This disease most often appears simultaneously with a viral or bacterial infection and in most situations is diagnosed in children aged six months to six years.
The main danger of stenosing laryngitis is the high likelihood of severe edema of the pharynx and trachea.
It is edema that can lead to acute oxygen deficiency and even suffocation.
Causes of the disease
It should be understood that in otolaryngology, there are various types of terminology, therefore, such a diagnosis as false croup has several synonymous names: stenosing laryngitis in children, subglottic laryngitis, acute obstructive or subglottic laryngitis. However, the term "false croup" is most often used in medicine.
As practice shows, children most often suffer from croup. This is mainly due to the anatomical features of the structure of the pharynx in childhood. Also, the seasonality of the disease should be noted. The vast majority of cases of croup occur in the autumn-winter period.
Stenosing laryngitis is a disease that occurs in children as a complication resulting from diseases of the nasopharynx organs caused by various infections. Often, viruses (parainfluenza, adenovirus), as well as bacterial pathogens (staphylococcus, Haemophilus influenzae) act as pathogenic microorganisms. In this case, the virus, once on the nasopharyngeal mucosa, becomes the cause of the development of the inflammatory process, which in turn provokes an increased production of mucus, swelling. As a result, the lumen of the larynx narrows, causing subglottic laryngitis.
Thus, the causes of false croup are as follows:
- immaturity of the main reflexogenic zones in the child's nasopharynx;
- looseness of the pharyngeal surface, small diameter of cartilage tissue;
- excessive looseness of tissue in the subglottic region, hence the name subglottic laryngitis;
- small size of the vocal cords;
- small size and lumen in the larynx;
- funnel-shaped pharynx;
- a large number of vessels in the mucous membrane, as well as in the submucous layer of lymph formations, a deficiency of elastic fibers;
- increased excitability of the muscles.
Important! The likelihood of developing false croup in a child increases in the presence of congenital abnormalities, frequent respiratory diseases, a tendency to allergies, with a decrease in general immunity, for example, after vaccination.
Symptoms
Most often, false croup is preceded by symptoms of a common viral disease, which can last for two to three days: general weakness, fever, runny nose, sore throat. Whereas the symptoms of directly stenosing laryngitis are often sudden and occur during a night's sleep. The main signs of false croup:
- hoarseness;
- dry "croaking" cough;
- noisy labored breathing.
Depending on the stage of the disease, these signs have varying degrees of severity.
- The initial stage is called compensated. At this stage of the development of the disease, the characteristic symptoms of stenosing laryngitis appear only with physical exertion. For example, it may be shortness of breath that occurs when inhaling. At this stage of the disease, the ratio of oxygen to carbon dioxide in the blood remains within normal limits. The attack can last from several hours to several days.
- The second stage is called subcompensated. In this situation, the symptoms of false croup arise and intensify even in a calm state. Breathing becomes noisy, additional muscles take part in the inhalation / exhalation process. The child's behavior is restless, the skin turns pale, the attacks can be repeated for three to five days.
Important! In order for false croup in children to pass without complications, it is necessary to start treatment no later than the first two stages of the disease.
- The third stage of development of false croup is called decompensated. At this stage, a significant deterioration in the patient's condition occurs: there is a change in the gas composition of the blood, shortness of breath becomes stronger, anxiety increases, which is often replaced by drowsiness, a superficial cough occurs, breathing is arrhythmic. If at this stage of the development of stenosis the patient does not receive the necessary treatment, then the disease often passes into the last stage.
- At the fourth stage of acute stenosis of the larynx, asphyxia occurs - a serious condition, which is accompanied by frequent, arrhythmic, shallow breathing, which is often accompanied by periods of stop. At this stage, a coma may develop, a significant shift occurs in the ratio of oxygen to carbon dioxide in the blood (the amount of oxygen decreases sharply).
First aid and treatment
Treatment of a child in the event of stenosis should be carried out in a hospital setting. After all, self-therapy with false croup may be ineffective and lead to serious consequences. However, parents have the opportunity to provide first aid to a child in case of an attack on their own, alleviating unpleasant symptoms:
- calm the child down, do not panic, because the excitement leads to spasm of the vocal cords, exacerbating the stenosis;
- free the neck area from tight clothing;
- raise the upper body by placing an additional pillow under the head;
- offer the patient a warm drink, preferably alkaline (Borjomi, Polyana Kvasova or a solution of baking soda prepared at the rate of 5 mg of dry matter per liter of boiled water);
- ventilate the room by opening the window;
- humidify the air with a special device, a spray bottle, containers with water, wet cleaning, humidity in the room above 50% is considered the norm;
- you can use distracting procedures, for example, steam your legs (which will help the blood drain from the throat area);
- if the child has an increased body temperature (above 38 degrees), it is necessary to give an antipyretic, for example, Paracetamol or Ibuprofen;
- to reduce edema, you can use antihistamines in the required dosages (Zodak, Suprastin, Diazolin);
- if you have a nebulizer, you can independently make alkaline inhalations with mineral water or saline solution, such procedures moisturize the pharyngeal mucosa and contribute to the liquefaction of sputum;
- in severe stages of false croup, it is recommended to carry out inhalations using hormonal drugs (Prednisolone, Dexamethasone), which can quickly reduce mucosal edema and eliminate muscle spasm;
- to reduce edema, you can also use inhalations with any vasoconstrictor drops indicated for use by a child, or simply drip them into the nose;
Important! Inhalation over steam with false croup is undesirable - this can only aggravate the child's condition, providing an additional rush of blood to the nasopharyngeal region, thereby increasing the edema.
- to reduce the muscle tone of the nasopharynx, antispasmodic drugs (No-shpa, Papaverine) are used.
When trying to help a child with false croup on their own, you should be aware of some contraindications. So, with acute stenosing laryngitis, it is impossible:
- use antitussive drugs without the appointment of a specialist, otherwise there is a risk of complications due to an excessive amount of mucus accumulated in the respiratory tract;
- inhale or rub the child using infusions and essential oils with a pungent smell, as well as put mustard plasters on the upper respiratory tract, as these procedures can cause muscle spasm in the throat, which will only aggravate suffocation;
- if the child is prone to allergies, beekeeping products, citrus fruits should not be used during the period of illness, because this can only aggravate the condition of the big one.
After hospitalization, treatment of false croup is primarily aimed at restoring difficulty breathing - relieving edema. For this purpose, intravenous administration of hormonal drugs is used. If acute laryngotracheitis has developed against the background of a viral disease, then treatment with antiviral drugs (Groprinosin) is carried out, mucolytic and expectorant drugs are also used (Erespal, Lazolvan). If false croup has arisen against the background of a bacterial infection, in this case, antibiotics of the macrolide group or of the penicillin series, for example, Sumamed, Augmentin, are included in the general therapy of laryngitis.
If the child is in serious condition at the later stages of stenosis, then the following are added to the above measures carried out in a hospital setting:
- use of a special mask with a supply of humidified oxygen;
- intravenous administration of a hypertonic sodium chloride solution to quickly relieve swelling;
- intravenous administration of calcium preparations;
- droppers with hormonal drugs;
- drugs to maintain heart function, diuretics (Furosemide) to remove excess fluid, sedatives (Valerian, Persen, Novo-passit) to reduce nervousness;
- if the drugs did not have the desired effect, and it was not possible to restore normal breathing, they resort to surgical intervention: intubation or tracheotomy (installation of a breathing tube).
Prophylaxis
False croup is a dangerous disease, especially in childhood. Therefore, the timely implementation of preventive measures significantly reduces the risk of laryngotracheitis, especially in cases where the child has a predisposition to the onset of symptoms of false croup in infectious diseases. In this case, parents should know the main ways to prevent stenosis, as well as methods for quickly relieving the first symptoms of the disease.
Among the preventive measures in this case, there are:
- balanced diet, active lifestyle;
- correct alternation of sleep and wake time;
- hardening: walking barefoot, swimming;
- prevention of viral diseases, which consists in limiting the child's visits to crowded places (shops, public transport) and taking antiviral drugs, vitamins, especially during seasonal epidemics;
- timely treatment of chronic diseases;
- maintaining a sufficient level of humidity in the room, timely disposal of dust, airing, walking in the fresh air.
