Laryngeal stenosis: how to avoid tragedy?

General information about pathology

Types of laryngeal stenosis and their description
Laryngeal stenosis is a disease often diagnosed in children due to its anatomical features; it can occur in acute or chronic form. Experts say that the acute form is more dangerous because it develops rapidly, while the body does not have time to regulate the disturbances caused by insufficient oxygen supply.

The chronic form is characterized by a sluggish course. No matter how severe chronic stenosis is, it almost never leads to death. But if the patient does not treat the disease and take the necessary measures, the disease can cause complications on the nervous system, heart and other vital organs.

It is necessary to understand that with chronic stenosis of the larynx, the entire body will suffer, since the organs will not be saturated with the necessary amount of oxygen.

Specifics of complications

Acute laryngeal stenosis usually complicates the lives of children; the disease can cause the following complications in the shortest possible time:

• Difficulty breathing, leading to the development of hypoxia.
• An increase in the level of carbon dioxide in the blood causes dysfunction of vital systems and organs.

There is also a circulatory failure - common consequences of the disorder are:

• arterial hypertension;
• cardiopalmus;
• lack of respiratory activity.

If a child develops all complications at once, in the absence of timely treatment, the probability of death will be more than 80%.

If a patient with such a pathology is taken to the hospital on time, the therapy will have a positive effect, as a result of which the size of the trachea will be restored. But if treatment of the respiratory tract is unsuccessful, the disease will become chronic and will also constantly progress.

If you suspect laryngeal stenosis, you should immediately contact the clinic. Experts assure that if the disease is detected at the first stage, its development can be blocked with the help of modern medications. But if the disease develops, surgical intervention will be required.

Chronic laryngeal stenosis can easily develop into pneumonia

The disease, especially the chronic form, always entails various complications. Even with treatment, many patients begin to accumulate sputum in the respiratory tract, causing pneumonia and various forms of bronchitis.

In the chronic form of stenosis, cardiac pathologies often develop as the circulatory system begins to malfunction. Doctors say that the body of a person suffering from such a disease becomes vulnerable because the nervous and cardiovascular systems malfunction.

Even a common cold can cause serious harm to a person and cause complications, since the body simply cannot adapt to new conditions.

At the first symptoms or pain in the larynx, consult a doctor immediately

• All diseases associated with the larynx and respiratory system must be treated in a timely manner.
• It is necessary to protect the throat from injury.
• It is not recommended to consume too hot food and drinks.
• If work involves toxins and toxic fumes, the activity must be carried out taking into account all safety rules.

Since laryngeal stenosis always has a negative impact on later life and can cause disastrous consequences, the appearance of the disease should never be ignored. If suspicious symptoms appear and a sharp deterioration in health, you should immediately seek professional help.

Laryngeal stenosis often causes chronic hypoxia, which disrupts the functioning of all vital organs. Also, with this disease, there is a high risk of decompensation with any respiratory infection - the body cannot, as it were, adapt to pathological conditions.

If medical assistance is not provided in a timely manner, the patient may suffocate. You need to call an ENT specialist or an ambulance to your home as quickly as possible.

• arterial hypertension,
• cardiopalmus,
• lack of respiratory activity.

Forecast

The prognosis for laryngeal stenosis is different, as it depends on its degree and the provoking pathology. At the terminal stage, it is necessary to take urgent measures to resume the passage of air through the lumen of the larynx.

The prognosis worsens in cases such as:

• self-medication;
• treatment for individuals who do not have a medical education;
• the occurrence of stenosis against the background of allergic reactions;
• neglected state;
• late diagnosis;
• incorrect medical tactics;
• the occurrence of complications.

Kovtonyuk Oksana Vladimirovna, medical observer, surgeon, consultant doctor

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Causes of laryngeal stenosis in children and adults

Laryngeal stenosis, which in professional language is called stenotic laryngotracheitis, is not an independent disease, but a whole complex of symptoms that appear as a complication of more serious pathologies.

Causes of development of laryngeal stenosis

• Damage and injury to tracheal tissue.
• The presence of various laryngeal inflammations.
• Phlegmonous laryngitis.
• Swelling of the throat caused by an allergic reaction.
• Various infectious diseases.
• Stenosis is often a consequence of such ailments: typhoid and typhus, influenza, measles, syphilis, scarlet fever, tuberculosis.
• Impaired excitability of the larynx.
• Thermal burn - people whose activities involve chemical and toxic substances often suffer from this pathology.
• Incorrectly performed tracheal intubation.

In rare cases, pathology can also occur due to foreign objects getting inside. Whatever the primary source of the disease, self-medication is contraindicated. The only way to preserve your health and life is to seek help from a qualified physician in a timely manner.

According to the nature of the course, acute and chronic stenoses of the larynx are distinguished. The cause of acute narrowing is most often allergies. This is Quincke's edema, anaphylaxis.

Choking can be caused by a neck injury, the presence of a foreign body in the respiratory tract, or infection.

In childhood, common causes of an extremely dangerous pathological condition can be allergies or infections.

Today, with timely diagnosis, almost any disease can be prevented and cured.

The diagnosis of laryngeal stenosis is made when there is partial or complete narrowing of the lumen of the larynx, which leads to difficulty breathing in an adult or child, as a result of which the doctor prescribes treatment. There are only two stages of the disease: chronic and acute.

In acute cases of the disease, you must immediately seek help from a specialist. Refusal of treatment can lead to a serious threat to a person's life.

Diagnosis Stenosis is a process of narrowing of the larynx, which can lead to obstruction of air passage. The disease is divided into two types according to the nature of its development: acute and chronic. The causes of acute stenosis include both inflammatory diseases of the throat and physical trauma. Pathological narrowing of the larynx can occur due to:

• allergic reaction;
• infectious disease;
• foreign body getting into the throat, after which it may swell;
• due to a tumor process;
• ARVI;
• false croup.

The disease has the following varieties: cicatricial stenosis, stenosis of the extrathoracic respiratory tract, etc. For example, the scar type is a complication of infectious diseases (abscess, lupus, etc.

), injuries (burns, blunt trauma, wounds), which provoke cicatricial obstruction of the larynx and the development of chronic insufficiency syndrome of the respiratory function of the larynx.

Sometimes the cause of cicatricial stenosis can be surgery.

Symptoms

The main symptoms of the disease depend on the stage of the disease. In most cases there may be no temperature. Doctors divide the disease itself into 4 stages, in which the following signs of stenosis are noted:

1. Compensation stage. At this stage, symptoms such as a pause between inhalation and exhalation become noticeable, the inhalation becomes longer, the number of breaths becomes rare, the voice begins to wheeze, noise appears on inhalation, and the heart rate decreases.
2. Subcompensation stage. During this stage, the following symptoms are observed: signs of hypoxia, shortness of breath increases, when inhaling, retraction of the intercostal spaces, jugular, supraclavicular and subclavian fossae is noticeable, the mucous membrane and skin acquire a bluish tint, the patient behaves restlessly, cold sweat appears, breathing becomes more frequent, noise increases .
3. Stage of decompensation. When you inhale, the larynx begins to move downwards, and when you exhale upwards, breathing becomes noisy, the face is pale, cyanosis begins to appear, cyanosis of the lips, fingertips, nose, the pulse quickens, the ability to breathe fully becomes critically difficult.
4. Stage of suffocation or asphyxia. Cardiac activity decreases, breathing is rare and intermittent (reminiscent of Cheyne-Stokes syndrome), the skin becomes pale gray, the pupils are wide. This is the last stage of stenosis, in which the patient becomes lethargic, does not show activity, loses consciousness, breathing stops, the eyes bulge (exophthalmos), involuntary urination and loss of feces occur. The pulse is threadlike, cardiac activity drops, and death occurs.

Acute stenosis

As a rule, acute stenosis in children develops within one month. Its symptoms arise suddenly, which is why compensatory mechanisms do not have time to form.

The body is not able to adapt so quickly to difficulty breathing and lack of oxygen; as a result, all its processes and functions suffer.

If you do not seek help quickly, the disease can cause the death of the patient.

Chronic

Different forms of the disease manifest themselves in their own ways. The chronic course of the disease is characterized by a slow development of symptoms, which parents do not always pay attention to.

During the gradual appearance of signs of the disease, the human body adapts to breathing problems and lack of air.

The cause of the chronic form can be: cicatricial narrowing of the trachea, tumor processes, the development of granuloma, disruption of the innervation of the laryngeal cleft.

Symptoms in children

1st degree stenosis in a child:

• there is a noise in breathing when inhaling;
• shortened pause between inhalation and exhalation;
• moderate retraction of pliable areas in the chest area;
• slight cyanosis of the nasolabial triangle;
• dilation of the nostrils;
• hoarse voice;
• Purulent inflammation and catarrhal laryngitis may occur;
• the lumen of the larynx is narrowed by ¼ - ⅓.

Second stage stenosis:

• the child is capricious and may be lethargic;
• breathing noises;
• swelling of the wings of the nose;
• neck muscles are tense;
• the larynx moves synchronously with exhalation and inhalation;
• skin is moist, pinkish or pale;
• when inhaling, tachycardia is observed;
• narrowing of the larynx by ½.

Stenosis in children of the third stage:

• serious condition;
• apathy, anxiety, fear;
• shortness of breath with prolonged inhalation with noise;
• retraction of the supraclavicular and suprasternal fossa;
• loss of pause between inhalation and exhalation;
• cyanosis of the nasolabial triangle, fingertips, lips;
• pale skin, cold sweat;
• narrowing of the larynx by almost ⅔.

Stenosis in children of the fourth stage:

• serious condition;
• skin pale gray;
• cyanosis;
• temperature is reduced;
• pupils are wide;
• convulsions;
• involuntary urination, loss of feces;
• breathing is frequent, intermittent;
• thready pulse;
• decline in cardiovascular activity;
• Cardiac and respiratory arrest may occur;
• narrowing of the larynx by more than ⅔.

Causes

Acute narrowing of the larynx does not belong to a separate type of disease, but is considered a symptom complex that occurs as a complication of various pathological phenomena. The most important causes of pathology are infectious diseases:

• measles;
• malaria;
• scarlet fever;
• typhus;
• syphilis;
• tuberculosis;
• flu, etc.

Local exogenous causes include: foreign bodies of the larynx, mechanical and chemical injuries of the larynx, gunshot wounds, medical procedures. Local endogenous factors due to which the disease can develop include:

• birth defects;
• inflammatory processes;
• tumors;
• cancer;
• laryngeal paresis;
• problems with the thyroid gland.

Classification

The disease can last as: acute, subacute, protracted, complicated. It is further divided into four stages: compensated stenosis, subcompensated, decompensated, asphyxia. Based on the location of the inflammatory process, the following types of disease are distinguished:

• epiglottitis;
• supraglottic laryngitis;
• subglottic laryngitis;
• laryngotracheitis;
• laryngotracheobronchitis.

Stenosis can be classified according to the nature of the inflammation. The following forms of the disease are distinguished as the pathology develops:

• catarrhal;
• fibrinous;
• purulent;
• ulcerative-necrotic;
• hemorrhagic;
• herpetic;
• mixed.

Diagnostics

Using anamnesis, clinical picture of the disease and examination, a general diagnosis of the pathology can be made.

The doctor must find out in detail the symptoms, time, circumstances under which they arise, the dynamics of the development of the disease, its nature.

The first thing people pay attention to during examination: difficulty breathing, retraction of certain places in the chest area, changes in voice, cough, cyanosis.

First aid

As soon as the first symptoms appear, parents should immediately provide first aid to the child, and call an ambulance. Even if the person helped the patient cope with the attack and all the symptoms went away, it is worth waiting for the specialists to arrive. Before the ambulance arrives, the following methods should be used:

• Make the patient recline, try to stop the panic that may accompany an attack of stenosis.
• Take off too warm clothes and ventilate the room.
• Press the spoon onto the root of the tongue.
• Inhale with saline solution, mineral water, or let them breathe steam at a hot water tap.
• Rub the calves of your legs, you can take a bath with hot water and steam your legs. This will help move blood away from the upper body.
• Give the patient an antihistamine.
• In a very serious condition, you need to inhale a glucocorticosteroid (Hydrocortisone, Pulmicort) or give an injection of Prednisolone.

Treatment

Causes of laryngeal stenosis

All the reasons for which laryngeal stenosis occurs in adults can be divided into:

• Impact of endogenous factors;
• Impact of exogenous factors.

Among the endogenous factors the following can be distinguished:

• tumor formations of the larynx, malignant and benign;
• the presence of congenital malformations;
• tumors of the thyroid gland, mediastinal organs;
• paresis or paralysis of the nerves responsible for the innervation of the muscles of the larynx;
• allergic swelling of the mucous membranes after contact with an allergen;
• As a result of infectious diseases of organs of other localization, a complication develops - stenosis. It could be diphtheria, syphilis.
• Inflammatory diseases of the mucous membranes of the nose, tonsils, pharynx, larynx. Bacterial inflammation in the form of sore throat, rhinitis, pharyngitis, laryngitis. In this case, stenosis is a complication of these pathologies.

But not only endogenous factors influence the development of pathology.

The most common exogenous factors are:

• entry of foreign bodies into the lumen of the upper respiratory tract;
• swelling of the mucous membranes after prolonged artificial ventilation;
• damage to the walls during surgical interventions;
• domestic injuries - wounds, gunshot wounds;
• chemical or thermal burn of mucous membranes.

Stenosis when exposed to exogenous factors is easiest to prevent; for this type, preventive measures are effective.

Important to know: Abscess in the throat and pharynx - symptoms and complications

Classification of stenoses

Depending on the speed of development of the disease, there are:

• Acute – develops in 1-2 hours, accompanied by a sudden onset of severe symptoms. These include allergic and reflex variants.
• Chronic – the formation process lasts 30 days or more. Symptoms increase gradually and appear with severe narrowing of the airways.
• Recurrent – ​​occurring repeatedly at short intervals.

1 – reduction in diameter by 2 times.

2 – narrowing from half to 2/3.

3 – from 2/3 to almost complete obstruction.

4 – the gap is impenetrable for air.

Laryngeal stenosis

The clinical course options depend on the degree of the disease and the speed of development. There are three types:

• Compensated – the syndrome exists, but it does not reduce the quality of life. This is a partial chronic stenosis.
• Subcompensated – a person has difficulty with physical activity and must take medications to relieve symptoms.
• Decompensated - an acute condition requiring medical intervention, otherwise death is possible.

Such damage to the mucous membrane has 4 stages, each of them is characterized by its own symptoms.

The first stage of stenosis is called compensated, its main symptoms are:

• At rest, a person will not have inspiratory dyspnea.
• During physical activity and even banal walking, shortness of breath, on the contrary, will become very pronounced.

A sure sign of the development of the disease is a change in breathing, but in most cases people begin to breathe slowly and deeply, and this happens both at rest and during physical activity.

The second stage of stenosis is accompanied by the following symptoms:

• The glottis decreases in size.
• The patient develops inspiratory shortness of breath, which develops even at rest.
• During diagnosis, noises begin to be heard in the respiratory tract.
• The activity of the main muscles of the sternum changes, movements become accelerated.
• The person experiences increased sweating.
• Due to lack of oxygen, the epidermis changes color and becomes bluish.

Some people at this stage begin to develop a feeling of fear; young children especially often suffer from an anxious state.

At the third stage of the disease (decompensated), the following complications develop:

• The respiratory system works in an enhanced mode, but this still does not bring results.
• During inhalation or exhalation, the larynx moves to its maximum distance.

Stages of disease development

Laryngeal stenosis is characterized by the following degrees of development:

1. At this stage compensation occurs. Breathing becomes rare and deep, pauses between inhalations and exhalations become shorter, and the heartbeat becomes less frequent.
2. At this stage of disease development, incomplete compensation occurs. Breathing is noisy. There are difficulties with inhalation, the intercostal spaces are retracted, the skin is pale. The patient becomes restless. The dynamics of an attack sometimes occur rapidly. Therefore, if conservative therapy at this stage is ineffective, surgical treatment is performed, the purpose of which is to restore the patency of the respiratory canals.
3. At this stage, maximum tension is observed in the muscular apparatus of the respiratory system. Breathing is frequent, shallow, the patient takes a semi-sitting position. The face becomes pale and bluish, severe fear, anxiety, increased sweating appear, lips, fingertips and the tip of the nose become bluish, the pulse quickens. The width of the lumen of the larynx narrows to two millimeters.
4. The fourth stage is characterized by asphyxia. Drowsiness, indifference, fatigue appear, breathing is shallow and intermittent, and the pupils dilate greatly. The epidermis takes on a gray tint, the pulse is barely visible, and the glottis narrows to 1 millimeter.

At the last stage, after a few minutes, a person loses consciousness, the bladder and intestines involuntarily empty their bladder and intestines, and cardiac arrest occurs. It is very important to provide timely assistance for a disease such as laryngeal stenosis; a person’s life may depend on it.

Stage of disease leading to death

The main symptom of stenosis is the physiological manifestations of suffocation, their severity depends on the stage of the disease and the degree of narrowing of the larynx.

In an acute process, manifestations appear simultaneously with the onset of narrowing of the glottis. The child’s motor activity sharply decreases, and the adult also tries to move less. The patient complains of squeezing or a feeling of a lump in the throat.

Difficulty in the passage of air is expressed in the form of shortness of breath. Outwardly, this is manifested by a forced posture: sitting upright or leaning forward and resting on the knees. When you inhale, the shoulder muscles tense, the intercostal spaces are drawn in, and the hollows above the collarbones become deeper.

If the narrowing progresses, air stops flowing, and brain function is disrupted due to hypoxia. This can lead to stupor or coma, and if the person is not given emergency assistance, to death.

Determining the severity of the disease depending on the severity of symptoms:

• The first is that shortness of breath occurs only during physical activity. An increase in heart rate at rest is typical. Blood pressure and body temperature are not changed. The patient's condition is satisfactory, there are minimal or no complaints.
• The second is shortness of breath when walking quietly or while sitting. Noisy breathing is heard with a frequency of more than 18-20 breaths per minute. The skin turns pale, turns blue in the area under the nose and on the fingers, and feels cold and damp to the touch. Heart rate is sharply increased. The patient is nervous and frightened, but the movements do not increase. This corresponds to a borderline level of laryngeal stenosis between grades 1 and 2, the lumen is narrowed by half.
• Third, the patient cannot get up and walk due to severe shortness of breath, weakness and dizziness, and cannot remain lying down. The nature of the pose is half-sitting, with a straight back, and the person tries to lean his hands on his knees, sitting in front of him. Respiratory movements are more often than 20 per minute. Contact is difficult due to lack of air. The patient does not answer questions, reacts poorly to other stimuli, and his gaze is unfocused.
• The fourth is the terminal state. Complete stenosis and cessation of breathing. The pulse is absent or palpable only in the carotid arteries, rare, weak filling. The pupils are dilated but constrict when exposed to bright light. Emergency assistance required.

The fourth stage is asphyxia, it is characterized by the following symptoms:

• Impaired heart function, slow pulse, decreased blood pressure.
• Since oxygen completely stops entering the body, a person’s skin becomes pale blue.
• The pupils increase in size and dilate.

Many people with such damage to the mucous membrane develop a severe cough and fever. If immediate medical attention is not provided, the patient may die within 2–3 days as the symptoms only worsen.

Experts warn that if a person suffers from stage 3 or 4 of laryngeal stenosis, he should never be allowed to lose consciousness, as this will increase the likelihood of death.

Treatment

When treating patients at the stage of compensation and subcompensation of acute and chronic stenosis, they resort to conservative and surgical treatment. The main method of treating stenosis is surgical, which involves reconstructing the structures of the trachea and larynx.

Drug treatment is of auxiliary value, aimed at preventing complications after operations and the formation of a deforming scar.

Conservative treatment

The patient is prescribed drugs that eliminate inflammation in the larynx and trachea and reduce swelling.

They use antihistamines, diuretics, and conduct a course of hormonal therapy.

Before performing a planned operation for chronic stenosis, prophylactic antibiotic therapy is used to suppress pathogenic microflora and prevent complications.

Antibiotics are administered intravenously or by inhalation for a week. Then antibiotics are taken in tablets for another 5 days.

The drugs of choice are ampicillin with sulbactam, amoxicillin, cefazolin, cefuroxime.

After tracheotomy surgery, medications are prescribed to prevent the formation of deforming scars:

1. ointments containing mupirocin, heparinoid, fusidic acid;
2. agents that improve blood circulation in tissues - actovegin, pentoxifylline;
3. antioxidants – meldonium, retinol with vitamin E;
4. multivitamins, glucose.

a positive effect during conservative treatment.

The patient is prescribed laser therapy for 12 days after surgery, electrophoresis, phonophoresis.

The first three days after surgery, antibiotics and mucolytics are injected directly into the trachea - solcoseryl, acetylcysteine, trypsin with chymotrypsin.

Surgery for laryngeal stenosis

Surgical reconstructive interventions using flexible fiber optics in combination with radical operations make it possible to achieve positive results even with the most complex deformities and injuries of the trachea and larynx.

The scope of surgical intervention is individual in each case, the assessment is made based on an analysis of the localization and degree of narrowing, ossification of cartilage tissue, and destruction of tracheal structures.

The main goal of surgery is to restore breathing. For this purpose, the first stage of the operation is performed - tracheotomy.

Tracheotomy is a surgical operation that involves creating an anastomosis between the patient’s respiratory tract and the surrounding air. A cannula is installed in the anastomosis through which the patient breathes.

Depending on the patient’s condition, the extent of the surgical operation is planned. In addition to tracheotomy, tracheoplasty and allocartilage implantation are performed.

The operation is performed under general or local anesthesia. All interventions on the trachea are complex; prosthetics are important in the rehabilitation of respiratory function.

To maintain the lumen of the trachea after tracheotomy, they resort to installing a temporary (removable) or permanent prosthesis.

To ensure rapid healing of the surgical wound, temporary functional plastic tubes are installed. If permanent prosthetics are necessary, silicone prostheses are installed.

First aid for laryngeal stenosis

If a person is taken to the hospital with stage 3 or 4 laryngeal stenosis, he requires medical attention within the first seconds; therapy must be radical, otherwise the patient will die.

Doctors often perform a conicotomy, and after that a trachecomy. The essence of the procedure is that a hole is made in the person’s larynx, into which a special tube is inserted to provide air flow.

If the tracheectomy is successful, a course of drug therapy is selected. Treatment in most cases takes place in a hospital setting.

First aid should be provided immediately, as the disease progresses within a few minutes. After calling an ambulance, you need to facilitate the passage of air into the lungs.

At home, the algorithm includes the following steps:

• Take the victim to the bathroom or kitchen, sit him next to the tap and run hot water into the bathtub or sink so that steam rises. Warm, moist air does not irritate the larynx and can quickly relieve acute spasms.
• Open windows or vents to ventilate the room.
• For swelling of the neck, it is recommended to rub the skin of the legs with a towel moistened with hot water. At the same time, blood flow in the extremities increases, blood flows away from the head and neck.
• It is necessary to remove thick clothes from the patient, unfasten buttons and belts.
• If allergic swelling of the larynx is suspected, the person should be given an antihistamine. People suffering from allergies should have first aid medicine in their medicine cabinet: Erius, Claritin, Zyrtec.
• If the patient does not suffer from severe shortness of breath and can swallow, you need to give him a warm, but not hot liquid. This will help relieve muscle spasms.
• If the cause of the spasm is a foreign body, then you should not hit the person on the back - this will lead to the object falling further into the trachea and further injuring the organ, or causing lung atelectasis. An adult needs to lean forward, hang his head between his knees and try to clear his throat. If a child is injured, you can lift him by the legs and shake him.

Medical assistance

Acute stenosis of degree 2 and higher, decompensated chronic version of the disease are indications for hospitalization. Treatment is required in a hospital.

Prescription of medications:

• Corticosteroids - used to relieve inflammation and acute allergic reactions. Relieves swelling and allows you to expand the larynx. These include Prednisolone and Dexamethasone.
• Beta-agonists - relax the muscles of the bronchi and larynx. Used for laryngospasm, asthma, chronic obstructive pulmonary disease. This group includes Berodual, a combination drug intended for inhalation.
• Adrenaline is an adrenergic agonist and is administered intravenously when stenosis threatens the patient’s life.
• Papaverine is an antispasmodic that relaxes the walls of the airways.

Eliminating the cause of the disease. Antibiotics or surgery may be required to widen the lumen, remove a tumor, or remove a foreign body. Only surgical intervention can eliminate the narrowing of the 4th degree. With stenosis, the physiological path of air is impossible, so an opening is formed - a stoma.

Types of operations:

1. Conicotomy - a puncture is made in the conical ligament connecting the thyroid and cricoid cartilages. A tube is installed in the hole to allow air to pass through.
2. Cricotomy - the cricoid cartilage is cut. This is done if narrowing of the airways occurs throughout the entire larynx.
3. Tracheotomy - the trachea is incised and a hole is created in the anterior wall.

The listed operations are considered emergency measures, and only doctors have the right to perform them, observing the rules of asepsis and performing hemostasis, otherwise the person will choke on blood.

The disease can be caused by pathological processes occurring in the respiratory tract, allergens, infections, acquired or congenital changes in the larynx.

The disease can develop slowly in a chronic form or manifest itself in the form of an acute attack - lightning-fast swelling of the larynx and complete closure of its lumen. In the latter case, emergency assistance is necessary to prevent asphyxia and save life.

Symptoms of laryngeal stenosis develop depending on several factors, namely:

1. the reasons that provoked the narrowing of the lumen;
2. forms of the disease;
3. the degree of its neglect.

The main symptom of this disease is respiratory failure. In the initial stages, it manifests itself in the form of shortness of breath, difficulty entering, rapid breathing with a characteristic noise and whistle. When the disease reaches an advanced stage, the patient can breathe only in a sitting position, experiences suffocation and may die from lack of oxygen.

Along with respiratory disorders, a patient with laryngeal stenosis exhibits the following signs of the disease:

• heartbeat disturbance;
• fast fatiguability;
• panic and anxiety caused by difficulty breathing and lack of oxygen;
• drowsiness;
• apathy to what is happening;
• choking cough;
• change in skin color depending on the stage of the disease: pallor - with the initial form of laryngeal stenosis, cyanosis of the skin and oral mucosa - with pronounced signs of asphyxia;
• disturbance of brain activity caused by asphyxia, including loss of consciousness, decreased orientation, involuntary excretion of feces and urination.

The combination of the last symptoms described above is the first sign of the onset of irreversible processes in the brain structures and the body as a whole. If treatment is not provided promptly, laryngeal stenosis can be fatal.

Causes of acute, allergic and chronic cicatricial stenosis of the larynx

Narrowing of the lumen can occur for several reasons. Acute laryngeal stenosis very often develops due to taking medications or eating foods that cause an allergic reaction and angioedema. Allergic laryngeal stenosis can be caused by eating foods such as citrus fruits, some seasonal fruits, honey, fish, seafood, etc.

In addition, the cause of the development of stenosis, especially in young children, can be respiratory diseases, which are accompanied by inflammation of the airways. Often, a narrowing of the lumen develops with sore throat, laryngitis and inflammation of the laryngeal cartilages.

The probable causes of the development of this unpleasant and dangerous condition also include:

• injuries of the larynx and chest, damage to the pharyngeal nerve;
• entry of a foreign body along with air into the respiratory tract;
• thermal and/or chemical burn of the respiratory tract.

Chronic cicatricial stenosis of the larynx develops in the presence of various tumor formations, constant inflammatory processes that do not respond to adequate therapy, as well as after suffering from syphilis or diphtheria.

Laryngeal stenosis: symptoms, causes, treatment, emergency care for stenosis

Laryngeal stenosis is a significant narrowing of its lumen - a life-threatening condition accompanied by certain symptoms. Clinical manifestations of stenosis depend on the degree of development of the disease.

To make a diagnosis, it is often enough to only evaluate a set of characteristic signs; however, to obtain a more detailed picture, instrumental examination of the organs of the respiratory system may be required.

The choice of treatment method for stenosis directly depends on the stage of development of the disease. In the early stages, stenosis can be treated with medication; in severe cases, the patient is prescribed surgery.

Structure of the larynx

The larynx is an organ whose structure resembles a tube. It is part of the respiratory system, located between the pharynx and trachea.

The structure of an organ includes various components. These are cartilage, muscle tissue and ligamentous apparatus, epithelium lining the organ from the inside.

Laryngeal cartilages

The larynx has several cartilages - 3 large unpaired elements and 3 smaller paired cartilages.

Each of them has its own structure and performs certain functions:

1. The cricoid cartilage, shaped like a ring, is the main one that helps maintain the organ in its anatomically correct position;
2. The thyroid cartilage, consisting of 4 plates fused together, performs a protective function, preventing compression of the larynx. At the site of fusion of the plates, a special bone growth (Adam’s apple) is formed;
3. The epiglottis retains particles of saliva and food, preventing their penetration into the organs of the respiratory system;
4. Wedge-shaped, horn cartilages (paired) make it possible to strengthen the ring of the lumen of the larynx and prevent its narrowing as a result of external factors;
5. With the help of arytenoid cartilages, which are also paired elements, muscle tissue is attached to other elements of the larynx.

Joints

The larynx is a mobile organ that changes its position when speaking or singing, swallowing, and also during breathing. This mobility is achieved through joints and muscle tissue. The structure of the organ includes 2 fairly large joints.

It is impossible to say right away which method of therapy will be prescribed to the patient, since everything depends on the original source of the disease, the stage of the disease, the age and general well-being of the patient.

Diagnostics

The diagnosis is established based on the results of a general examination, X-ray examination, stroboscopy, computed tomography of the larynx, trachea, and magnetic resonance imaging data.

Laboratory tests are carried out to determine the sensitivity of the microflora of the larynx and trachea to antibiotics, and a general blood test is performed.

A mandatory method for diagnosing tracheal stenosis is the endofiberoscopy method using flexible probes with an optical system, allowing the doctor to visually assess the condition of the trachea.

Endofibroscopy allows you to determine the degree of deformation of the trachea.