What is the larynx?
Many people, even those who know anatomy well, may confuse the larynx with the pharynx, throat, or trachea. The larynx is not a separate organ, but a section of the respiratory system that is especially important and very complex in structure.
The larynx is located in the upper part of the trachea, at the level of 4-6 cervical vertebrae. Its position is ensured by its attachment to the thyrohyoid gland and connection with the hyoid bone. Air passing through the larynx forms vibrations in a person’s vocal cords - from here the human voice is born1.
The structure of the larynx includes a combination of many cartilages (epiglottis, thyroid cartilage, cricoid cartilage and others) with muscle joints and ligaments. Inside, the larynx is covered with a mucous membrane, which is so loved by viruses and various bacterial infections.
1.General information
Laryngeal edema is a life-threatening condition that manifests itself as obstruction of the upper respiratory tract and, in the case of severe asphyxia, can be fatal.
Like other local edema, laryngeal edema is an accumulation of fluid in the intercellular space, as a result of which the tissue swells and increases in size, and the air lumen, accordingly, narrows. In contrast to the spasm of the larynx described on our website (see), which in most cases resolves quite quickly, swelling of the larynx can persist for a long time; any tendency towards its progression requires emergency medical attention.
Obviously, local laryngeal edema cannot be considered an independent disease - it is always a consequence of some process, reaction or condition. In general, there are many reasons, which explains the relatively high incidence of laryngeal edema in clinical practice.
A must read! Help with treatment and hospitalization!
Causes of laryngeal edema
The mechanics of edema are simple. In the larynx, as a result of one or another effect, there is a sharp or gradual increase in the volume of mucous tissue, which begins to block the lumen of the respiratory tract. In medicine, this condition is called laryngeal stenosis2.
The reasons that can cause swelling of the larynx are extremely varied. It is generally accepted to divide laryngeal edema into two main types - inflammatory and non-inflammatory.
Pathologies and inflammatory diseases that provoke laryngeal edema include:
- Viral and bacterial infections - acute tonsillitis (tonsillitis), chronic tonsillitis, pharyngitis, tracheitis, inflammatory diseases of the oral cavity, abscess and most diseases of the ARVI group.
- Chronic infectious diseases - tuberculosis, syphilis and others.
- Acute infectious diseases - scarlet fever, measles, typhus.
- Vasomotor edema and allergic edema of the larynx. The cause is an allergy familiar to many, which provokes inflammation of the mucous membrane of the larynx. The laryngeal mucosa is very sensitive to the influence of allergens and the reaction in the form of swelling is quite common.
Non-inflammatory causes are no less diverse; these include swelling due to mechanical, chemical (toxic) or thermal effects. Burns from food that is too hot or cold is a common cause, especially in children. Swelling can also be caused by a foreign object in the throat or a piece of food.
In addition to the nature, inflammatory or non-inflammatory, there are two forms of edema - limited and diffuse (spill). With limited swelling, a person may not even be aware of the condition of the larynx, he is not bothered by severe pain and can breathe freely. Diffuse edema is characterized by severe narrowing of the larynx and damage to a large area of mucous tissue; breathing is almost always difficult2.
Treatment of angioedema of the larynx.
Treatment of angioedema consists of two stages. The first is emergency care, the second is hospital treatment. Before starting treatment, the cause of angioedema is determined, and then a treatment regimen is prescribed. This may include:
- taking antihistamines (“Suprastin”, “Loratadine”, “Tavegil”);
- corticosteroid drugs (for example, Prednisolone, Dexamethasone, Nasonex, Celeston);
- diuretics (for example, Furosemide);
- enterosorbents for removing allergens and toxins (for example, Multisorb);
- enzyme preparations (“Pancreatin”, “Festal”);
- administration of a C1 inhibitor, a blood protein whose deficiency leads to non-allergic angioedema;
- administration of fresh frozen plasma (for non-allergic edema);
- administration of androgens - sex hormone preparations (for non-allergic edema).
Main symptoms of laryngeal edema
Despite the fact that in most cases laryngeal edema itself is a symptom, it is not always possible to detect it promptly. Professional medical diagnostics or special signs characteristic of laryngeal edema3 come to the rescue:
- Severe cough, most often of the “barking” type;
- Hoarseness, loss or severe changes in voice - given that the human voice apparatus is located in the larynx, this is a quite obvious sign;
- Gradual progression of suffocation, breathing becomes difficult.
Laryngeal edema does not always develop slowly and unnoticeably. In rare cases, an emergency condition occurs in which swelling occurs immediately (laryngospasm). In such a case, the symptoms of laryngeal edema will be pronounced:
- The appearance of cyanosis on the face;
- Severe suffocation and oxygen starvation, complete asphyxia is possible.
Additional signs of the development of laryngeal edema may include more general symptoms that are characteristic of many other diseases:
- Temperature increase;
- Feeling of a foreign object in the throat, while the exact position cannot be determined;
- Discomfort and pain in the larynx area, especially when swallowing;
- Intoxication of the body - general weakness, nausea, headaches, muscle pain, etc.;
- Shortness of breath, even at rest.
Forms of sore throat and symptoms of the disease in adults
Each form of sore throat manifests itself differently. It is important to find out which pathogenic microorganism caused the disease. But it is impossible to determine this at home. Only a qualified doctor can accurately identify the nature of the pathogen and prescribe adequate treatment for sore throat, promoting a speedy and complete recovery.
Catarrhal sore throat
Acquired through contact with an infected person, it begins acutely, with a slight increase in body temperature and a feeling of weakness. The tonsils and submandibular lymph nodes are slightly enlarged. Dryness in the mouth and throat is accompanied by a sore sensation; swallowing is painful and difficult. If not stopped in time, the disease can develop into a severe form with subsequent complications.
Lacunar tonsillitis
The purulent form of tonsillitis is characterized by a very rapid onset of symptoms. The lymph nodes become enlarged and swollen, the tonsils are markedly swollen and covered with a white-yellow purulent coating. The throat with lacunar sore throat hurts especially badly.
An increase in temperature to 40 degrees is accompanied by headache, muscle and joint pain, sometimes radiating to the heart. Fever may cause seizures, vomiting, and confusion.
In the absence of proper treatment, lacunar tonsillitis can develop into fibrinous tonsillitis, when severe purulent intoxication of the body begins, in some cases causing brain damage.
Follicular tonsillitis
The purulent form has symptoms similar to lacunar angina. The tonsils are covered with many purulent follicles. Sometimes the patient complains of pain in the lower back, joints ache, like with the flu. Unbearable pain in the throat radiates to the ear.
This form of purulent tonsillitis is dangerous due to a wide range of complications, as well as rupture of the follicles inward, followed by a purulent abscess.
Herpangina
A dangerous viral form acquired by using a shared toilet, shaking hands and any type of tactile contact with a carrier of the disease - a person or animal. Small serous blisters appear on the tonsils, throat and palate. The throat hurts unbearably, the cervical lymph nodes are swollen and painful to the touch.
At the same time, all the symptoms characteristic of influenza appear: fever, chills, headache, nausea, diarrhea.
Confirming the diagnosis of “herpetic sore throat” is only possible by consulting a doctor. A qualified specialist will first of all direct the patient to undergo tests for serological testing and virology, after which he will prescribe a course of necessary antibiotics.
Otherwise, improper treatment can have serious consequences: encephalitis, meningitis, and myocarditis.
Phlegmonous sore throat in adults
This is a purulent form of the disease, typical for the age group of 20-40 years. The causative agent is streptococci, and the cause is not long-standing catarrhal or follicular tonsillitis. With this form of sore throat, redness is observed not only of the palate and tonsils, but also of the peri-almond space.
The throat hurts on one side, the focus of suppuration does not have clear boundaries and requires surgical intervention.
The patient has chills and fever, the voice is hoarse or disappears completely. As a result of purulent melting of the tonsil, a characteristic, unpleasant odor comes from the mouth.
Treatment of phlegmonous sore throat cannot be delayed. In the absence of timely assistance from specialists, in most cases, cervical or brain abscesses, purulent meningitis, and general blood poisoning occur.
Treatment of angina should occur under the strict supervision of a doctor, who will be able to notice in time and prevent the development of complications that are of the most unexpected nature.
Diagnosis of laryngeal edema
In most cases, an experienced doctor (otolaryngologist, pulmonologist or even a therapist) can easily diagnose laryngeal edema. A visual examination or laryngoscopy will give an understanding of the condition of the sick person’s larynx. Endoscopy will show the most complete condition of the larynx. With edema, redness is almost always present, as is swelling of the laryngeal mucosa, and the glottis will be noticeably narrower4.
However, it is not recommended to diagnose this condition yourself. A doctor should examine it, since complications or severe forms are possible, in which there is a risk of suffocation, and swelling can directly indicate the development of a dangerous disease.
Swelling of the throat due to a cold
One of the symptoms accompanying colds is swelling of the larynx. Swelling of the throat during a cold manifests itself:
- sore throat, pain when swallowing;
- dry cough, change in voice timbre up to aphonia (complete loss of voice);
- difficulty breathing.
The severity of the clinical picture depends on the disease and the individual reactivity of the patient’s body. For example, with false croup, swelling of the throat in a child can be complicated by laryngeal stenosis.
First aid and treatment of laryngeal edema
If swelling occurs that causes immediate breathing problems, you need to act quickly. Man's main enemy is panic. In this case, in addition to promptly calling doctors, first aid should be provided.
The first step is to free the chest of an adult or child from any load, including clothing. If you are in a panic state, you should try to calm the person down. Next, provide access to fresh air, and, if possible, reduce the ambient temperature. If the cause of swelling is known, for example the effect of a certain allergen, then it should be blocked immediately. Spraying cool water on your face will help relieve the condition5.
Most often, a timely visit to a doctor solves everything, and treatment of laryngeal edema is as effective as possible. Having established the cause of the swelling, the doctor prescribes medications. Depending on the reasons, anti-inflammatory and antiallergic medications (antihistamines) are used. If the cause is a viral or bacterial infection, immunomodulators and antibiotics may be prescribed for the most serious bacterial infection. In case of sharp progression of edema and suffocation, drug therapy is carried out based on antispasmodic and hormonal drugs.
A person with edema should remain completely at rest, eat liquid foods and drink enough water. It is not recommended to talk a lot - you need to minimize all irritating factors. In the most serious cases, surgery may be required.
As you know, disease is easier to prevent. The same applies to laryngeal edema. The most common causes of edema are acute respiratory diseases. Viruses or bacteria enter the mucous membranes of the larynx and begin to act insidiously. Often, this happens due to insufficient strength of local and general immunity.
To maintain local immunity, doctors may prescribe immunostimulating agents. One of these drugs, but with interesting features, is a drug based on bacterial lysates, Imudon®. The effect of the drug is associated with an increase in the number of cells aimed at fighting bacteria and viruses. Imudon® has direct indications for pharyngitis and chronic tonsillitis6.
Imudon® is presented in the form of lozenges with a pleasant taste, which is especially important for children. The drug can be used from three years of age7. This form allows the drug to act at the very site of inflammation and directly influence local immunity.
Instructions
Learn more
Developed with support from Abbott to improve patient health awareness. The information in the material is not a substitute for healthcare advice. Contact your doctor. 1. Babiyak, V. Otorhinolaryngology / V.I. Babiyak, I.B. Vyacheslav // “Peter” - Study guide, manual - 2009 - Volume 2 - P. 13-30. 2. Soldatsky, Yu. Diseases of the larynx / Yu.L. Soldatsky // Pediatric pharmacology - 2008 - No. 2 - Volume 5 - P. 20-25. 3. Trukhan, D. Respiratory diseases. Tutorial. / D.I. Trukhan, I.A. Viktorova // SpetsLit – 2013 – P. 175. 4. Svistushkin, V. Application of contact endoscopy in the diagnosis of diseases of the larynx / V.M. Svistushkin, N.D. Chuchueva // RMJ – 2015 – No. 23 – P.1406-1408. 5. Gurov, A. Local therapy of inflammatory diseases of the pharynx / A.V. Gurov, M.A. Yushkina // RMJ – 2022 – No. 11 – P. 792-796. 6. Luchikhin, L. Efficacy of the drug Imudon® in the treatment of patients with acute and chronic inflammatory diseases of the pharynx / L. A. Luchikhin [et al.] // Bulletin of Otorhinolaryngology - 2001 - No. 3. – pp. 62-64. 7. Instructions for medical use of the drug Imudon® lozenges dated 07/02/2018.
RUS2157722 from 08/19/2020
Symptoms of Quincke's edema.
The first sensations that a person experiences are a burning sensation and a slight tingling sensation at the site of future swelling. Then swelling occurs. Dangerous swelling appears on the face (lips, eyelids, cheeks) and neck. The tongue is very swollen. It gets to the point where a person’s face becomes like a ball, and the patient is not even able to fully open his eyes.
In the first minutes after interaction with the irritant, symptoms may appear in adults and children, such as lacrimation, problems breathing through the nose, the appearance of a dry cough and hoarseness in the voice. Another important symptom of angioedema of the throat is “wheezing”, heavy breathing. All these symptoms very quickly gain momentum and become intense. It’s as if a person was bitten by a swarm of bees - this is what angioedema looks like externally.
In addition to external changes, this dangerous condition has other symptoms: decreased blood pressure, excessive sweating, and rapid heartbeat.
Angioedema of the larynx is the most dangerous manifestation of angioedema, when swelling affects the throat and airways. An emerging cough, sore throat, difficulty swallowing, a feeling of a lump in the throat, problems with speech - all these symptoms indicate incipient asphyxia (suffocation).
When the first symptoms of Quincke's edema appear, you need to call an ambulance so as not to waste precious time. If the swelling of the larynx is not relieved soon, the person may die. Even if death was avoided and treatment of angioedema was not delayed, prolonged absence of normal breathing can lead to damage to brain activity.
3. Symptoms and diagnosis
The classic clinical picture of laryngeal edema includes changes in phonation timbre (hoarseness, loss of sonority, hoarseness, complete aphonia in severe cases), difficulties in speech and swallowing, foreign body sensations, stridor breathing (noisy, whistling), anxious restlessness (in case of rapid increase in hypoxia panic with uncontrolled psychomotor agitation may develop), cyanotic tint of the lips and skin as a typical symptom of respiratory failure. Depending on the etiology (eg, with angioedema), severe swelling of the face, arms, neck, etc. may also be observed.
The dynamics of the condition can be very different - from fulminant (developing at lightning speed) to chronic edema, sometimes persisting for weeks. The faster laryngeal edema develops, the more dangerous it is.
For a qualified specialist, as a rule, clinical manifestations, anamnestic information and a visual examination are sufficient for a confident diagnosis. Instrumental laryngoscopy is performed very carefully, given the risk of sudden laryngeal spasm.
As diagnostic needs arise (to clarify the causes, monitor dynamics, etc.), if time and the patient’s condition permit, additional instrumental studies may be prescribed.
About our clinic Chistye Prudy metro station Medintercom page!
Possible consequences of sore throat in children
Angina is one of those diagnoses that, with adequate and timely treatment, have a favorable prognosis for recovery. But if the treatment was incorrect, it is possible that complications will develop, which may appear immediately during the course of acute tonsillitis, or may become delayed and appear after recovery. Complications are also divided into local, which negatively affect the pharynx, and general, which affect other organs and systems of the body.
Local consequences of sore throat in children include:
- purulent lymphadenitis - inflammation of the lymph nodes that occurs with the formation of purulent accumulations, the disease is treated surgically;
- swelling of the larynx - the greater the swelling, the higher the risk of suffocation;
- otitis - the nasopharynx is connected to the ear through the auditory (Eustachian) tube, through which the infection easily penetrates into the middle part of the ear during coughing or sharp blowing of the nose, triggering an inflammatory process in it;
- peritonsillar abscess - a condition in which the cavity located in the tissues around the tonsils fills with pus;
- bleeding from the tonsils;
- the likelihood of transition to the chronic form of acute tonsillitis, that is, the development of chronic tonsillitis, when the symptoms of the disease will return throughout the year, subsiding only during remission.
Common complications include heart, kidney, and joint complications.
Friends! Timely and correct treatment will ensure you a speedy recovery!
All these dangers can certainly be avoided if the disease is diagnosed and treated in a timely manner.
