarse, uneven breathing with whistling sounds;
• Fear, anxiety of the child;
• Shortness of breath, lack of air.

Treatment false croup should be urgent, because acute laryngitis and its symptoms in this case can lead to dire consequences. Typically, severe attacks occur at night, which requires special attention from parents to the child’s condition. In addition to possible suffocation, there is a risk of developing cardiac collapse due to the high load on the myocardium.

Diagnostics

Diagnosis and treatment of acute laryngitis is the task of an otolaryngologist. For stenosing laryngitis, direct laryngoscopy is performed. For other forms of pathology, it is often sufficient to collect an anamnesis and external examination of the patient’s throat. Acute laryngitis is differentiated from diphtheria, a retropharyngeal abscess, and in children - from malformations of the larynx.

Treatment of acute laryngitis

For treatment to be successful and quick, some restrictions on diet and daily routine must be introduced in children and adults. It is advisable for the patient to comply bed rest, ensure vocal peace, give up bad habits. The diet should exclude spicy, too salty, cold, hot food. You should drink as much warm water as possible mineral water, herbal teas, warm milk.

Drug treatment of pathology such as acute laryngitis in children and adults includes:

1. Antibacterial therapy. Treatment is usually prescribed if laryngitis becomes protracted or purulent. In addition to antibiotics, the patient is prescribed sulfonamide drugs.

2. Cough medications (inhibiting the cough center - for a non-productive cough, expectorants and thinning mucus - for a wet cough).

3. Prelytic enzymes are prescribed in the presence of sputum that is too viscous and difficult to separate.

4. Vitamins, restoratives, immunostimulants.

5. Antihistamines (if you are prone to edema).

6. Antiviral agents(If ).

7. Anti-inflammatory, antipyretic drugs for high temperature And severe pain in the throat.

Acute laryngitis in adults and children goes away faster if local treatment is used:

• Inhalations with antibiotic solutions;
• Irrigation of the throat with local antiseptics, antibiotics (for example, Bioparox, Hexoral);
• Instillations into the larynx oil solutions together with antibiotics, anti-inflammatory drugs, glucocorticosteroids (according to indications);
• Lozenges and lozenges to relieve symptoms of the disease (for example, Septolete, Faringosept)

Non-drug treatment includes:

1. Steam inhalations with mineral water to relieve dryness and itching.

2. Warm compresses.

3. Mustard plasters, warming the feet with mustard powder.

4. After acute symptoms have been relieved, treatment may include physiotherapy (UHF, microcurrents, electrophoresis).

An acute attack of stenosing laryngitis in a child requires an urgent call to an ambulance.

If signs of false croup develop in children or with severe swelling of the larynx in adults, the emergency treatment program includes intravenous administration of antihistamines, glucocorticosteroids, antispastic agents, sedatives, as well as instillation of adrenaline. Ineffective therapy sometimes leads to the need for surgical treatment- tracheostomy and tracheal intubation.

Treatment of laryngitis with traditional methods

Traditional methods are allowed for use in uncomplicated laryngitis in adults. In childhood, the course of treatment should contain only medications recommended by a doctor. The most effective recipes:

1. Rub a cotton cloth laundry soap, tie to the throat area and leave overnight. Repeat every evening for 5-6 days.

2. Every day for 2 weeks, take a spoonful of honey combined with 10 drops of aloe juice. Repeat the procedure twice a day.

3. Take 100 ml. a mixture of carrot juice and potato juice in equal parts, which was slightly heated. Continue treatment until recovery.

4. Add 30 ml to warm milk (glass). radish juice, drink in small sips. Repeat 2 times a day for at least a week.

Since there are no specific methods for preventing laryngitis, you should protect yourself and your child as much as possible from contact with sources of infection, stop smoking, avoid damage to the larynx and hypothermia, because preventing the disease is much easier than curing it!