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Laryngeal edema

Laryngeal edema occurs as one of the manifestations of an inflammatory or non-inflammatory lesion of the larynx and is usually localized in places of accumulation of loose submucosal tissue of the larynx (subglottic space, vestibular folds, scooped palatine folds, surface of the epiglottis from the side of the tongue). May be limited or diffuse. Causes: trauma (mechanical, thermal, chemical) of the mucous membrane of the pharynx or larynx, allergies, acute infectious diseases, diseases of the cardiovascular system and kidneys, collateral edema with pathological changes in the cervical lymph nodes, thyroid gland, and inflammatory processes in the pharynx (peritonsillar parapharyngeal abscess, etc.); phlegmon of the neck in acute, especially phlegmonous laryngitis, with neoplasms of the larynx.

Symptoms, course depend on the location and severity of edema. They can only consist of a feeling of awkwardness, moderate sore throat when swallowing, or be more serious up to a sharp difficulty in breathing. In this case, significant stenosis of the laryngeal lumen often occurs. With laryngoscopy, a limited or diffuse, intense gelatinous tumor-like formation of pale pink is visible. The contours of the anatomical details of the larynx in the area of ​​edema disappear.

Treatment. The patient is hospitalized, since even slight edema can increase very quickly and lead to severe stenosis of the larynx. If possible, it is necessary to eliminate the causes of edema. The patient is allowed to swallow pieces of ice. put an ice bladder on the neck, prescribe distraction therapy (mustard, banks, hot foot baths), inhalation of oxygen, inhalation of aerosols of antibiotics, i / m antibiotics, sulfonamides, dehydration therapy (i / v infusion of 20 ml of 40% glucose solution), / in the introduction of 10 ml of a 10% solution of calcium chloride, 1 ml of a 5% solution of ascorbic acid. Intranasal novocaine blockade, diuretics, antihistamines inside, i / m (pipolfen, suprastin, etc.), aerosol inhalations of corticosteroids are also shown. In severe cases, 1–2 ml of hydrocortisone (25–50 mg) or iv in 1–2 ml of an aqueous solution of prednisolone is injected intramuscularly (slowly over A-5 min). With unsuccessful drug therapy and an increase in stenosis of the larynx, a tracheostomy (or prolonged intubation) is indicated.