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Acute laryngitis

Acute laryngitis is an inflammation of the mucous membrane of the larynx, which, as a rule, is secondarily affected in acute respiratory infections, is less often an independent disease, while there is always inflammation of the mucous membrane of the trachea and it is more correct to call this disease laryngotracheitis, especially since from our point of view this disease begins it is with inflammation of the trachea, and then the larynx. In the first place is the defeat of the voice (dysphonia or aphonia), perspiration and burning in the larynx, cough, fever. On examination, hyperemia of the mucous membrane of the vocal folds, other parts of the larynx, sometimes mucus on the folds. Dysphonia is explained by swelling of the mucous folds, swelling of the tissues of the organo ventricles, which violates the free vibrations of the folds. Aphonia occurs with paresis of the vocal muscle (m. Vokalis), the glottis does not close completely, assuming an oval shape during phonation. With influenza, hemorrhagic laryngitis is observed when hemorrhages occur under the mucous membrane of the vocal folds. When conducting differential diagnosis, it is necessary to take into account the state of the pharynx, since acute laryngitis with diphtheria, measles, scarlet fever is rarely isolated. The main method of treating acute laryngitis is inhalation: alkaline, alkaline oil, inhalation with an individual inhaler (for example, "bioparox"), according to the indications of analgesics, antihistamines, vitamins, rarely antibiotics. Phonophoresis with hydrocortisone to the larynx region, or electrophoresis with potassium iodide, especially with aphonia, helps. Infusion of various medicinal mixtures is also used with the help of a laryngeal syringe, which has a special long curved tip. For example, in equal parts, sea buckthorn oil, menthol oil and an alkaline mixture for inhalation. Before infusion, the mixture is emulsified by adding 1-1.5 ml of emulsion, under the control of indirect laryngoscopy, with phonation, the mixture is applied to the vocal folds. The forecast is favorable. The duration of the disease is 7-10 days.



Sub-folded laryngitis (false croup). This kind of acute laryngitis usually affects children. These features are explained by the structure of the larynx in children - the presence of loose fiber between the cricoid and thyroid cartilage outside the laryngeal mucosa, which disappears with the growth of the larynx during puberty. This cellulose is characterized by rapid (20-30 min.) Edema with inflammation of the larynx, which occurs most often at night, with a horizontal position of a child who wakes up in fear, rushes, cries, stridor breathing appears, with a clear voice - a barking cough, as indicated V.I. Voyachek, as a special difference between false croup and diphtheria (true croup), because differential diagnosis is carried out mainly between these diseases. When examining the larynx, three floors of folds are noted - voice, vestibular and below the edema of the sub-vocal space in the form of third folds. During an attack of false croup, the child should immediately be picked up, giving it an upright position, a hot bath (42-45 degrees) to the feet, inhalation of a mixture of hydrocortisone and halosoline, mustard on the chest, and antihistamines inside. An examination of the pharynx and larynx is necessary, although laryngoscopy in children is extremely difficult and sometimes fails. By itself, false croup is not dangerous, an attack sometimes goes away even without treatment when the patient is upright, it is dangerous not to recognize diphtheria and not to introduce serum on time. For diphtheria - enlarged cervical lymph nodes, hoarse voice, epidemiological data (contact with a patient with diphtheria, - consultation of an infectious disease specialist).



Laryngeal tonsillitis (submucous laryngitis).
V.I. Voyachek suggested calling the saturated conglomerate of lymphocytic follicles lying in the submucosal layer of the larynx and the vestibular part of the larynx "laryngeal tonsil", and its inflammation of the laryngeal tonsillitis (synonym for submucous laryngitis). The disease is caused more often by vulgar flora during mechanical and thermal trauma, or during the passage of purulent processes from the tonsils, during pharyngeal processes. Laryngeal tonsillitis has three forms: inflammatory swelling, abscess of the larynx, phlegmon of the larynx.

With laryngeal edema, the general condition is disturbed a little. With laryngoscopy, areas of vitreous edema are more often found in the epiglottis and (or) arytenoid cartilage. Swallowing is not difficult, moderately painful, breathing free. However, with severe swelling there may be moderate disturbances in voice and breathing. Timely therapy has a good effect. Recommended are aspirin, antihistamines, a warming compress on the neck, dehydration therapy, for example, intravenous infusions suggested in our clinic: prednisone 30 mg, 5% ascorbic acid 5.0, panangin solution, saline 400.0, lasix 1.5-2 ml The effect of treatment usually comes quickly, the prognosis is favorable. however, individuals who are weakened and immunocompromised can have serious complications. So we observed in the clinic a patient who was admitted as an emergency care worker, in whom the phenomena of edematous laryngitis were not very pronounced, and who died after 16 hours from purulent mediastinitis, pericarditis and pleurisy.



Laryngeal abscess. Symptoms are similar to the previous disease, but are much more pronounced. With laryngoscopy, you can see not only the epiglottis and arytenoid cartilage, but also the spread of edema to the valcoles, pear-shaped sinuses. Salivation and aphonia are noted due to the sharp pain of swallowing and voice formation. After 3-4 days from the onset of the disease, the formed abscess spontaneously opens, relief comes. Otherwise, the abscess is opened with a special laryngeal knife. Conservative treatment is the same as with edematous laryngitis.



Phlegmon of the larynx - the disease is very serious, but relatively rare. The process covers the submucosal tissue of the entire larynx. Amid severe fever, swallowing disorder due to intolerable pain. Respiratory disorders come to the fore. With laryngoscopy, infiltration and hyperemia of all the walls of the larynx are determined. In various places, purulent foci can be opened with the release of thick dark (hemorrhagic) pus. The fever is high, there may be dehydration due to the inability to swallow, therefore, such patients require parenteral nutrition and the introduction of saline solutions (for example, bisol, trisol). Because of the threat of asphyxiation, an early tracheotomy is required. Intensive anti-inflammatory treatment: large doses of modern antibiotics, hormones, antihistamines, analgesics. Lethal outcomes are rare, but disability often occurs in the form of aphonia, cicatricial stenosis of the larynx, which then requires surgical intervention, since, along with other factors (specific infections, injuries, foreign bodies), laryngeal phlegmon can cause chondro-perichondritis of the cartilage of the larynx. Along with trauma, dull, acute, gunshot, and in the last two decades, a frequent reason was the long stay in the larynx of the endotracheal tube (more than 3-5 days) for mechanical ventilation. The result is persistent laryngeal stenosis requiring surgical treatment.
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Acute laryngitis

  1. Acute catarrhal laryngitis
    Acute inflammation of the mucous membrane of the larynx (laryngitis catarrhalis acuta) is often observed as an independent disease. Often is a continuation of catarrh of the nasal mucosa, pharynx with a cold or acute catarrh of the upper respiratory tract, acute respiratory viral infection, flu; it can also occur after voice overload, inhalation of irritating
  2. Acute laryngitis. U04.0
    {foto163} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, cough, difficulty
  3. Acute professional laryngitis
    The disease occurs due to overexertion of the voice or improper manner of voice control. Patients complain of discomfort in the larynx and fatigue of the voice after exercise. On examination (indirect laryngoscopy), redness of the vocal folds is detected, they look dull, dry, the edges of the folds are sluggish. With phonation, the vocal folds do not close completely. It is necessary to pay attention
  4. Acute laryngitis and tracheitis. U04
    {foto162} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, cough, difficulty
  5. Acute obstructive laryngitis (croup). U05.0
    {foto167} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, cough, difficulty
  6. Acute obstructive laryngitis (croup) and epiglottitis. U05
    {foto166} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, cough, shortness of breath, difficulty
  7. Laryngitis
    The clinical picture of acute laryngitis Acute laryngitis (inflammation of the larynx) occurs more often with acute catarrh of the upper respiratory tract, flu and other infectious diseases, as well as as a result of overexertion of the voice. Depending on the degree of inflammation - a change in voice from mild hoarseness to loss of it, coughing, dryness, soreness in the throat. Sometimes a slight fever, headache
  8. Laryngitis
    Physical blockage Laryngitis is an inflammation of the larynx, the organ by which we make sounds. Laryngitis is characterized by hoarseness, coughing and sometimes shortness of breath. (If it is a lesion of the larynx with diphtheria, see the article CROUP). Emotional blocking Partial or complete loss of voice indicates that a person does not allow himself to speak, as he is afraid of something. He wants
  9. respiratory diseases: laryngitis, bronchitis.
    Acute laryngitis in children is also called false croup. It is an inflammation of the larynx. The frequency of the disease increases in winter and spring. In most cases, the causative agents of acute laryngitis are respiratory viruses. Acute laryngitis can also develop as a complication of some infectious diseases: childhood measles, scarlet fever. Poor contribute to disease
  10. respiratory diseases: laryngitis, bronchitis.
    Acute laryngitis in children is also called false croup. It is an inflammation of the larynx. The frequency of the disease increases in winter and spring. In most cases, the causative agents of acute laryngitis are respiratory viruses. Acute laryngitis can also develop as a complication of some infectious diseases: childhood measles, scarlet fever. Poor contribute to disease
  11. Laryngitis with stenosis
    Laryngitis with stenosis (false croup) develops, as a rule, with acute respiratory viral infections in preschool children, rarely in adults. It is associated with swelling of the mucous membrane of the respiratory tract and spasm. Often starts at night. At first the voice becomes rough and hoarse, a barking cough appears. Then there is difficulty in breathing, it becomes noisy, the patient draws in air with effort, intercostal retraction is noted
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