Why does laryngitis occur in children and how to treat it. Laryngitis in children: characteristic symptoms, treatment, possible complications

Stenosing laryngitis is a serious disease that affects adults and children, men and women equally. In classical literature, you can find such a name for the disease as false croup. During its development, the patient's well-being worsens, and drug therapy is indispensable, since the symptoms are very pronounced, cause discomfort and stress. If you suspect the occurrence of this disease, you should immediately contact a specialist.

What is stenosing laryngitis

The disease is an acute inflammation of the mucous membrane of the larynx. Sometimes the infection spreads to the trachea and descends through the bronchi, which complicates the course of the disease and treatment. Pathology is characterized by severe edema, making it difficult for the patient to breathe.

Both adults and children can equally become victims of stenosing laryngitis.

Initially, stenosing laryngitis is practically no different from acute respiratory infections, and sometimes is its consequence. This causes an untimely visit to the doctor and a significant deterioration in the patient's condition.

Elena Malysheva about laryngitis - video

Factors in the development of acute inflammation of the mucous membrane of the larynx

The vast majority of diseases are caused by viruses and bacteria. Sometimes laryngitis is formed due to allergic or autoimmune factors. Depending on the underlying cause of the appearance, a suitable symptomatic therapy is selected.

The disease can be provoked by:

1. Infections, fungi or viruses. Pathological microorganisms can enter the mucous membrane of the larynx for the first time from the external environment or be the result of inflammatory diseases of a protracted course, when the bacteria spread beyond the focus of infection. When a virus releases toxic substances on the surface of the throat, the body turns on its protective functions, as a result of which the mucous membrane swells.
2. Allergy. The formation of laryngitis can be facilitated by an allergic response of the body to external stimuli: dust, wool, medicines, or certain foods. If edema is formed, it threatens the patient's life with the development of asphyxia.
3. Physical impact on the larynx. The inflammatory process occurs due to a throat injury during the intake of irritating food (spicy, cold or hot), inhalation of industrial smoke or other harmful substances, as well as tension of the vocal cords (singing, screaming).
4. autoimmune response. Occasionally, stenosing laryngitis appears as a result of a violation of the immune defense of the human body during serious diseases (for example, with amyloidosis or relapsing polychondritis).

In addition, gastroesophageal reflux, during which the contents of the stomach periodically pours into the larynx, sometimes causes swelling and inflammation of the mucosa.

Stenosing laryngitis can rarely be avoided if there are predisposing factors for the development of the disease:

• bad habits (smoking, drinking alcohol);
• chronic infectious diseases;
• a history of allergic manifestations;
• hypothermia;
• dry indoor air;
• work in hazardous production;
• regular overstrain of the vocal cords;
• lack of fortified food;
• ARI and influenza.

Human immunity plays an important role. If it is strong, no serious consequences will happen. Therefore, it is important to strengthen it and treat respiratory diseases in time.

Symptoms and stages of the disease

The development of the disease is remotely similar to the onset of bronchial asthma. The patient is disturbed by a dry and unproductive cough, it becomes difficult to breathe, shortness of breath occurs. A person begins to inhale more air, because of which the mucous membrane dries up, becomes even more injured. There are 4 stages in the development of pathology:

1. Compensation. Noisy, labored breathing. Short-term attacks of suffocation are present. The skin turns pale, there is a slight cyanosis on the nasolabial triangle.
2. Subcompensation. Feeling worse, weakness appears. Coughing and seizures become more frequent, loud noises are heard during breathing. Paleness and cyanosis become more pronounced. There is a mild degree of respiratory failure.
3. Decompensation. Breathing is difficult, superficial, with signs of expiratory dyspnea. There is sweating, sleep disturbance and noticeable respiratory failure with a possible malfunction of the heart muscle.
4. Asphyxia (terminal degree). Complete lack of oxygen supply to the body, violation of all functions.

The earlier the qualified assistance is provided to the patient, the less negative consequences for vital organs and systems. The state of asphyxia develops into a coma, and not everyone can get out of it. In this case, you can not do without resuscitation.

Diagnostics

Diagnosis of stenosing laryngitis includes a set of studies. During the initial treatment, the doctor listens to complaints, collects an anamnesis of the patient. Based on the survey, an instrumental study is prescribed - laryngoscopy, which allows you to assess the condition of the throat mucosa. During preparation for the procedure, an x-ray of the larynx and chest is sometimes prescribed, it is advisable to use computed tomography. The study has its own contraindications, which the otorhinolaryngologist will warn about.

There are several types of laryngoscopy:

• direct - a laryngoscope is inserted into the larynx to assess the condition of the mucosa;
• indirect - inspection is carried out using a special tool with a mirror;
• microlaryngoscopy - helps to exclude the development of tumor diseases;
• retrograde - is indicated for patients with an installed tracheostomy.

If the diagnosis remains unspecified, a differential diagnosis is prescribed. Although in most cases this is still not required.

Differential Diagnosis

Such a diagnosis helps to exclude diseases similar to laryngitis, as well as to establish the cause of its occurrence. Identical symptoms are:

Important! With the help of differential diagnosis, you can find out the cause of the disease, distinguish an infectious course from an allergic one or any other.

Therapeutic measures

The fight against the disease should take place under the supervision of a specialist, with the help of complex treatment. Depending on the cause of stenosing laryngitis, a certain drug therapy and other restorative measures are selected.

Irritating food (spicy, fried, fatty, salty) is excluded from the diet, the temperature regime of nutrition is observed. During treatment, it is forbidden to talk, whispering is also not recommended. The patient should not smoke, drink alcohol and carbonated drinks.

What can be done at home: emergency care for the sick

If there are initial signs of laryngitis, before the arrival of the medical team, the victim should be given first aid to alleviate the condition.

1. Lay on the bed, lifting the pillow. It is better if the position is half-sitting.
2. Open a window for fresh air.
3. Drink as much warm (not hot) water as possible.
4. If laryngitis is chronic, give the drugs prescribed by the doctor in the form of inhalations.

The victim should be calmed, unfasten his clothes, which may interfere with breathing. If it's a child, it needs to be distracted.

Treatment in a hospital

Regardless of the origin of laryngitis, in the hospital, the patient is prescribed a hypoallergenic diet with strict adherence to the temperature regime of food.

If a virus or fungus has joined, antibiotics (Azithromycin), antifungal drugs (Nystatin) and symptomatic therapy (for example, cough - Bromhexine) are indicated. If an allergic component is detected, antihistamines (Tavegil) are taken.

Important! It is strictly forbidden to treat the disease at home! This is fraught with complications and deterioration.

Medical treatment - photo gallery

Azithromycin - an antibacterial agent, with the addition of a secondary infection
Nystatin is an antifungal drug
Bromhexine is a symptomatic remedy that helps get rid of cough
Tavegil is necessary in case of detection of an allergic component

Stenosing laryngitis in children and pregnant women

A similar disease is a fairly common occurrence in children under the age of three. This is due to the friability of the mucosa and the immaturity of the walls of the larynx. As a rule, in young patients, the disease does not last long and, with proper therapy, quickly passes without consequences.

Viral diseases in a child should be treated in a timely manner, since in most cases they are the root cause of respiratory complications. If you suspect laryngitis, you should immediately show the baby to the pediatrician.

If an attack begins, you must immediately call an ambulance.

Parents should calm down so as not to frighten the child even more and not worsen the situation. It is allowed to be treated with folk remedies only under the supervision of a doctor.

During pregnancy, the female body is characterized by a weakened immune system, which causes infectious diseases. In addition, it is impossible to be treated with most drugs, respectively, the development of the chronic form of the disease is not long in coming.

A feature of laryngitis is that viruses can infect the fetus. In addition, in the last weeks of pregnancy, many experience shortness of breath as a result of the pressure of the uterus on the lungs, and this, as you know, worsens the condition with stenosis.

Treatment should be carried out in a timely manner by a specialized specialist - an otorhinolaryngologist.

Doctor Komarovsky about laryngitis - video

Possible consequences

The more severe the stage of the disease, the more serious the consequences for the body it can be. If stenosing laryngitis is not treated in a timely manner, the following complications are possible:

• development of the chronic stage of the disease;
• asphyxia (with untimely resuscitation - coma and death);
• long-term failure of the vocal cords;
• violation of blood circulation and secretion in the tissues of the laryngeal region;
• the appearance of severe infectious diseases (phlegmon of the neck, abscess, sepsis);
• the occurrence of tumors;
• violation of laryngeal mobility.

With timely diagnosis and proper treatment, all negative consequences are reduced to zero.

Important! Home medicine is not suitable for therapy. It is permissible only with the permission of the doctor and in conjunction with the intake of indicated medicines.

Prevention

Prevention includes a set of measures that help protect the body from the development of infectious complications, even if the patient is already ill with acute respiratory infections. This requires:

1. Regularly (twice a day or more) ventilate the housing.
2. Timely treat viral diseases.
3. To refuse from bad habits.
4. Follow a hypoallergenic diet if you have a history of an allergic disease or other pathologies associated with it (bronchial asthma).
5. Be careful when taking medications, especially in children. Poisoning with inappropriate drugs can also cause stenosing laryngitis.
6. Change work associated with industrial hazards (chemistry, dust, smoke, gas) or use a respirator.
7. Regularly be in the fresh air, do exercises and breathing exercises.

In addition, you should avoid overstraining the vocal cords, do not injure them with frequent screaming or rough food.

If you prevent and treat a respiratory disease at an early stage, you can avoid the development of more serious problems, including stenosing laryngitis, as well as its recurrence in the future. After all, human health is often exclusively in his hands.

Frequent runny noses and coughs in children, especially during the cold months, do not surprise anyone. The imperfection of the immune system and the peculiarity of children's physiology make the baby's body susceptible to respiratory infections, and diseases are more severe than in adults. The most acute manifestations of laryngitis occur in children prone to allergies. A cough that turns into choking is a symptom of a narrowing of the larynx - a condition that requires urgent measures to be taken to facilitate the child's breathing. Parents should know how to provide first aid. This complication is especially dangerous for infants.

The larynx in children is narrower than in adults. With inflammation, the volume of the mucosa increases, narrowing the lumen even more. This makes breathing difficult. The younger the child, the more dangerous this condition, as respiratory arrest can occur. The greatest danger of laryngitis is for children under 3 years of age.

The disease can occur both in an acute form and in a chronic one.

Causes of inflammation of the larynx

The causes of laryngitis can be:

1. Infection with a viral infection with influenza, measles, scarlet fever, whooping cough, SARS. The occurrence of laryngitis of this nature is facilitated by low immunity in a child, frequent sore throats, colds, and hypothermia.
2. The presence of allergies to any products, tobacco smoke, household chemicals, animal hair, plants.
3. The reaction of the imperfect nervous system to strong excitement.
4. Congenital defects of the mucous membrane of the larynx, which usually disappear by the age of 3. But before this age, a periodic recurrence of laryngitis in children is possible.
5. Individual features of the structure of the larynx and nasopharynx.
6. Treatment of runny nose and sore throats with sprays. The medicine injected under pressure, getting into the throat, can cause spasm of the larynx and vocal cords.
7. Dust, gas contamination, low humidity and high ambient temperature.
8. Overexertion of the vocal cords when shouting or singing loudly.

It is impossible to exclude the ingress of a foreign body into the windpipe (trachea).

Typical symptoms and signs of laryngitis

The disease usually begins with a runny nose and sore throat. On examination, it turns out that it is red and swollen. There is a characteristic barking cough associated with irritation of the mucous membrane and itching in the throat. Initially, the cough is strong and dry. Gradually, sputum appears, which may contain blood clots. The child's voice becomes hoarse. It is difficult for him to breathe due to swelling of the larynx. Temperature rise is possible. The baby has a headache, dry mouth appears. During coughing, a cyanotic triangle appears above the upper lip.

In the acute form of laryngitis, the symptoms in a child are pronounced. During the transition to a chronic form, he is mainly worried about a sore throat, there is a constant need to cough. The timbre of the voice changes.

Signs of laryngitis in an infant

Since the baby still cannot tell where it hurts, parents should be especially attentive to changes in his condition. To the general signs of acute respiratory infections, such as a runny nose, lethargy, increased moodiness, a strong hoarse cough, whistling and noises in the respiratory tract, blue between the mouth and nose are added.

Varieties of laryngitis in children

Depending on the nature of changes in the mucosa and the causes of the inflammatory process, the following types of laryngitis are distinguished:

1. Catarrhal, in which the child coughs due to a sore throat. The voice becomes hoarse. There is no rise in temperature. Very young children may experience choking.
2. Hypertrophic. There is an overgrowth of the mucous membrane, characteristic nodules appear in the folds of the larynx, due to which irritation of the throat intensifies.
3. Atrophic - this condition occurs if the disease becomes chronic. The child coughs frequently and violently. The mucous membrane becomes thinner, the mobility of the ligaments decreases. He loses his voice for a long time. Difficulty communicating with others can lead to developmental delays. This type of disease is rare in children.
4. Hemorrhagic. With this type of laryngitis, hemorrhages occur in the mucous membrane. The child is disturbed by bouts of dry cough, especially in the morning. It seems to him that there is something foreign in his throat. There are streaks of blood in the sputum. Feeling dry in the mouth. In this form, laryngitis manifests itself when children have diseases of the heart, liver, and hematopoietic organs.
5. Phlegmous is an extremely rare type of laryngitis that can occur after infection or injury. Inflammation affects not only the mucous membrane, ligaments, but also the muscles of the larynx. This causes severe sore throat, high fever, cough with suffocation.
6. Laryngotracheitis is a simultaneous inflammation of the larynx and trachea.

Video: How to diagnose by the sound of a cough

What is false croup and true

Acute infectious laryngitis is known as false croup, or acute stenosing laryngotracheitis. This condition is characterized not only by inflammation of the mucosa, but also by the occurrence of difficulty breathing (it is difficult to inhale).

True croup is called diphtheria of the larynx (because of the similarity with the symptoms of laryngitis, this disease is considered its variety and is called fibrinous laryngitis). Diphtheria affects the tonsils and larynx. In this case, the mucous membrane is covered with a white-gray film that blocks the lumen.

The difference is that diphtheria croup develops gradually. First, the cervical lymph nodes increase, then films appear that overlap the larynx, and after that a barking cough occurs.

False croup occurs paroxysmal, suffocation appears due to swelling of the mucosa. An attack of false croup most often occurs in a baby at night. Breathing becomes more frequent, the temperature rises, a hoarse cough begins, the wings of the nose swell, the face turns pale, a cyanotic triangle appears above the lip.

Warning: It is especially dangerous if an attack occurs in a sleeping child. If the parents do not provide him with urgent assistance, he may suffocate. It is required to immediately lift it and hold it vertically, take measures to facilitate breathing, urgently call an ambulance.

Infectious stenosis (false croup) does not occur in children under 6 months of age.

Possible complications of laryngitis

The danger of laryngitis is that it develops quickly and gives severe complications. The most common of these is suffocation, which is especially characteristic of a disease that occurs due to allergies. Such a complication can also appear in infants due to the imperfection of the respiratory system.

In infectious diseases of the upper respiratory tract, attacks of false croup may occur. Purulent inflammation spreads to the muscles of the neck, lungs, causes blood poisoning.

Stages of narrowing of the lumen of the larynx

Respiratory failure (stenosis), resulting from mucosal edema and a decrease in the lumen of the larynx, develops rapidly. In this case, a gradual deterioration of the condition can be observed.

Stenosis 1 degree(so-called compensation). The child does not suffocate, but it can be seen that the muscles of the sternum and abdomen above the navel are involved in the process of breathing. The body can cope with this condition on its own within 1-2 days.

Stenosis 2 degrees(subcompensation). The baby turns pale, becomes more excited, a cyanotic nasolabial triangle appears, and the heartbeat quickens. The child does not have enough air, he breathes all over his chest and stomach. This state may last for several days.

Stenosis grade 3(uncompensated). Inhalation and exhalation are difficult, breathing is noisy, lips and nails turn blue, sweat comes out. The lower part of the sternum is retracted. Arrhythmia is observed, pressure decreases.

Stenosis grade 4(asphyxia). Breathing is shallow, the heartbeat is slow, convulsions appear, loss of consciousness occurs due to the high content of carbon dioxide in the blood and oxygen deficiency.

Video: Doctor's recommendations: how parents should act if a child has an attack of croup

allergic stenosis

Laryngeal edema occurs as a result of partial or complete inflammation of the mucous membrane of the larynx due to exposure to any allergen (plant pollen, household dust). The child's voice becomes coarse, it hurts to swallow, signs of asphyxia may suddenly appear.

In what cases it is necessary to call an ambulance

Since laryngitis can develop very quickly, especially in young children, at the first sign of difficulty in breathing, parents should immediately call an ambulance, before it arrives, take measures to eliminate the spasm of the larynx.

If a child develops a barking cough, shortness of breath and shortness of breath, this can lead to the development of heart failure and the rapid progression of stenosis. Treatment for grade 2-4 stenosis requires urgent hospitalization. Especially high is the risk of a sharp exacerbation of laryngitis in children with neuropsychiatric disorders, as well as in allergy sufferers.

Signs such as frequent coughing, shortness of breath, combined with high fever can be alarming symptoms of developing acute laryngitis. It is urgent to understand the cause in order to begin adequate treatment.

First aid in the event of an attack of stenosis

Before the ambulance arrives, to relieve spasm of the larynx and facilitate breathing, the child needs to breathe steam. To do this, you can open hot water in the bathroom so that steam accumulates, and stay there with the baby. A large child will be able to breathe over a saucepan with a solution of soda or potato broth. You need to breathe steam for 5-10 minutes in several steps with a short break. At the same time, dry cough weakens, sputum appears, breathing becomes easier.

The following procedures will also help:

1. A foot bath with warm water will reduce swelling of the larynx. After this procedure, the baby needs to wear warm socks.
2. The baby should drink plenty of water. It is best to give him mineral water without gas or simple with the addition of a small amount of soda.
3. It is urgent to humidify the air in the room if it is too dry (spray water or put a basin of water, hang wet towels).
4. Give the child no-shpu or papaverine, which relieves spasms, as well as antihistamines (suprastin, for example), to reduce sensitivity to allergens. It is best to inject intramuscularly.
5. It is very important to calm the baby, distract him with something, since worrying and crying will only increase the spasm of the larynx.

Addition: As the doctor of the department of emergency pediatrics of the Union of Pediatricians of Russia I. Artemova points out, the typical mistakes of parents who are faced with the occurrence of stenosis of the larynx in a child are that they try to give him an antibiotic to prevent a recurrence of an attack. With a viral infection, this is completely useless. It is recommended to have a nebulizer for inhalation at home, use the Pulmicort preparation in it.

Video: An attack of stenosis in a child with laryngotracheitis (mom's advice)

Home treatment of laryngitis in children

If the doctor does not consider it necessary to keep the child in a hospital, laryngitis is treated at home. At the same time, it is necessary to observe strict bed rest.

The patient should not talk much. Excessive stress on the vocal cords leads to their incorrect formation. Subsequently, the child may have a hoarse voice.

It is necessary to monitor the humidity and freshness of the air, the cleanliness of the room. The baby should not play with soft toys, as dust accumulates in them.

Requires frequent drinking. If the disease is of an allergic nature, then in no case should you give compotes, juices, herbal teas. Food should be fortified, not irritating to the mucous membranes.

At home, for the treatment of dry cough, mustard foot baths are made, mustard plasters are applied to the back. Physiotherapy is carried out in the form of inhalations over a decoction of potatoes with the addition of mint, eucalyptus. Traditional medicine recommends using infusions of calendula, pine buds, chamomile with a few drops of essential oils for inhalation.

For the same purpose, a solution of 3 tbsp. l. sea ​​salt, 3 tsp. soda in 1 liter of water. A few drops of iodine are added there.

To relieve inflammation, the baby needs to gargle with infusion of chamomile, St. John's wort, sage. They not only have a strong anti-inflammatory effect, but also help to remove sputum. You can also gargle with beetroot juice or warm water with honey.

Warning: If the cause of laryngitis is unknown, then the use of herbal remedies for inhalation, gargling or compresses is prohibited, since spasm of the larynx may be an allergic reaction. Before using any folk remedies to eliminate the symptoms of laryngitis, you should consult a doctor, do a blood test for viruses, a general blood test for leukocytes. You may also need to do tests for various allergens.

The use of medicines

According to the doctor's prescription, drugs that have an expectorant, antipyretic, anti-inflammatory, anti-allergenic effect are used. In each case, the dose is individually selected, taking into account the age and weight of the child.

Expectorants. Stoptussin-phyto drops are used (from 6 months old), herbion with plantain (from 2 years old), libexin (from 3 years old). They are used for dry cough. For the subsequent elimination of a wet cough, bronchosan, lazolvan, ambrobene are used.

Antipyretic. These include panadol, paracetamol, efferalgan. For young children, suppositories and syrups are available that are easy to use.

Anti-inflammatory treatment. Non-steroidal anti-inflammatory drugs are used: ibuprofen and its analogues (ibufen, nurofen).

Antihistamines. The most popular are drops fenistil, zirtek (for infants), claritin (from 2 years old), zodak, cetrin (from 6 years old).

If it is known for sure that the cause of the disease is a bacterial infection, then the pediatrician prescribes antibiotic.

Treatment in a hospital

If the child's condition is unstable, there are signs of stenosis of 2, 3, 4 degrees, then treatment is carried out only in the hospital. After the elimination of an acute attack of suffocation, drugs are used to get rid of fever and dry cough, inhalations are made. Means are injected through a dropper to relieve inflammation and swelling in the throat. If it turns out that the inflammatory process in the larynx has arisen due to bacterial infection, antibiotics are prescribed for the treatment of laryngitis.

At 4 degrees of stenosis, children are treated in the intensive care unit. In a critical situation, if asphyxia occurs, an incision is made under the thyroid gland and a breathing tube (tracheostomy) is inserted directly into the trachea. After the condition improves, the tube is removed.

How to prevent laryngitis in children

To prevent the occurrence of this disease, it is necessary to minimize the child's contact with allergens if he has signs of intolerance to any substances or products.

Bacteria can easily enter the larynx if the adenoids, tonsils are inflamed, there are bad teeth. If a child breathes only through his mouth all the time, his mucous membrane dries up, this creates conditions for the rapid penetration and development of infection. Therefore, it is important to treat ENT diseases in time and check the condition of the teeth.

It is necessary to harden the baby from birth, to monitor his correct physical development. In the apartment to maintain normal sanitary and hygienic conditions. The child should sleep well. This is necessary to strengthen the nervous system. Proper nutrition improves immunity.

Laryngitis with stenosis is an acute inflammation of the larynx that most often develops in children from 1 to 4 years of age. This condition is dangerous with the likelihood of developing suffocation due to spasm of the respiratory tract, so it is important to know its symptoms, causes of development and methods of treatment. It is also important to know first aid during an attack.

Stenosing laryngitis in children can develop against the background of an acute viral infection. This disease is characterized by inflammation of the larynx, in neglected conditions, the bronchi and trachea also suffer. This disease begins with a runny nose and sore throat. The mucous membrane becomes red, in parallel there is a change in the voice, it begins to sit down. Hoarse voice, frequent cough, runny nose, slight fever - all these are the initial symptoms of laryngitis. If treatment is not started on time, then a rapid manifestation of spasms of the respiratory tract is possible.

Acute stenosing laryngitis is the result of untimely treatment of the primary form of the disease.

The child has a dry cough more and more often, which prevents him from breathing normally. Often this type of cough is called barking, as attacks are found one after another. If in an adult the respiratory system is fully formed and the lumen of the larynx is wide, then in children under 3 years old it is narrow. An increase in swelling in this area leads to stenosis of the larynx in children. In this state, breathing begins to become difficult, the child's nasolabial triangle begins to turn blue. With such symptoms, it is important to provide the correct first aid. Parents with laryngitis in their child should monitor his sleep and breathing.

Causes of stenosing laryngitis

Stenosing laryngitis can develop not only because of SARS. Can provoke this condition: influenza virus, parainfluenza, measles, whooping cough, scarlet fever. The main reasons for the development of laryngeal stenosis with laryngitis are:

• Weakened immunity due to constantly recurring colds, tonsillitis;
• Hypothermia of the body;
• Drinking and eating food that irritates the mucous membrane;
• The development of allergies to food, tobacco smoke, pollen, dust, wool, household chemicals;
• Pathology of the mucous membrane of the larynx;
• Anatomical features of the nasopharynx;
• Too dirty and dusty air in the room, low humidity, gas contamination;
• Prolonged tension of the ligaments due to screaming, crying, loud talking, singing.

Do not exclude the possibility of developing stenosis of the larynx when a foreign body enters the respiratory tract, which is often observed in children. Also, a similar tissue reaction is possible after severe stress, because the nervous system of babies has not yet been fully formed.

Anatomical differences in the child's respiratory system are due to:

• Slight weakness of muscle tissue;
• Thin mucous membrane of the larynx;
• The saturation of the mucous tissue with cellular elements;
• Elongated in shape and soft in structure, the epiglottic cartilage.

Together, all these factors make the larynx of preschool children too vulnerable. When deciding on self-treatment of a child, you need to understand the seriousness and level of responsibility. Do not forget that the use of sprays for the treatment of the throat can cause spasm of the larynx. This reaction is due to the injection of the composition under high pressure.

Stenosis with laryngitis develops in stages, because at first the patient experiences a strong swelling of the mucosa. Breathing in this state is difficult, there is a spasm of muscle tissue. Spasm entails increased secretion of mucus, which additionally closes the lumen of the larynx. Emergency care in this condition must be provided correctly, so it is important for parents to know the sequence of actions. When the condition is accompanied by blue skin near the nasolabial triangle, this indicates the development of hypoxia. Stenosing laryngotracheitis is dangerous at any stage of development. In the absence of proper assistance, the patient's condition deteriorates sharply, up to irreversible processes in the brain due to lack of oxygen.

Symptoms

Stenosing laryngitis in adults and children is a dangerous condition that develops in stages. Each period of the disease is characterized by its own symptoms. Otolaryngologists distinguish four stages in the development of laryngeal stenosis:

• Compensation;
• subcompensation;
• Decompensation;
• Asphyxia.

The compensation stage develops with a slight narrowing of the lumen of the larynx, but even in this state the patient experiences a number of changes in his state of health:

1. The voice becomes hoarse, the timbre changes;
2. The cough becomes rough, reminiscent of the barking of a dog;
3. Coughing attacks are repeated more and more often;
4. There is a slight shortness of breath;
5. With active crying or screaming in a child and an adult, a slight cyanosis of the nasolabial triangle is observed.

In the stage of subcompensation, the cough becomes even more rough. The patient's breathing can be heard at a distance, whistling may occur with a deep breath. Also, at the moment of inspiration, the patient observes the retraction of the intercostal spaces. In children, this condition is accompanied by crying and anxiety, which further exacerbates well-being.

During the period of decompensation, when inhaling, the intercostal lumen is drawn in even more, the patient has nothing to breathe. All this indicates the development of acute respiratory failure, which leads to impaired consciousness. The skin begins to become pale, the nasolabial triangle noticeably turns blue, the heart rate quickens.

If emergency care is not provided in time, then the patient develops the stage of asphyxia or suffocation. The body becomes blue, the pupils dilate, the pulse becomes thready, breathing remains shallow, convulsions may occur.

The stage of decompensation and asphyxia is dangerous for the health of both children and adults. Especially brightly such changes are reflected in the further condition of children, because oxygen starvation of the brain leads to irreversible processes. After such a critical period, the child is able to differ in terms of mental development.

Diagnostics

An otolaryngologist or pediatrician is able to establish the diagnosis of "stenosing laryngitis". It is not worth it to independently “calculate” the illness of your child, because the specialist knows exactly what methods to determine the cause and type of the disease. Upon arrival to the doctor, he is obliged to review the patient's history. Next, the examination procedure takes place, which consists in listening to the lungs, determining the respiratory rate, measuring the pulse and blood pressure. As information is collected, the doctor will need bacteriological or viral diagnostics.

Treatment

Therapy of this disease is always aimed at the complete removal of spasm in the muscles of the respiratory tract. They must be completely cleared of mucus. Puffiness can interfere with all these processes, therefore it is necessary to fight it properly. The main vectors for the treatment of stenosing laryngitis are:

1. The use of inhalation therapy using solutions of adrenaline, ephedrine or atropine. It is recommended to carry out these manipulations with a nebulizer.
2. The appointment of mucolytic drugs that are able to thin and remove mucus (Libeksin, Mukaltin).
3. At the initial stages of the disease, the use of antiviral drugs (Zinamivir, Arbidol) is appropriate.
4. To relieve spasm, antispasmodics are also prescribed in the form of No-shpa, Papaverine.
5. If the stenosis was caused by allergens, then the patient must take antihistamines in the form of Tavegil, Tsetrin.
6. As the main treatment for cough, doctors prescribe bronchodilators and antitussive drugs (Eufillin, ACC, Sinekod).
7. Expectorant drugs manage to remove the accumulated mucus. Such medicines are Stoptusin-phyto, Gerbion, Ambrobene, Lazolvan.

If a patient is diagnosed with stage 2,3,4 stenosis of the larynx, then his treatment should take place under the supervision of doctors in the hospital of the clinic. Medicines are administered both intravenously and intramuscularly. With asphyxia, resuscitation procedures are possible. In critical cases, surgeons make an incision over the thyroid gland and install a tracheostomy, a special breathing tube. With its help, breathing is completely restored, and the state is stabilized. As the swelling decreases and the patient's spontaneous breathing is fully restored, the tube is removed.

Urgent care

First aid for laryngeal spasm should be given correctly and without panic. The complexity of the course of symptoms depends on every minute. The first thing to do is call an ambulance. Next, you need to follow the following algorithm of actions:

1. Provide access to fresh and clean air. To do this, you can open a window. If it is cold outside, then wrap the child a little so that there is no hypothermia. A very small baby can be carried directly into the street in your arms.
2. Free your neck from tight scarves, strings, etc. The baby's chest should move freely.
3. If such measures do not help, then to reduce the spasm, the patient is given the opportunity to breathe steam. To do this, either prepare a hot solution of soda, or simply boil the potatoes. To minimize the likelihood of developing an allergy to the inhalation composition, plain hot water is used. You need to breathe steam for no more than 15 minutes, but with breaks.
4. To relieve spasm, the child is given No-shpu or Papaverine. For a quick effect, drugs of this kind are administered intramuscularly.
5. If a spasm of the larynx is observed in a baby, then it is important to calm the child by any means. Crying and screaming only worsen the condition. For peace of mind, let's take
6. Increase warm drink. For such purposes, sweet tea is suitable.

In the room where there is a small child, there should be high humidity. To do this, the room must have a humidifier. If such equipment is not available, then during a coughing fit, the humidity in the air rises by any means. For this, a large basin of water, hanging wet towels, sheets, etc., is suitable.

Complications

If the treatment of laryngitis is not started on time, the likelihood of developing a number of complications increases sharply. Incorrectly or untimely diagnosed laryngitis can transform into:

• Obstructive bronchitis;
• pneumonia;
• Purulent laryngitis;
• bacterial otitis;
• Sinusitis;
• Acute form of tonsillitis;
• Asphyxia.

Asphyxia carries the maximum danger, because when you suffocate, the brain simply does not receive the proper amount of oxygen. Other bacterial diseases require treatment with antibiotics, as well as a number of physiotherapy procedures. Do not think that taking antibiotics will help to cope with laryngitis, because this disease is of a viral nature.

In order to avoid allergic spasms of the larynx during the treatment of cough with inhalation, you should consult your doctor before using any prescription. For such purposes, doctors recommend taking a series of tests to identify the allergen.

Prevention of stenosing laryngitis

Viruses and bacteria affect a person's well-being, but some people quickly cope with such pathogens, while others immediately go to bed. Such a reaction is due to the different protective forces of the body, and what can we say about the immunity of young children. In order to be less exposed to viral and bacterial diseases of the respiratory system, it is necessary to strengthen your body. Laryngitis will not develop if a person is constantly tempered and monitors his diet. Daily routine and physical activity also play an important role. Doctors place special emphasis on the sleep period of young children, because it is at this moment that their nervous system develops and strengthens. As a prevention of laryngitis, doctors recommend:

• At the first negative symptoms, seek medical help;
• Do not self-medicate without first consulting a specialist;
• Timely treat carious teeth, adenoids;
• Take vitamin complexes during the off-season, as well as during flu epidemics;
• Treat ENT infections in time;
• Monitor the cleanliness and humidity of the room.

Detailed preventive measures are indicated by the attending physician, based on the individual characteristics of the patient's body. If the patient is allergic, then it is worth minimizing his contact with a potential source of allergy.

Stenosing laryngitis requires proper and prompt treatment. In the absence of the necessary procedures and medication, a rapid transition of the disease from one stage to another is possible.

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An acute inflammatory disease that occurs before the age of 6 years. The inflammatory process affects the larynx and can spread to the trachea and bronchi. immediate treatment, as the disease is a threat to the life of the child.

The reasons

Stenosing laryngotracheitis in children most often develops against the background of acute viral infections. In most cases, the causative agents of the disease are adenoviruses and the parainfluenza virus. Bacteria that enter the upper respiratory tract during SARS play a significant role in the progression of inflammation.

The emergence and development of the disease is associated with the peculiarities of the anatomical structure of the upper respiratory tract in children. In babies, the larynx, which is a continuation of the pharynx, has a funnel-shaped shape. It is located higher than in adults, and has a narrower lumen. In addition, in babies, the vocal folds are disproportionately short, and the breathing muscles are relatively weak. The anatomical features of the structure of the larynx in children cause the rapid development of the inflammatory process and the formation of edema in its mucous membrane.

Among other factors affecting the development of stenosing laryngitis, overweight, allergic reactions, and intracranial injuries are distinguished.

Symptoms

Acute stenosing laryngitis develops in children during SARS, so the signs of the disease are often similar to the symptoms of a complication after the flu.

Signs of stenosing laryngotracheitis are most clearly manifested during the child's sleep. This disease is characterized by the following symptoms:

1. Voice change, hoarseness. The pathology progresses as the edema increases, and in the later stages of the disease, the child speaks only in a whisper.
2. "Barking" cough. A hacking cough in a child is accompanied by muscle spasm. It is these symptoms (spasms of the larynx, rough and spasmodic cough) that are the main signs of laryngotracheitis.
3. Shortness of breath, difficult breathing. Shortness of breath in a child is associated with a decrease in the lumen of the larynx in the region of the vocal cords.
4. Noisy and short breathing at night.
5. Long breath. Respiratory failure is due to the fact that with laryngitis in a child, stenosis (narrowing of the lumen of the larynx) makes it difficult for the passage of air flows.
6. Increase in body temperature up to 38-39 degrees.
7. General weakness of the child.

The severity of the disease

Depending on the degree of narrowing of the lumen of the larynx, 4 stages (severity) of the disease are distinguished.

1 compensated stenosis. At this stage of the development of the disease, stenosing laryngotracheitis is manifested.

Grade 2 - subcompensated stenosis - is characterized by an increase in all manifestations of acute laryngitis. In patients, rough breathing is noted, which is heard even at a distance. In the chest area, soft tissue retraction is observed. In the absence of proper treatment, the disease progresses rapidly and within 5 days passes into a new stage.

Grade 3 - uncompensated stenosis. At this stage, signs of severe respiratory and circulatory disorders appear. The child suffers from constant shortness of breath, which can occur on inhalation and exhalation. He has a rapid pulse, muffled sounds of the heartbeat. The baby is constantly in a state of nervous excitement, and his mind may be confused.

4 degree - asphyxia. At this stage of the development of the disease, the child needs. With asphyxia, the baby loses consciousness (a deep coma may develop), convulsions appear, and the heartbeat slows down.

Possible Complications

Stenosing laryngitis is a serious disease that can trigger the development of other diseases of the upper respiratory tract.

Possible complications of laryngitis:

• obstructive bronchitis, which is characterized by their narrowing);
• pneumonia (inflammation of the lungs);
• purulent laryngitis (develops in 40% of cases after the transfer of stenosing laryngotracheitis);
• bacterial or middle ear bacteria);
• sinusitis (inflammation of the mucous membranes of the paranasal sinuses);
• acute tonsillitis (tonsillitis);
• asphyxia (stop breathing).

Diagnosis of the disease

The diagnosis of "stenosing laryngotracheitis" is established by a pediatrician or an otolaryngologist based on anamnesis and examination of the pain. On examination, the doctor should set the child's breathing rate, listen to the lungs, measure the pulse and blood pressure.

If necessary, to exclude other diseases of the upper respiratory tract, virological and bacteriological diagnostics are carried out.

Emergency help for seizures

Properly rendered emergency care for laryngitis can save a child's life. That is why parents need to know the rules of behavior during seizures in a baby suffering from stenosing laryngitis.

Basic first aid measures for an attack:

1. Soothe the baby (crying and screaming stimulate increased spasm).
2. Provide air access (fresh air saturates the blood with oxygen and soothes a cough);
3. Sit the child on the bed, put a pillow under his head;
4. Provide plenty of fluids.
5. Humidify the air with steam or water vapor;
6. Make an inhalation.
7. Give an antipyretic if you have a fever.

If a child shows signs of asphyxia, you should immediately call an ambulance!

Treatment of stenosing laryngitis

Therapy for laryngeal stenosis in children is aimed at relieving muscle spasm, restoring airway patency, eliminating mucosal edema and ensuring the removal of mucous contents.

So, how to treat laryngeal stenosis in children?

• Inhalation therapy is the basis for the treatment of childhood laryngotracheitis. To relieve mucosal edema and spasm of the larynx, inhalations with a solution of ephedrine, atropine or adrenaline are used. Procedures are carried out using a nebulizer. When inhaled, antitussive and mucus-thinning drugs are also used. Inhalation modern therapy in children allows you to quickly remove the symptoms of laryngotracheitis and avoid the development of complications.
• The use of corticosteroids during inhalation and the form of intramuscular injections.
• At the initial stages of the disease, antiviral therapy is indicated (Zanamivir, Ribavirin, Arbidol);
• If there is a bacterial infection in the upper respiratory tract, antibiotics are prescribed.
• "No-shpa" and "Papaverine" for laryngitis in children are used as antispasmodics for spasm of the larynx.
• If necessary, with stenosis, antihistamines are prescribed ("Diphenhydramine", "Tavegil").
• The use of antitussives and bronchodilators. "Eufillin" relieves swelling. "ACC" has a mucolytic effect and thins the mucus. "Sinekod" acts directly on the cough center, thereby relieving the baby of the unpleasant symptoms of laryngitis.

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Classmates

Laryngitis with stenosis of the larynx is a disease that threatens the life of the baby. This is an acute condition when the inflamed epiglottis and surrounding tissues practically block the passage of air. An attack of stenosis requires urgent assistance to the child, which, among other things, can be provided by parents. In the article we will talk about the principles of first aid, approaches to the treatment of the disease.

Stenosing laryngitis is a serious childhood disease. This is acute laryngitis, extending not only to the entrance to the larynx and the region of the true vocal cords, but also to the subglottic space. As a result, he causes difficulty breathing and severe shortness of breath.

On a note! Often stenosing laryngitis is called acute obstructive croup. In severe cases, the disease can easily go down, damaging the trachea and bronchi.

Laryngitis with stenosis of the larynx may occur at the initial stage of SARS under the influence of pathogenic microbes and viruses. Main pathogens:

• parainfluenza,
• influenza viruses groups A and B,
• rhinoviruses,
• enteroviruses and others.

Often the cause is a wand that provokes the appearance.

On a note! A few decades ago, the diphtheria bacillus was a factor provoking the walls in children. Today, it is not included in the list of dangerous viruses due to mass vaccination against diphtheria.

Degrees of stenosis

Stenosing laryngitis in children, otherwise false croup, is important to distinguish from true croup, diphtheria. Laryngeal stenosis is characterized by:

• sudden appearance,
• end speed while maintaining the voice.

With diphtheria croup, medical assistance is urgently required, and at the same time, the baby:

• breathing becomes heavy, increasing on the rise,
• the voice disappears.

In addition, diphtheria does not appear spontaneously, but is characterized by increasing symptoms.

The degree of stenosis of the larynx directly depends on the severity of the small patient. In total, it is customary to distinguish 4 steps.

Carefully! Any of these stages of stenosing laryngitis requires immediate hospitalization of the child. Treatment at home is unacceptable. In the hospital, the condition of the baby will be assessed using a special Westley scale. Points are scored depending on the severity of certain symptoms. The lowest score, equal to three, corresponds to the mild stage of the attack. The crisis state is estimated at 6 or more points.

The reasons

The disease is most likely in children from birth to 6 years. This is due to the special age structure of the larynx:

• respiratory muscles are very weak,
• mucous thin and saturated with cellular elements,
• the submucosal layer is very loose and soft.

Therefore, the croup develops almost at lightning speed: 1-2 days after the onset of acute respiratory disease. A characteristic feature of attacks of stenosis of the larynx - appearance and exacerbation at night.

Suddenly, in the middle of the night, the child becomes restless, cries, grabs his mouth with his hands, coughs. On inhalation and exhalation, a whistle flies out of the larynx, the baby himself becomes pale, the area around the nose and mouth turns blue.

Causes of laryngitis with stenosis, in addition to the above age features, there may be several:

1. Started infection, which provoked a complication in the form of stenosis of the larynx. This also includes complications after suffering scarlet fever and.
2. Often the cause of stenosis of the larynx can be chicken pox, measles, herpes.
3. Allergic reaction.
4. Frequent "air contact" with cigarette smoke. This happens if one of the parents smokes in the house where the child lives. Acrid cigarette smoke is a strong factor provoking laryngitis with an attack of stenosis. Such irritants include dust.
5. The child as a whole reduced immunity.

Therapy

Therapy aimed at relieving an attack of stenosis includes a number of activities that contribute to removing excess mucus from the child's airways. This is necessary so that a lumen opens in the larynx, and breathing is restored.

Urgent care

started an attack of laryngeal stenosis requires immediate ambulance intervention from parents or doctors. Predicting the development of stenosis can be done by a pediatrician after an initial examination of the baby. As a rule, according to the external manifestations of laryngitis, the doctor can already assume the development of attacks of false croup in the coming days or even a day.

If the child has the first signs of false croup before the arrival of doctors, it is necessary to act according to the following algorithm:

1. try hard soothe the baby taking him in his arms. The more nervous the baby is, the worse the access of oxygen is.
2. Urgently provide fresh air to the room: open the windows, but make sure that the air is not too cold. Free the neck area from tight clothing, unbutton the collar, or remove clothing from the child altogether.
3. Make the air as humid as possible. To do this, you can use a humidifier, or hang wet sheets on radiators and doors.
   Children's doctors advise taking the baby to the bathroom, turn on hot water and close the door. Warm air can make breathing easier for a suffering child.
4. Give the baby have a drink: A warm drink will make breathing a little easier.
5. Permission to give antihistamine by the age of the child. Most often I use drops "Zodak", "Zirtek".
6. Inhalations with Pulmicort. This hormonal drug quickly stops the attack and restores breathing. Discuss the possibility of using this drug with a pediatrician in advance and select a dose.
   Since there is no laryngitis in the indications for use, the use of Pulmicort is usually allowed in a hospital. However, the attending physician may allow its use at home.

Carefully! As a rule, attacks of stenosis of the larynx occur at night almost immediately. Several minutes may pass from the initial stage to the stage of asphyxia. Only emergency care can provide qualified assistance to the child.

Why does the child suffocate at night and attacks of false croup are more severe? The human body is designed in such a way that during sleep, the amount of mucus increases, the muscles of the airways contract.

If during the day an awake baby can cough up this mucus, then at night this process is absent. All this provokes a narrowing of the lumen of the larynx and seizures.

The principle of first aid is similar. Two conditions must be met:

1. Providing fresh air. In winter, you can wrap the child in a warm blanket and take it out to the balcony; in summer, when it is stuffy outside, it is permissible to put the baby in front of an open refrigerator.
2. Inhalation with saline, and in the absence of improvement, carry out inhalation with Pulmicort according to the rules described above.

Treatment

Stenotic laryngitis can be treated in two ways:

• medication
• surgical.

The latter is used in extremely severe cases.

With stenosis of the larynx and stenosing laryngitis The following drugs and methods are not effective:

• antibiotics;
• antiviral agents;
• steam inhalation.

The traditional treatment for this type of laryngitis is inhalation procedures using glucocorticosteroids in inpatient care.

It is very important to treat the child under the supervision of a doctor in a hospital. When, if the stenosis of the larynx has passed into the stage of asphyxia, surgical intervention may be required. An incision is made in the front of the neck between the tracheal rings, where a thin tube is inserted. Through it, oxygen will enter the lungs, due to which the child will begin to breathe normally.

Conclusion

1. Stenosis of the larynx in laryngitis associated with age-related features of the structure of the larynx in children. As a rule, attacks of false croup occur in preschool children.
2. If the child suffocates at night, parents need to take a number of urgent measures to stop the attack. If there is no improvement within a few minutes, calling an ambulance is mandatory.
3. Usually, stenosing laryngitis is a consequence Therefore, during treatment, it is important to create conditions for recovery and timely relieve the symptoms of infection.

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