Laryngitis - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Respiratory Diseases

laryngitis is a common syndrome, respiratory tract infections and may be without proper medical attention cause of the terrible life-threatening complications.

Laryngitis - a clinical syndrome of laryngeal lesions caused by inflammatory changes of the mucous membrane as a result of infection by a viral or bacterial etiology, or other causes, which manifests itself in the form of an acute or chronic form.

Laryngitis

laryngitis Risk factors are the following:

1) reduced immunity due to frequent colds or concomitant chronic diseases;
2) hypothermia (cold and windy weather conditions);
3) professional factors (in the group of persons with a risk of forced overstrain the vocal cords - singers, teachers - 'lecturers laryngitis "and other persons to harmful chemical industries);
4) children's age group (breathing through the mouth in the cold, clothing for the weather);
5) bad habits (smoking - "laryngitis smoker", abuse of alcohol);
6) The dust-laden air;
7) etiological factor (acute form of the inf

ection to acute laryngitis - SARS, measles, whooping cough, scarlet fever and other chronic bacterial pockets - to the chronic form of laryngitis);
8) external allergens (food, plant, chemical).

Thus, laryngitis may be contagious, professional (laryngitis lecturer), as a result of bad habits (smoker laryngitis), allergic.

Causes of infectious laryngitis

Pathogens of laryngitis are divided into two groups:

1) viruses (influenza, parainfluenza, measles and others);
2) bacteria (the causative agent of scarlet fever, diphtheria, pertussis, streptococci, staphylococci, mycobacteria, Treponema, and others).

source of infection - a sick man, who becomes contagious with the onset of the first symptoms of the disease.

infection mechanism laryngitis - aerogenic and main way - airborne, which is implemented by sneezing and coughing sick person within a radius of 3 meters.

universal susceptibility of the organism.At risk children age group due to the massive infection of SARS.For laryngitis, especially its acute form, there is a winter-spring season (the season of colds).

Laryngitis can be: sharp , occurs suddenly after exposure to one of the above reasons or chronic , which arises as a consequence of acute laryngitis, the presence of chronic hearth in the nose and sinuses, pharynx, and also as a consequence of repeated exposure damaging factor(illness teachers, singers, smokers, alcohol abuse).

physiology and anatomy of the larynx

throat (Latin larynx.) - It is the upper respiratory tract, located between the pharynx (in most cases, which is the entrance gate of infection) and trachea.The larynx contains the vocal apparatus.Located at the level of IV-VI of the cervical vertebra, has a direct connection with the pharynx and trachea.The larynx consists of hyaline cartilage skeleton including unpaired or large cartilage (cricoid, epiglottic, thyroid) and paired or small (arytenoid, cuneiform, rozhkovidnye).The mobility of the body is provided with two joints: a ring-arytenoid joint and a ring-thyroid joint.human voice apparatus is located in the larynx, which is represented by the vocal cords attached to the thyroid and arytenoid cartilages.Formation of sounds going on at both the inhalation and exhalation through the vibration of the vocal cords.Pulling them and change the glottis form occurs at reducing muscular apparatus of the larynx.

laryngitis, larynx in profile

Laryngitis, anatomy of the larynx

Pathological changes larynx laryngitis

When exposed to infection or other causes there are inflammatory (or damaging) effects of the larynx mucosa: mucosal edema,vascular congestion, infiltration of mucosal inflammatory cells (neutrophils, lymphocytes, macrophages).These changes lead to the emergence of local reactions such as hyperemia (redness), edema (and as a result, narrowing of the lumen of the larynx, narrowing of the glottis, edema ligaments) on the mucosa may appear hemorrhagic rash (often enanthema the flu).The pathological process is accompanied by effusion copious amounts of mucus.Often the process involves the epiglottis and the area, and sometimes goes to the trachea, causing damage to the combined (laryngotracheitis).

Pathological changes can be different, which leads to the emergence of different clinical forms of laryngitis.
Catarrhal laryngitis manifested light inflammatory mucosal changes.
Hypertrophic growth of laryngitis characterized mucosa with formation of specific nodules diameter 4.3 mm, including the ligaments - so-called "singer's nodules" shell and proliferation can lead to irreversible deformation ligaments.
Atrophic laryngitis as thinning of the mucosa of the larynx as a result of eating habits (hot and spicy food).
diphtheria laryngitis characterized by the formation of dense fibrinous raids dirty-gray color, which tend to merge, parallel develops mucosal edema, which is particularly dangerous in the vocal cords, since it leads to a marked narrowing of the glottis and can quickly regress with standard therapy.
Tuberculous laryngitis manifested in the formation of nodules of the larynx mucosa in the form of nodules, tubercles, epiglottis defeat cartilage.When
syphilitic laryngitis second stage formed ulcers and plaques on the mucous membrane of the larynx, which in the third stage of the rumen, resulting in deformation of the ligament apparatus and the larynx itself.

Clinical symptoms of laryngitis

Acute laryngitis is characterized by the acute onset of the disease, often with a rise in temperature to febrile digits (up 37,5-38º), intoxication symptoms of varying severity (on a small weakness to weakness, from mild dizziness to headaches, from nausea to vomiting).Severity of symptoms depends on the type of infection or other reasons caused the laryngitis.Some patients complain of pain when swallowing (in the case of the localization process in the pharynx, larynx, epiglottis and the back wall).Patients worried about hoarseness or hoarseness, dry, tickling, scratching sensation in the throat, dry "barking" cough.Later the cough becomes moist (mucous expectoration, can be transparent when the viral nature or greenish-yellow in bacterial laryngitis), voice gradually coarsens and even disappears.shortness of breath at inhalation can appear With the progression of the process (due to the narrowing of the glottis, its swelling and spasm).In the absence of timely assistance can develop complications (see. Below).In the provision of timely medical treatment disease duration of 7-10 days.

Laryngeal edema, detected during laryngoscopy

Chronic laryngitis milder in severity, but has a longer duration.Chronic laryngitis is characterized by a feeling of sore throat, rawness, constant cough, fatigue voice, as evidenced by hoarseness and voice hoarseness.In remission of these complaints become smaller and disappear, but the aggravation reappear.Chronic laryngitis is fixed when the duration of the disease for more than 10 days, but the process can take years.

Chronic laryngitis

There are clinical forms of laryngitis:

1) Catarrhal laryngitis - patient scratchy, hoarse voice, a sense of rawness in the throat, cough fickle, dry and little pronounced.Current favorable and easy.
2) Hypertrophic Laryngitis is characterized by a dry cough, severe hoarseness in the voice, a pronounced tickling constant.The characteristic symptom - the so-called "nodules singer" on the ligaments that give hoarseness in his voice.In advanced cases can cause deformation of the vocal cords, which has irreversible.Hypertrophic laryngitis is accompanied for "laryngitis lecturer" or "laryngitis singer" (ie professional laryngitis).
3) Atrophic laryngitis manifested pronounced tickling and dryness in the throat, hoarse voice
constant, painful dry cough, in which at times may deviate bloody clots with crusts.Most often seen in adult patients with certain taste preferences (hot and spicy food).
4) diphtheria laryngitis characterized by a descending process, that is, in isolation larynx is affected very rarely.The most common pathological process goes to the oropharynx and larynx descends into.Due to the spread of diphtheria attacks of edema and the patient has a pronounced soreness in the throat, hoarseness, cough, shortness of breath.When diphtheria occurrence of laryngitis is an unfavorable moment because gives rise to severe complications - "True grits" (see below.).Associated symptoms of diphtheria laryngitis - fever, sore throat diphtheria minor sore throat, typical local oropharynx change.
5) Tuberculous laryngitis is secondary clinical form, occurring after the spread of pulmonary tuberculosis.Against the background of the pulmonary process appears tickling, hoarseness in voice and enhanced cough.Typically the process involves not only mucosal and cartilage.
6) Syphilitic laryngitis formed on 2 and 3 stages of the disease, complications related to syphilis.Patients impose quite specific appeal to laryngitis, and as a result of specific changes in the mucous by coughing may depart purulent blood clots or muco-bloody turn.A characteristic feature of the third stage is irreversible deformation of the larynx changes that manifest constant (lifelong) hoarseness.
7) Allergic laryngitis occurs in patients with an allergic reaction (allergic rhinitis, pharyngitis, etc.).The reason - allergic laryngeal edema, which is manifested at night - barking cough, shortness of breath, the patient's agitation.In the acute form occurs suddenly, and in the chronic form of the disease - gradually.

Complications laryngitis

1) stenosis of the larynx or cereals (in conjunction with laringospazmom), which can be of two types:
«false croup" and "true croup."Most occur in the pediatric age group, due to the special funnel form of the larynx and its small size.Laryngeal stenosis - a narrowing of the larynx and glottis due to mucosal edema, inflammation and spasm of the muscular system.

croup laryngitis

False croup (constrictive laryngitis, night complication) occurs in children with acute respiratory viral infection (usually parainfluenza, influenza, rarely adenoviral infection, measles, whooping cough, Haemophilus influenzae, streptococcal infection, etc.)and develops suddenly.Against the background of the main symptoms of the disease on 2-3 th day of the disease in a young patient has a painful barking cough, respiratory disorders (noisy breathing, or wheezing), suddenly starts to choke the baby at night (inspiratory dyspnea or difficulty inhaling).The child becomes nervous, restless.When viewed listened dry whistling hipy.Complete loss of voice does not happen!

are 4 stages of stenosis, already at the 2nd stage the skin becomes cyanotic (hypoxia).The third stage is characterized by tachycardia, loss of voice, shortness of breath has mixed character (and difficult to exhale and inhale) and stage 4 is dangerous due to the appearance of convulsions and a sharp drop in blood pressure.Develop stage stenosis very quickly - the first few hours.In the absence of medical care stenosis may end fatally.When the first symptoms of stenosis is an urgent need to call a doctor on the house!

Stenosis larynx laryngitis

true croup (constrictive laryngitis in diphtheria) is a severe complication of diphtheria and developed in the late first and early second week of illness.It develops gradually true croup.The patient appears hoarseness, barking cough, shortness of breath.voice disappears in a few hours (up to complete aphonia), shortness of breath becomes more tangible, there is cyanosis.Also, there are 4 stages of croup, but we must act without delay, otherwise the patient when the first of its symptoms can not save.Specialized emergency medical help!

2) Scar larynx strain due to chronic or acute laryngitis process with a prolonged course with cartilage damage.Clinically deformation is accompanied by a constant hoarse voice, cough, respiratory disorders.

Diagnostics laryngitis

1) Clinical data: laryngitis symptoms are quite specific - a rough "barking»
cough, hoarseness and voice hoarseness, feeling sore throat, dry mouth and in the throat, voice change from dysphonia (coarseness) to aphonia(loss of voice), respiratory disorders (difficulty inhaling or inspiratory dyspnea).
2) Collection of epidemiological history and the history of life (contact tracing infectious
Sick, the presence of chronic foci of infection, the presence of occupational hazards and factors, bad habits, allergic history).
3) Laboratory data:
- blood count changes depending on the cause of the laryngitis may be leukocytosis, ESR increase, eosinophilia, lymphocytosis;
- specific tests for infection (smears, swabs from the nasal and oropharyngeal virus, a swab from the throat to the BL - the causative agent of diphtheria, sputum for MBT - the causative agent of tuberculosis, blood for antibodies to syphilis, and so on);
- allergological examination for suspected allergic laryngitis.
4) Instrumental research - direct laryngoscopy (study of the larynx using
flexible endoscope to examine the nature and extent of changes in the mucosa of the larynx, ligaments) or indirect laryngoscopy (study of the larynx using a special mirror).In the course of this study possible tissue for biopsy sampling (with the exception of cancer processes and other diseases).

Direct laryngoscopy

Indirect laryngoscopy

Treatment of laryngitis

1) Performance and protective measures - home mode in outpatient treatment and in severe forms - in-patient treatment.Require immediate hospitalization of patients with diphtheria process and stenosis of the larynx.Complete rest to vote for 5-7 days.Special diet - the exception of spices, spicy and salty foods, too hot and cold dishes.Excluding bad habits.Displaying plenty of warm drinks (milk with honey, mineral water without gas), heat on his neck, warm steam inhalation.

2) Treatment of the underlying disease (the symptoms of colds and other infections)

3) Causal therapy is prescribed depending on the cause of laryngitis: antiviral (Arbidol, izoprinozin, tsikloferon and other drugs at the viral nature of the disease) or antimicrobial treatments (beta-lactams,macrolides, fluoroquinolones, drug selection is only for the doctor), the introduction of specific drugs (PDS - prtivodifteriynaya serum with diphtheria laryngitis), as appropriate TB therapy antisyphyllitic drugs.

4) Local therapy and anti-inflammatory provomikrobnymi sprays.

Sore throat always refers to the activity of pathogenic microorganisms, which help destroy the mucous nasal irrigation procedure preparation with antibacterial activity.Such means may be Bioparox spray containing a naturally occurring antibiotic fusafungine reducing inflammation and accelerating the healing process.The drug stops the proliferation of harmful bacteria and help to quickly cope with the pain in my throat.

5) Antihistamines (Loratadine, Zyrtec, tsetrin, Claritin, Aerius, etc.).

6) Treatment of stenosis of the larynx: an urgent call an ambulance;while waiting for the distraction therapy (yellow card in the area of ​​the throat, chest, calf muscles, hot foot bath for 7-10 minutes, warm milk or mineral water);patient sit or put under the back cushion to achieve a semi-sitting position;