The larynx plays an important role in the breathing process by promoting the movement of air into the trachea, bronchi and lungs. It also includes the vocal cords, which play a major role in sound reproduction. Thus, the development of a pathological reaction in the larynx is accompanied by a violation of the voice, and also affects the permeability of air through the respiratory tract, the supply of oxygen to the body. In this regard, inflammation of the vocal cords is a process that requires immediate correction.
Classification
The inflammation that affects the vocal cords is called laryngitis. It can be acute or chronic. The cause is most often the impact of the following factors:
- pathogenic microorganisms;
- dangerous impurities in the inhaled air;
- dry hot air;
- hypothermia;
- the use of hot and spicy foods, alcoholic beverages.
Inflammation of the vocal cords can occur in the form of a catarrhal form, atrophic and hypertrophic, which is characterized by a difference in the laryngoscopic picture. With catarrhal lesions, redness and swelling of the organ is noted. This nature of the inflammatory process is most typical for the acute course of laryngitis. After recovery, the condition of the ligaments returns to normal.
For the chronic course, the most characteristic is the hypertrophic form, which is manifested by the proliferation of the mucous membrane in the form of nodules. This symptom is most often found in patients whose activities are associated with the tension of the vocal cords. In this regard, the formations were called "singer's knots".
The atrophic form is predominantly found in certain peoples who consume large quantities of spicy, spicy dishes. The irritating effect of spices and leads to mucosal atrophy.
Clinical signs
The main symptoms characterizing inflammation of the vocal cords are caused by dysphonia, that is, a violation of sound reproduction. Normally, two ligaments are involved in this process, which, as a result of the contraction of the muscular apparatus, as well as the vibration of the cartilage, form a sound wave. If the inflammatory process affects these structures, then the smooth coordinated work of the ligamentous apparatus is disrupted, which is reflected in the timbre of the voice.
The most common symptoms of laryngitis are hoarseness and hoarseness of the voice.
With significant damage, there may be a lack of voice, aphonia. In addition, patients complain about
- sore throat, worse when trying to pronounce sounds;
- a sore throat;
- rapid fatigue of the voice when talking;
- severe dry cough.
The acute process, as well as exacerbation of chronic laryngitis, is accompanied by the development of hyperthermia. Usually, the disease is characterized by a mild course, and the increase in body temperature does not exceed 38 degrees.
Treatment principles
Treatment of inflammation of the vocal cords depends on the cause that caused the development of the pathological process. An important condition for a speedy recovery is the elimination of overstrain of the ligamentous apparatus. Such patients are advised to adhere to the silence mode. In addition, you should avoid spicy, sour, hot foods and drinks, which can irritate the mucous membrane and aggravate the situation.
Since the acute process is most often caused by viral pathogens, the treatment of inflammation of the throat ligaments does not include the appointment of antibiotics.
As for the use of local treatment, the use of lozenges, aerosols with anti-inflammatory, antiseptic action, Faringosept, Strepsils, Givaleks, Tantum Verde has become widespread. In the atrophic form of laryngitis, iodine-containing drugs, such as Lugol's solution, Jox, which have an irritating effect and promote the production of mucus, can improve the condition.
Cough with laryngitis is usually dry, hacking, paroxysmal. The most effective remedies are drugs with antitussive action, codeine and its analogues. Contribute to the dilution of sputum ACC, Bromhexin, Ambroxol. Mukaltin, Bronholitin have an expectorant effect.
In cases where the bacterial nature of the lesion is established, an effective remedy is the use of an aerosol preparation Bioparox, which contains antibiotics. In severe cases, when it is not possible to achieve a positive result in other ways, it is possible to use this group of drugs in the form of tablets. Penicillin antibiotics are usually used for this.
Physiotherapeutic procedures are also used to treat laryngitis:
- compresses with Dimexide;
- electrophoresis with novocaine;
- UHF;
- UFO.
In those cases, the year we are talking about the hypertrophic form of laryngitis, often the only possible treatment is the surgical removal of the overgrown epithelium. It is important to diagnose nodules on the vocal cords when nodules are found on the vocal cords. A malignant tumor localized in this area can also be presented in the form of a tuberosity.
To clarify the nature of the lesion, a biopsy will allow - a diagnostic study, which consists in the extraction and microscopic examination of the pathological focus.
Signs of laryngospasm
In rare cases, more often in children, acute laryngitis can be severe, accompanied by severe edema not only of the vocal cords, but of the entire larynx. In children, these processes are more pronounced, due to the peculiarities of the structure of the larynx. It has a narrower slit. As a result, even slight swelling can lead to significant narrowing of the lumen.
This development of the situation is dangerous, since it can cause laryngospasm. As a result of the narrowing of the respiratory gap, the oxygen necessary for breathing will enter the lungs with difficulty, which can lead to respiratory failure and the development of hypoxia. The area of the vocal cords is the narrowest point of the larynx, therefore it is this localization of the process that is so dangerous for the development of serious complications.
The symptoms that characterize laryngospasm are as follows:
- difficulty breathing;
- dyspnea;
- barking cough;
- the participation of auxiliary muscles in the breathing process;
- the presence of characteristic wheezing rales heard at a distance.
Depending on the degree of obstruction, the following symptoms may also occur:
- anxiety, panic;
- lethargy;
- pallor of the skin;
- cyanosis, most pronounced in the area of the nasolabial triangle;
- tachycardia or bradycardia.
Most often, such a lightning-fast course is due to exposure to an allergen or the ingress of a foreign body into the larynx. If urgent measures are not taken in a timely manner, the patient may die from suffocation.
True and False Croup
However, the inflammatory process can also be the cause of the development of laryngospasm. In this case, the symptoms are due to exposure to pathogenic microorganisms. Most often, it is the diphtheria bacillus that leads to the development of a condition that is described as true croup.
A true croup differs from a false one in that the symptomatology increases gradually and is caused by an increasing laryngeal edema and a narrowing of the respiratory gap.
Laryngospasm develops with diphtheria within 2-3 days, passing through several stages. With false croup, reflex spasm of the muscles of the larynx and blockage of the lumen with mucus play a great role in the development of clinical signs.
Of great importance for the diagnosis of diphtheria is an objective examination of patients, laryngoscopy. Detection of a characteristic fibrinous film is a typical symptom of the disease. Clarification of the pathogen is important, since therapeutic measures for diphtheria necessarily include the use of an appropriate serum. Diagnostics can be carried out using laboratory methods. Bacterial sowing of throat swabs, serological tests can reliably clarify the diagnosis, confirm the pathogen.
With false croup, signs of respiratory failure develop during the day. Most often, they manifest themselves at night in the form of an attack of suffocation due to the accumulation of mucus in the lining space. In rare cases, the cause of the development of false croup can be not only bacteria or viruses, but also specific pathogens such as tubercle bacillus, treponema pale, mycoplasma, chlamydia. Compared to laryngitis caused by other pathogenic microorganisms, this disease is characterized by a slower development. Clinical signs develop gradually, which allows the body to adapt to conditions of insufficient oxygen supply. Signs of respiratory impairment are very rare.
Urgent measures
Laryngospasm is a medical emergency. It is necessary to treat such patients in a hospital setting that has the ability to carry out resuscitation actions. The task of therapeutic measures is to prevent the development of hypoxia. To do this, it is necessary to ensure the introduction of oxygen into the lungs with the help of a catheter, and to carry out further measures aimed at combating the cause of the development of this condition. In the case of diphtheria, the administration of an anti-diphtheria serum will be necessary, with a bacterial pathogen, antibiotics should be continued.
If the cause of the development of laryngospasm was the effect of an allergen, then a prerequisite for the successful implementation of urgent actions is the use of antihistamines, corticosteroid drugs. Since the cause of the development of false croup is often the accumulation of mucus in the airways, it is necessary to use drugs that contribute to the expansion of the bronchi and evacuation of the discharge. For this, Euphyllin is administered intravenously, aerosol preparations, Berodual, Salbutamol are used.
With the aggravation of the condition, when for several hours, despite active therapeutic actions, the patient's condition continues to deteriorate, to provide the body with oxygen, it may be necessary to conduct a tracheotomy, transfer the patient to artificial ventilation, mechanical ventilation.
