Laryngitis symptoms treatment

Laryngitis is an inflammation of the larynx, the organ of the human body, responsible for voice formation, i.e.containing vocal cords. Its cause may be a viral or bacterial infectious disease. There are two forms of the disease: the acute , which lasts only a few days, and the chronic , which persists for weeks or months. In acute form, the throat begins to ache, dry out, mucus is often released, and the voice becomes hoarse. Chronic laryngitis develops in those who work in a dry dusty environment, and those who breathe through the mouth. The common symptom of both forms is hoarseness, which in a few days can lead to partial or complete loss of voice. Can also be observed fever, sore throat and difficulty in swallowing. Children, in addition, face difficulty breathing, because their larynx is still narrow, and inflammation severely restricts the flow of air. Laryngitis can occur as an independent infectious disease of the larynx or as part of another, more serious disease, for example, pneumonia or tuberculosis. In most cases, however, this disease is not severe and passes by itself in a few days or weeks. Laryngitis can also occur as a result of prolonged exertion of the voice. How to treat folk remedies look here.

Acute laryngitis is often seen as a manifestation of acute inflammatory diseases of the upper respiratory tract, but it can also be caused by overloading of the vocal apparatus, inhalation of irritating gases, hot or cold air, allergic reactions, trauma, foreign bodies, etc.

Depending on the pathomorphological changes and clinical manifestations of the disease, the following forms of acute laryngitis are distinguished: is catarrhal, edematous-infiltrative, phlegmonous.

In catarrhal laryngitis, the process is localized in the mucous membrane of the larynx, with infiltration, increased blood filling, subepithelial vascular ruptures( more often on vocal folds).

Symptoms. Most often, patients complain of dysphonia, hoarseness, perspiration, soreness and dryness in the throat at normal or subfebrile temperature. Sometimes there is a dry cough, which is followed by expectoration of sputum.

The history of almost always can be noted the presence of one or more of the above symptoms.

Diagnostics .With laryngoscopy, hyperemia, swelling and puffiness of the mucous membrane of the larynx are seen, more pronounced in the area of ​​vocal folds, on their surface there may be point hemorrhages, viscous mucus.

Treatment of for acute catarrhal laryngitis includes:

voice rest;

sparing diet( should be excluded from acute, salty foods, hot, cold, alcoholic beverages, smoking, alcohol);

local drug therapy: alkaline-oil inhalations, irrigation of the mucous membrane of the larynx combined preparations containing anti-inflammatory components( bioparox, IRS-19, etc.), infusion into the larynx of medicinal mixtures from corticosteroid, antihistamines and antibiotics.

In cases of infections accompanied by fever and intoxication,

is prescribed as general antibiotic therapy - penicillin drugs( phenoxymethylpenicillin, 1 million 4-6 times a day, 500 mg ampicillin 4 times a day) or macrolides;

inside for liquefaction and better evacuation of sputum appoint mucolytics - ATSTS, fluimutsil, carbocysteine, sinupret, gelomirtol forte, etc.;

antihistamines preparations of systemic or topical action - claritin, telfast, histimet, allergodil;

immunomodulating medications - IRS-19, imudon, polyoxidonium, etc.

With adequate treatment and observance of the vocal regimen, the prognosis is favorable.

Osteo-infiltrative laryngitis - acute inflammation of the larynx , in which the process is not limited to the mucosa, but extends to deeper tissues. The process can extend to the muscular apparatus, ligaments, perichondrium.

Symptoms. The manifestations of this form of laryngitis depend on the extent and prevalence of the process.

With the diffuse form of laryngitis, the entire mucous membrane of the larynx is involved in the inflammatory process, only limited parts of it( intercellular space, vestibular department, epiglottis, podogolospace) are involved.

The patient complains of pain, worse when swallowing, pronounced dysphonia, high fever, poor health. Often there is a cough with expectoration of thick mucous-purulent sputum. Against the background of these symptoms, breathing is possible. The regional lymph nodes are compacted, and when palpation they feel pain.

With laryngoscopy, pronounced hyperemia, puffiness and infiltration of the laryngeal mucosa, cherpalodnagortan folds, scoops, and vocal folds are visible, which may be the cause of stenosis of the laryngeal lumen, aggravated with viscous thick mucus.

Treatment of with edematous-infiltrative laryngitis is performed in an ENT hospital. Prescribe antibiotics at the maximum dosage for each age, antihistamines, mucolytics, and if necessary short-term corticosteroid therapy.

A kind of laryngitis is the lining of the laryngitis( false croup), which is more often observed in young children( up to 5-8 years), which is related to the peculiarities of the structure of the podogolospace: loose fiber under the vocal folds in small children is well developed and reacts easily to irritation by the appearanceedema. When the child is in a horizontal position, the blood flow to the larynx increases, and the edema increases, so the deterioration is more pronounced at night.

The disease develops on the background of acute inflammation of the upper respiratory tract, accompanied by obstruction and discharge from the nose, subfebrile temperature, cough. The general condition of the child during the day is quite satisfactory, however, at night, an asthma attack suddenly begins, a barking cough appears, cyanosis develops of the skin. Dyspnoea is mainly inspiratory in nature and is accompanied by retraction when inhaling soft tissues of the jugular fossa, supra- and subclavian spaces and epigastric region.

This condition lasts from a few minutes to half an hour, after which there is profuse sweating, breathing normalizes, the child falls asleep. Similar conditions can be repeated after 2 - 3 days.

Diagnostics. When laryngoscopy, you can observe a roll-like symmetrical swelling, hyperemia of the mucosa of the podogolovoy space, which in the form of rollers protrudes from under the vocal folds, significantly narrowing the laryngeal lumen and thereby making breathing more difficult.

Differential diagnosis of false and true croup

True croup( diphtheria)

- causative agent - diphtheria bacillus

- the disease develops gradually

- dysphonia up to aphonia, asthma develops gradually

- cough usually not present

- regional lymph nodes are enlarged, swollen, painful on palpation

- in the pharynx and larynx fibrinous dirty gray color diphtheria films

False groats ( lumbar lining)

The onset of the disease is associated with acute inflammation of the mucous membraneki e.d.

- the disease has a paroxysmal nature

- the voice is not changed

is a characteristic barking cough, there is no significant increase in lymph nodes

- with laryngoscopy, a cylindrical symmetrical swelling is seen, hyperemia of the mucosa of the podogornogo space

The term "false groats" indicates that the disease is contrasted with "truecroup ", i.e. diphtheria of the larynx, which has a similar symptomatology. In contrast to diphtheria, lumbar lining is paroxysmal - a satisfactory condition during the day gives way to difficulty breathing and increased temperature at night. The voice in diphtheria is hoarse, and with lining the laryngitis is not changed. With diphtheria, there is no barking cough, characteristic of a false croup. In lining, laryngitis is not observed a significant increase in regional lymph nodes, and in the throat and larynx there are no diphtheria-specific films. Nevertheless, with acute laryngitis, it is always necessary to carry out bacteriological examination of swabs from the pharynx, larynx and nose to diphtheria bacillus.

With highly virulent infection or in the absence of timely adequate therapy, acute infiltrative laryngitis can pass into a purulent form - phlegmonous laryngitis( laryngitis phlegmonosa).Pain symptomatology is sharply increased, the temperature rises, the general condition worsens, breathing becomes difficult, up to asphyxia.

Diagnostics. With an indirect laryngoscopy, an infiltrate is detected, and a limited abscess can be seen through the thin mucous membrane, which is a confirmation of the formation of an abscess.

Laryngeal abscess may be the final stage of infiltrative laryngitis and occurs primarily on the lingual surface of the epiglottis or in the region of one of the arytenoid cartilages.

Treatment of .With phlegmonous laryngitis urgent hospitalization is necessary. Prescribe broad-spectrum antibiotics, detoxification agents, if necessary - funds that normalize cardiac activity.

If there is an abscess, an ulcer is shown with a laryngeal knife. It is necessary to monitor the patient's breathing, when traumatic stenosis of the larynx occurs, tracheotomy is produced. Distribution of phlegmon on the neck tissue dictates the need to perform external incisions with a wide drainage of purulent cavities.

Hemorrhagic laryngitis occurs primarily as a complication of the toxic form of the flu, less often in the pathology of the hematopoietic organs, cardiovascular system, liver, pregnancy, etc. Morphologically, the process is characterized by hemorrhages in the thickness of the mucous membrane of the larynx, especially in vocal and cherpalodnagortan folds in the form of petechiaeor large spots.

Symptoms. A constant sign of the disease is a paroxysmal dry cough, more often in the morning hours. In the future, when coughing up crusts, veins or blood clots appear in the sputum, scarlet blood is less often used for expectoration. In some cases, hemorrhage is possible, which sometimes leads to suffocation. Of the unstable symptoms, one should note the dryness and sensation of a foreign body in the throat.

Diagnostics. Based on anamnesis and laryngoscopy data. In the larynx, bleeding areas of the mucosa and places of submucous hemorrhage of various sizes are found. In each case, special attention should be paid to the cause of hemorrhagic laryngitis, since the tumor nature of bleeding is possible.

Treatment of .First of all, a patient with hemorrhagic laryngitis must comply with bed and voice regimens;a gentle diet is needed;smoking is excluded. With a slight bleeding, a good effect is the ingestion of 10% calcium chloride solution 1 tablespoon 2-3 times a day, vitamin K tablets 0.015 g 2 times a day, expectorant potions. With more severe bleeding, put a bubble with ice on the neck and make blood transfusion 50-100 ml;10 ml of a 10% solution of calcium chloride are injected intravenously. After bleeding treatment is the same as with acute laryngitis.

Forecast. Depends on the cause of the disease;more severe in the defeat of blood, liver, vascular system, etc.

The disease in most cases is a consequence of acute inflammation of the mucous membrane of the larynx. In persons whose profession is associated with the load on the voice apparatus( singers, readers, lecturers, etc.), the main etiological role in this pathology plays a prolonged overexertion. Professional factors( dustiness, contamination of premises) are important.

Symptoms of .A constant sign is a disorder of the voice-forming function of the larynx in the form of rapid fatigue of the voice and varying degrees of hoarseness. Complaints of patients are also reduced to dryness, a constant sensation of a foreign body in the larynx, which causes coughing or coughing.

Laryngoscopic congestion of the laryngeal mucosa is more pronounced in the region of both vocal folds;Often on this background, enlarged blood vessels are visible. In the lumen of the larynx - slime.

Diagnostics of .It is based on history, complaints, laryngoscopic picture and clinical examination. It is necessary to examine the lungs, cardiovascular system, etc.

Treatment. Elimination of the etiologic factor, adherence of patients to the vocal regimen, the use of local therapy in the form of an infusion of a solution of antibiotics with a suspension of hydrocortisone into the larynx: 4 ml of isotonic sodium chloride solution + 150 000 units of penicillin + 250 000 units of streptomycin + 25 mg hydrocortisone in emulsion( 1 ml).This composition is poured into the larynx at 1.5-2 ml once a day. The same composition is used for inhalation. The course of treatment consists of 10 inhalations. With this treatment, the amount of antibiotics and hydrocortisone entering the body is extremely small, but on the surface of the mucosa their concentration is sufficient to provide antimicrobial and anti-inflammatory effects. In this composition, antibiotics can be changed. From the composition, hydrocortisone can be excluded, and chymopsin( 25 mg) can be added to dilute mucus. In this case, it is always necessary to determine the tolerability of all the drugs that make up the composition.

After such treatment if necessary, you can make inhalation with 2% oil solution of citral, 1-2 inhalations daily for 10 days. The use of only oily and alkaline-oil inhalations must be limited, since these drugs negatively affect the ciliated epithelium, inhibiting and completely stopping its function, and alkali, in addition, has a depressing effect on the function of the mucous and goblet glands laid in the mucosa of the upper respiratory tract.

A large role in the fight against chronic catarrhal laryngitis should be given to climatotherapy, since favorable climatic conditions contribute to the elimination of the catarrhal process.

Forecast. Favorable with vigorous therapy;otherwise the transition to a hyperplastic or atrophic form is possible.

Chronic hyperplastic laryngitis is characterized by various kinds of hyperplasia of the laryngeal mucosa;By prevalence, there is a limited and diffuse form of the disease.

Symptoms. The main complaint is hoarseness, or even aphonia, which is usually caused by an uneven thickening of the vocal folds or by an incorrect phobia of the vestibular folds. In case of exacerbations, complaints and symptoms of catarrhal laryngitis are added. Indirect and direct laryngoscopy can detect hypertrophy of the mucous membrane, usually symmetrically located on both sides of the larynx and in the intercellular space in the form of a transverse cushion with a jagged edge that extends into the laryngeal lumen. Often, hypertrophy of the mucous membrane of the laryngeal ventricles is determined, which in the form of two ridges is located between the vestibular and vocal folds.

A variant of hyperplastic laryngitis is a warty thickening of the flat epithelium in the form of a cup-shaped protuberance, located in the area of ​​the inter-head space, vocal folds or the inner surface of the arytenoid cartilages and called pahidermy. Hoarseness usually occurs with hypertrophic process in the area of ​​vocal folds. Singers, readers, etc. often have one or two small pointed protrusions as large as 1-2 mm, located symmetrically on the free edges of both vocal folds at the border of the anterior and middle third of them. These so-called singing nodules are a fibrous formation.

Diagnostics. Chronic hyperplastic laryngitis in typical cases is recognized on the basis of complaints and laryngoscopic pattern. In the presence of isolated hyperplasias, chronic laryngitis must be differentiated from the tuberculosis process, syphilis, scleroma or malignant tumor. In these cases, a number of serological reactions and a tuberculin skin reaction are put. Histological examination plays a decisive role in the diagnosis.

Treatment. First of all, it is planned to eliminate all harmful factors and ensure complying with a gentle voice mode. During periods of exacerbations, treatment is performed, as in acute catarrhal laryngitis. With significant hyperplasia of the mucous membrane, the affected areas are staked in a day 1-2% lapis solution within 2 weeks. In addition, a good effect gives cryo-exposure to areas of hyperplasia of the mucous membrane of the larynx. Periodically prescribed courses of treatment with inhalation or aerosol 2% oily solution of citral, alkaline-oil, isotonic sodium chloride solution, etc.

Forecast. In terms of complete cure, a doubtful one, however, a significant improvement is usually possible.

Most often, atrophic laryngitis is etiologically and pathogenetically associated with atrophy of the nasal and pharyngeal mucosa;in a number of cases it develops after the transferred diphtheria or scarlet fever. Conditions of dustiness and gas pollution of the environment contribute to the development of atrophy of the larynx mucosa as well as smoking and alcohol abuse.

Symptoms of .Patients complain of a feeling of dryness and perspiration, foreign body, progressive dysphonia. At the beginning of the process, with laryngoscopy, a bright hyperemia of the mucosa is determined, it looks shiny. Hyperemia disappears later, a sticky secret appears, the cortices in the larynx of a dark green color. At a cough in a sputum there are blood veins owing to infringement of an integrity of an epithelium of a mucous membrane of a larynx at the moment of a cough thrust.

Diagnostics. Based on complaints and laryngoscopic pattern.

Forecast of .Systematic treatment usually improves the course of the disease.

Treatment. Rational therapy includes the identification and elimination of the cause of the disease. It is recommended to the patient to exclude smoking and strongly irritating food, to observe a sparing voice mode. From medicinal substances are appointed funds that help liquefy sputum and its easy expectoration: irrigation of the pharynx and inhalation of isotonic sodium chloride solution( 200 ml of solution + 5 drops of 10% tincture of iodine) are performed 2 times a day, using 30-50 ml of solution,long courses for 5-6 weeks or more. These procedures the patient can spend at home in the morning and evening. Alkaline oil inhalations are prescribed for 3-5 days in only one case - with viscous mucus and crusts in the larynx. Periodically prescribed inhalation 1-2% solution of menthol in oil;daily for 10 days, the same drug can be poured into the larynx( menthol has a slight irritant and weak disinfectant effect, so you need to take into account its individual tolerability).At the atrophic process simultaneously in the larynx and pharynx, submucous infiltration into the lateral sections of the posterior wall of the pharynx of the solution of novocaine and aloe( 2 ml of a 2 ° solution of novocaine + 2 ml of aloe, gives a 2 ml injection in each side simultaneously, the injections are repeated oncein 7 days, only 8 injections).To increase the activity of the glandular apparatus of the mucous membrane, 30% solution of potassium iodide is administered 8 drops 3 times a day for 2 weeks( before the appointment it is necessary to determine the tolerability of iodine).

In adults, laryngitis proceeds more easily than in children. If you do not bring the disease to a chronic condition, then the ailment can be defeated in just a few days.

It is important to realize in time that silence is gold in the literal sense of the word. It is better to talk a few days in a whisper than to torment yourself after many weeks.

The patient should always try to breathe through the nose, not the mouth. Dry air dries out the vocal cords, which increases hoarseness.

The main thing with laryngitis is to find the cause of the disease and eliminate it.

If the inflammation of the larynx was caused by a virus, you need to take antiviral drugs, with an allergic reaction - antihistamines. Prolonged laryngitis can signal the presence of bacterial infection, which means that there is a need for a more comprehensive examination in the otolaryngologist.

In the early days of the disease, hot foot baths help: the water temperature should be 42-45 ° C, the procedure time - 20-30 minutes. After the bath you need to wear warm socks and do not go out.

Drink with laryngitis as much warm water as possible, at least 1.5-2 liters per day. I want to quench my thirst more gradually, in small portions: then the bundles will be much easier to restore.

Effective with laryngitis inhalation. It is better, if it is an ultrasonic inhaler, and the patient will breathe the infusion of medicinal herbs, for example chamomile.

For mild forms of the disease, relief will also be provided by steam inhalations over boiled potatoes, infusions of herbs( chamomile, St. John's wort, sage).

Infusion of medicinal plants is prepared as follows: in a glass with boiling water you need to put 2 tablespoons of herbs, boil it in a water bath for 15 minutes, then cool, strain and bring water to the original volume.

You can also use oil solutions. For example, quickly remove inflammation and dryness in the throat of inhalation with eucalyptus oil, mint. However, people who are prone to allergic diseases, any treatment with herbs is contraindicated.

Fast cure for laryngitis will not occur if you do not follow a certain diet. Eliminate the food from spicy seasonings, spices, ketchup, fried foods. Better often spoil your neck with dairy products, cooked vegetables, cereals with butter.

It helps to get rid of hoarseness and hoarseness of voice warm boiled milk. The effect will be better if a glass of milk is added a piece of melted butter.

With laryngitis, to remove perspiration and dryness in the pharynx, you can use sucking candies or throat sprays with menthol, but this is more of an ambulance. Rinsings, pastilles from a cough relieve only the symptoms of the disease.

In the case of chronic laryngitis, adaptogens are good - an extract of Eleutherococcus 40 drops 3 times a day, tinctures of aralia, rhodiola rosea, pantocrinum in the same doses, saparal by 0.05 g 3 times a day. The effect of these drugs is multifaceted: they have a positive effect on the functioning of the immune system, metabolic processes, increase the body's resistance to adverse environmental effects.

For preventive purposes, people prone to laryngitis should pay more attention to the hygiene of the larynx.

At the first manifestations of laryngitis, it is advisable to consume more warm drink. Tea should be decaffeinated, since caffeine has a dehydrating effect.

It is useful to suck a lemon, because it stimulates the secretion of saliva. You can use lemon candies, which protect the throat from drying out.

Speak better less and quietly, but do not whisper: the whisper strains the bundles more than a quiet voice.

You should not smoke by yourself and allow smoking to those nearby: passive smoking irritates the larynx. When it is in dry rooms, it is necessary to maintain the humidity of the air. It should also regularly do a wet cleaning, as dust is also an irritant to the mucous membrane of the larynx.

Use with caution the medications that cause the mucous membrane to dry out( diuretics, antihistamines).

The upper airways can be strengthened by adjusting the inhalation and exhalation of the Buteyko system.

Diseases such as laryngitis, tracheitis, bronchitis, asthma, are the result of a wrong, unnecessarily deep breathing - hyperventilation. As a result, carbon dioxide is removed from the body, without which the correct regulation of the heart, respiration, oxygen exchange between the blood and the cells of the body is impossible. Symptoms of hyperventilation are irritability, hot flashes, insomnia, unreasonable fears, sweating, fits of weakness, obesity or weight loss, fever, metabolic disorders.

Normal breathing of a healthy person is a slow shallow breath( 2-3 seconds), a slow exhalation( 3-4 seconds) and a pause( 3-4 seconds).