Inflammation of the larynx may result from bacterial or viral infection or inhalation of irritant gases. Unaccustomed overuse of the voice leads to edema of the vocal cords. Laryngitis is characterized by hoarseness and loss of voice. Irritant nonproductive cough may be present. Treatment consists of rest to the voice, steam inhalations, avoidance of smoking, and administration of analgesics and antibodies. In many cases the condition is self-limiting with rest and analgesics.
Causes of organic laryngeal
Involvement of the left recurrent laryngeal nerve is common in mediasternal tumors, aortic aneurysm and enlargement of the left atrium occurring in mitrial stenosis. One or other of the recurrent laryngeal nerves may be affected in the neck by enlargement of the cervical lymph nodes, goiter or other surgical causes.
Symptoms include hoarseness of voice, cough, alteration in the quality of the cough and dyspnea. Organic
It is symptomatic. Bilateral abductor
Acute laryngeal obstruction may present as a fatal emergency unless relieved in time.
• Foreign bodies may get impacted in the larynx, eg, dentures, large chunks of meat of other foreign bodies, etc. Obstruction by bolus of food is more common in subjects intoxicated with alcohol. This is called “Caf coronary”.
• Angioneurotic edema due to food, inhaled material or insect stings.
• Acute laryngitis and epiglottitis. This is especially common in infants. The organisms include H. Influenzae, pneumococcus or group A streptococcus. Irritant fumes like smoke, noxious chemicals or corrosives cause acute laryngeal edema.
• Chronic progressive obstruction occurs in carcinoma.
Stridor, aphonia and dysnea are the hallmarks of laryngeal obstruction. Acute obstruction in children leads to cyanosis and inspiratory indrawing of the trachea. The movement of a foreign body within the larynx may be palpable during respiratory efforts. When obstruction due to large bolus of food occurs at table, the victim becomes anxious, restless and cyanosed. He tries to cry, but the voice is lost. If the obstruction continues he falls unconscious and death may occur within minutes.
Acute laryngeal obstruction should be suspected when an otherwise healthy individual suddenly becomes choked and cyanotic with loss of voice.
First aid consists of the removal of the foreign body manually or with a pair of tongs. The impacted foreign body can be dislodged by a sudden forcible thud on the chest with the head lowered.
This effective method is to be learnt by all first aid teams. The patient is hugged from behind with the rescuer’s hands crossing each other over the patient’s epigastrium and the chest is compressed suddenly. This helps in dislodging the obstruction. If this fails, the airway should be made patent by tracheostomy or by inserting a few large-bore hypodermic needles in to the trachea. The patient is transported to hospital for further management. Further management of chronic obstruction depends upon the cause.