OSLT is dangerous because inflammatory processes occur in several parts of the respiratory tract at once.
In most cases, laryngotracheitis occurs as a complication of respiratory illness caused by a viral or bacterial infection.
Laryngospasm is a hallmark of ENT disease that can cause asphyxiation. In the event of an attack, the patient may require emergency first aid and, accordingly, hospitalization.
Etiology
As a rule, acute laryngotracheitis is diagnosed in young children up to 7-8 years old. The incidence of ENT disease is largely associated with the imperfection of the immune system and the anatomical features of the structure of the respiratory tract, in particular the larynx. In adults, the disease is much less common, but the likelihood of ASLT increases with the development of an infection in the respiratory organs or a prolonged course of ARVI.
The peculiarity of the disease is that the mucous membranes of several sections of the upper airways are involved in the inflammatory processes. Local edema of the mucous membranes of the larynx, trachea and pharynx causes insufficient mucus secretion and, accordingly, the appearance of a barking unproductive cough. The following provoking factors contribute to the development of the disease:
- inflammation of the paranasal sinuses;
- sluggish sore throat and adenoiditis;
- herpes lesion of the oropharynx;
- dehydration and dry air;
- burns of the mucous membranes of the ENT organs;
- respiratory diseases of bacterial and viral etiology.
Important! With the development of laryngotracheitis, it is necessary to quit smoking, since tobacco smoke stimulates laryngospasm and can cause suffocation.
The primary localization of pathogens is observed in the laryngeal mucosa, as evidenced by recurrent cough and sore throat. Then, the tracheal tissues are involved in the pathological processes, which are something like a conductive node for air. With tracheal edema, breathing becomes difficult, and inhalation and exhalation are accompanied by whistling sounds. If inflammation is not diagnosed and eliminated in time, a critical narrowing of the airway will cause laryngospasm and acute asphyxia.
Clinical picture
How does acute stenosing laryngotracheitis manifest? Symptoms of the disease are determined by the stage of development of inflammatory processes in the mucous membranes of the upper respiratory tract. Sometimes the first signs of OSLT make themselves felt when visiting a bathhouse, strenuous physical activity, inhalation of tobacco smoke or frosty air.
The clinical picture of laryngotracheitis includes the following pathological symptoms:
- headache;
- temperature increase;
- dryness and rawness in the throat;
- feverish condition;
- burning sensation in the chest;
- decrease in the timbre of the voice;
- periodic dry cough.
Many patients confuse the manifestations of OSLT with the common cold, therefore they are treated with antiviral pills, throat sprays, lozenges, etc. However, it should be borne in mind that due to inflammation of the mucous membranes of the laryngopharynx and the practical absence of mucus in the airways, throat suppression can provoke a repeated attack of barking cough and spasm of the pharyngeal muscles.
Development stages of OSLT
As already mentioned, the symptoms of ENT disease largely depend on the stage of development of inflammation in the airways. In most cases, stenosing laryngotracheitis appears suddenly, mainly at night or immediately after awakening. In otolaryngology, it is customary to distinguish 4 stages of OSLT development, which include:
| Stages | The general condition of the patient | Distinctive symptoms |
|---|---|---|
| Stage 1 (compensated) | in the absence of physical exertion, symptoms of respiratory failure do not appear |
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| Stage 2 (subcompensated) | breathing becomes difficult when the patient assumes a horizontal position or minor physical exertion |
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| Stage 3 (decompensated) | respiratory failure is complemented by symptoms of nervous overexcitation |
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| Stage 4 (acute asphyxia) | vital functions are impaired, hypoxic coma develops |
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If you do not provide timely assistance to the patient at stages 3 and 4 of the development of stenosing laryngotracheitis, this can be fatal.
Emergency care for grade 1 OSLT
Is it possible to prevent the development of laryngospasm on your own? It is possible to stop the manifestations of stage 1 of laryngeal stenosis without the participation of a specialist. However, before providing emergency assistance, it is still worth calling the ambulance team at home. How to help the patient and prevent laryngospasm?
It is necessary to provide access to fresh and preferably moist air. If you don't have a special humidifier, hang damp towels or bedspreads in the room. To quickly restore normal breathing in a patient, spray an isotonic solution (saline) or ordinary mineral water near him.
Distraction procedures are one of the most effective methods of preventing prolonged laryngospasm. However, it should be noted that they will contribute to the restoration of normal respiratory activity only at the initial stages of the development of stenosing laryngotracheitis. Hot foot baths, mustard plasters on the calf muscles, and semi-alcoholic compresses on the chest will help to stop the attack.
To reduce the swelling of the mucous membrane and facilitate breathing, it is recommended to bury "Galazolin" in the nose and perform ultrasonic inhalations with "Lazolvan". Inhalations using expectorants stimulate the production of mucus in the laryngopharynx, thereby reducing the severity of laryngospasms. Before the arrival of an ambulance, it is better to put the patient to bed with a large pillow or blanket under his back.
Emergency care for grade 2 OSLT
At the subcompensated stage of the development of the disease, the risk of false croup is multiplied. Severe tissue edema in the laryngeal subglottic region can cause stenosis, i.e. critical narrowing of the lumen in the airways. The first manifestations of an attack are persistent coughing, hoarseness, and shortness of breath. To alleviate the patient's condition, it is necessary:
- provide access to fresh and humidified air;
- take sedative medications (Diazepam, Phenobarbital); to make inhalation of corticosteroids ("Hydrocortisone", "Pulmicort");
- drip into the nose vasoconstrictor drops ("Suprima-Noz", "Xymelin").
Vasoconstrictor drops can be used no more than 3 times a day, as they dry out the nasal mucosa, and can provoke a second attack.
Sometimes taking the above means does not help to completely stop stenosis of the larynx.In this case, to facilitate the patient's well-being, it is necessary to inject intramuscularly "Prednisolone" or "Dexamethasone".
Emergency care for grade 3 and 4 OSLT
It should be noted that stenosing laryngotracheitis at 3 and 4 stages of development must be treated exclusively in stationary conditions. To reduce the swelling of the airways, patients should undergo a course of oxygen therapy, which allows to restore the patency of the trachea, as well as to normalize the work of the cardiovascular system.
Before the arrival of the ambulance, the patient must be in a sitting position, otherwise the laryngospasms will only worsen. At the site, specialists can perform tracheal intubation to prevent acute asphyxiation. To do this, a special hollow tube is inserted into the oral cavity through which the patient can breathe freely.
With an increase in the phenomena of stenosis and the impossibility of intubation of the trachea, "Atropine" is injected into the muscles of the oral cavity, which helps to eliminate spasms. While maintaining the swallowing reflex, patients are injected intravenously with "Oxybutyrate". After completing all the necessary manipulations, the patient is hospitalized. If necessary, already in a hospital, cardiopulmonary resuscitation can be performed.
Treatment
The methods of therapy for stenosing laryngitis depend on the reasons for its development. With bacterial inflammation of the ENT organs, antimicrobial drugs of a wide spectrum of action are prescribed. If the cause of OSLT is a viral infection, antiviral and immunostimulating agents are included in the treatment regimen.
Throat stenosis occurs against the background of severe tissue edema. Narrowing of the lumen of the airways becomes the cause of the development of respiratory failure. To alleviate the course of the disease, the patient is prescribed antiallergic drugs. They prevent inflammation and swelling of the mucous membranes, due to which the patency of the trachea, throat and pharynx is normalized.
What drugs are used to treat stenosing laryngotracheitis? As a rule, the following types of drugs are used to treat ENT pathology in adults:
| Drug type | Operating principle | Drug name |
|---|---|---|
| antiviral | destroy pathogenic viruses, as a result of which inflammation and swelling of the trachea decreases |
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| antimicrobial | destroy the cellular structures of microbes, thereby reducing the severity of inflammation and symptoms of intoxication |
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| antihistamines | interfere with the biosynthesis of inflammatory mediators and / or reduce the sensitivity of allergic receptors, as a result of which the swelling of the ENT organs is eliminated |
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| solutions for inhalation | relaxes the muscles of the trachea and pharynx, which prevents the occurrence of laryngospasm |
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| expectorants | liquefy and stimulate the excretion of mucus from the respiratory tract |
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With adequate treatment of acute laryngotracheitis, the symptoms of stenosis will disappear within 5-7 days.
Prophylaxis
Compliance with preventive measures allows you to prevent the development of acute laryngotracheitis and laryngospasm. It should be noted that the symptoms of the disease can appear gradually or suddenly. A neglected inflammation of the trachea and throat leads to a persistent narrowing of the lumen of the airways and the onset of symptoms of suffocation. How to prevent recurrence of inflammation?
- it is necessary to treat colds and exacerbations of chronic tonsillitis or pharyngitis in time;
- within a month after recovery, it is recommended to perform breathing exercises, as it helps to strengthen the body and increase local immunity;
- you should refuse to eat too spicy food, which can provoke irritation of the esophageal mucosa and respiratory tract;
- on the eve of seasonal ENT diseases, it is necessary to take immunostimulants and vitamin-mineral complexes that contribute to an increase in the body's resistance.
It is worth consulting with a specialist about taking immunostimulating medications. Drug abuse can negatively affect kidney and liver health.
