Acute laryngitis: causes and treatment. Acute laryngitis

Acute laryngitis is an inflammation of the mucous membrane of the larynx lasting up to 7–10 days. If after this period the symptoms of the disease still persist, laryngitis becomes protracted, and later -.

Acute laryngitis: causes

Main etiological factors acute laryngitis are:

• viruses (more often: influenza, parainfluenza, adenovirus);
• bacteria (streptococci, staphylococci, pathogens of diphtheria and tuberculosis);
• thermal and chemical burns;
• laryngeal injuries.

The development of the disease is promoted by:

• local and general hypothermia;
• unfavorable working conditions (dry hot air, air pollution with dust and chemicals);
• allergens of various nature – food, chemical, plant;
• increased load on the vocal apparatus;
• foci of chronic infection (, sinusitis,);
• chronic (rhinitis, deviated nasal septum);
• smoking and drinking alcohol.

Laryngitis of an infectious nature is usually diffuse, or diffuse, that is, in pathological process The mucous membrane of all parts of the larynx is involved. Others, more often non-infectious causes, can cause inflammation of the mucous membrane individual parts this organ - the epiglottis, vocal folds, subglottic space.

In addition, acute laryngitis rarely occurs in isolation - usually, along with inflammation of the larynx, inflammation of other parts is also observed respiratory tract(nose, pharynx, trachea, less often - bronchi and lungs).

Acute laryngitis: symptoms

Usually the disease begins suddenly: against the background of seemingly complete health, the patient feels general weakness, fatigue, and becomes irritable. Sometimes body temperature rises to subfebrile levels (38 °C).

The throat area feels discomfort, dryness and soreness; some patients are left with the sensation foreign body, coma in the throat.

At first it is dry, paroxysmal, painful, but with adequate treatment it quickly becomes productive - with the release of sputum of a mucous, less often mucopurulent nature.

Complications of acute laryngitis

The most common and dangerous complications of this disease are:

• laryngeal stenosis;
• infiltration of the epiglottis;
• abscess formation of the epiglottis.

These conditions pose a threat to the patient’s life, and therefore require urgent hospitalization in a hospital.

Diagnosis of acute laryngitis

The diagnosis of acute laryngitis is established by a general practitioner or an otorhinolaryngologist (ENT doctor) at a clinic based on the patient’s complaints, medical history and life history (acutely ill, regular vocal stress or work in a dusty room, etc.) and examination data larynx - laryngoscopy.

Depending on the laryngoscopic picture, the doctor can conclude what form of acute laryngitis a given patient has:

• swelling and redness (hyperemia) of the entire surface of the laryngeal mucosa indicates diffuse form acute laryngitis;
• if signs of inflammation are localized in only one part of the larynx, this is a limited form of the disease;
• in addition to edema and hyperemia of the mucous membrane, expanded blood vessels and mucous or mucopurulent discharge;
• pinpoint hemorrhages in the mucous membrane are usually observed with influenza - this is a hemorrhagic form of acute laryngitis;
• whitish-yellow and white deposits in the larynx are a sign of fibrinous laryngitis, gray or brown deposits are a sign of diphtheria;
• reduced tone of the vocal folds and redness around their perimeter in the absence of changes in other areas of the larynx are characteristic features laryngitis due to functional overload of the vocal apparatus. This form is confirmed by anamnestic data - excessive vocal load preceding the disease.

Acute laryngitis: treatment

The main condition successful treatment acute laryngitis in adults and children is their compliance with the rules of the medical and protective regime:

• or, when body temperature rises, bed rest;
• temporary release from work of persons with or without signs of intoxication (if the person’s work activity is related to speech - actors, teachers, announcers, vocalists, tour guides and others);
• partial or, if possible, complete vocal rest;
• maintaining an adequate microclimate in the room in which the patient is located (frequent ventilation, air temperature 18–22°C, humidity - at least 55%);
• refusal of active and passive smoking during the entire period of illness and for 7–10 days after recovery (ideally, forever).

As for the nutrition of patients with acute laryngitis, they are recommended to have a gentle diet:

• exclusion from the diet of hot, cold, spicy, irritating foods;
• refusal of carbonated, alcoholic, cold and hot drinks;
• plenty of warm drinks are prescribed: milk with honey, alkaline mineral water(“Polyana Kvasova”, Borjomi).

If there is acute laryngitis of a viral nature (with ARVI), the patient is recommended antiviral therapy– Interferon, Groprinosin, Anaferon, Amizon.

Further drug treatment acute laryngitis is prescribed depending on the symptoms present in a particular patient:

• for pain and sore throat – locally acting anti-inflammatory and antimicrobials(Tera-flu sprays, Ingalipt, Givalex, Angilex or Strepsils, Trisils, Faringosept, Decatylene lozenges);
• with dry paroxysmal painful cough– codeine-containing antitussives: Sinekod;
• for dry cough - expectorants plant based(Prospan - contains ivy extract, Alteyka - contains marshmallow extract, Gerbion - contains plantain extract);
• at productive cough to thin sputum - mucolytics (drugs ambroxol (Ambrobene, Lazolvan), acetylcysteine ​​(AC), carbocysteine ​​(Fluditec);
• if you suspect accession bacterial infection An antibacterial drug may be prescribed for local application– Bioparox;
• in case of severe swelling of the laryngeal mucosa - antiallergic (antihistamine) drugs (loratadine (Lorano), cetirizine (Cetrin, Zodak), L-cetirizine (Aleron));
• in order to improve work immune system Multivitamins (Alphabet, Multitabs, Duovit) and immunomodulatory drugs (Echinacea extract, Ribomunil) may be prescribed.

If there is no effect from the therapy or the sputum produced becomes purulent, the patient is indicated for systemic antibacterial therapy. IN outpatient setting Only tablet forms of antibiotics are used; the use of these drugs in the form of injections or infusions (droppers) is possible only in a hospital setting, since allergic reactions to them often occur. The drugs of choice are the so-called protected penicillins - Augmentin, Amoxiclav, Flemoklav. If first-line drugs are ineffective, respiratory fluoroquinolone antibiotics are prescribed - Levofloxacin, Moxifloxacin.

If therapy is carried out in inpatient conditions, it is possible to carry out instillations - infusions of solutions of anti-inflammatory and antimicrobial drugs using a laryngeal syringe into the larynx.

Nebulizer therapy - inhalations - has also proven itself well. medicines(alkaline mineral waters, mucolytics, antimicrobial and anti-inflammatory drugs) through a special device - a nebulizer.

During the period when the symptoms of acute laryngitis regress, for more quick recovery mucous membrane, physiotherapeutic treatment is prescribed - DDT to the larynx area, electrophoresis, UHF.

Prevention of acute laryngitis

Measures primary prevention should be aimed at preventing the development of the disease, that is:

• prevention of contact with infection;
• treatment of chronic foci of infection;
• to give up smoking;
• adequate voice loads;
• prevention of injuries and burns of the larynx.

Purpose secondary prevention is to prevent complications and chronicity of the inflammatory process - timely adequate treatment of acute laryngitis.

Specific preventive measures does not exist.

Acute laryngitis has the second name false croup and occurs mainly in childhood. It is important to promptly diagnose and treat this disease. curative measures. The acute form of laryngitis is characterized by the appearance of a paroxysmal barking cough, which is accompanied by loss of voice.

This disease can be treated well, but despite this, the patient must be under the supervision of a specialist, which eliminates the development of possible complications.

Causes of development of acute laryngitis

Acute laryngitis develops in children and adults due to the penetration of viruses into the body, which provoke the development of infectious diseases such as diphtheria, influenza and scarlet fever. The cause of laryngitis is chemical or mechanical irritation of the larynx, as well as overstrain of the vocal cords.

Along with the vibration created, sound is produced. If there is an inflammatory process in this area, the ligaments swell and harden. This provokes hoarseness of the voice and is the cause of aphonia ( total loss vote).

Reasons for the development of laryngitis:

• ulcerative lesions localized in the area of ​​the vocal cords;
• the appearance of neoplasms on the mucous membrane;
• chronic forms of sinusitis or sinusitis, as well as enlarged adenoids;
• cancer, trauma and stroke.

Laryngitis occurs due to the influence of a number of certain predisposing factors on the body. Among them are hypothermia of the body, abuse bad habits, poor nutrition and obesity, inhalation of polluted air and excessive strain on the vocal cords.

It is also important to take into account factors such as reduction immune defense body and work in unfavorable working conditions.

Course of acute laryngitis

Acute laryngitis treatment in both adults and children, which should be carried out in a timely manner, is sufficient dangerous disease. The pathogenesis of the disease is as follows:

1. At the very beginning, hyperemia of the laryngeal mucosa develops due to damage by pathogenic microorganisms or viruses.
2. During the inflammatory process, blood vessels dilate, which provokes the infiltration of leukocytes and is accompanied by the release of submucosal transudate.
3. Transudate causes the release of purulent or mucous exudate, which may contain an admixture of blood.
4. Due to intoxication caused by the inflammatory process, swelling occurs in the mucous membrane, which is the cause of the development of laryngeal stenosis.

Symptoms of the disease

Acute laryngitis symptoms, which determine the stage of the disease, occur suddenly. General weakness occurs unexpectedly, accompanied by irritability and fatigue. In some cases, when primary stage development, an increase in body temperature to 38 degrees is observed. There is discomfort in the throat, a sensation of a foreign body or lump.

There is soreness, dryness and rapid fatigue of the vocal cords. The voice becomes rough or may be completely absent. Initially, a paroxysmal dry cough appears. At timely treatment he becomes productive quite quickly. When expectorating, mucopurulent sputum is released.

Possible complications

Acute laryngitis treatment, which is not started in a timely manner, can provoke the following complications:

• laryngeal stenosis of varying degrees;
• abscess formation of the epiglottis;
• infiltration of the epiglottic mucosa.

These conditions pose a serious threat to the patient's life. That is why in case of acute laryngitis it is recommended to hospitalize the patient, which allows timely treatment measures to be taken and, if necessary, assistance to the patient.

Acute laryngitis symptoms and treatment in both adults and children, which are closely related to each other, should be diagnosed in a timely manner. The diagnosis can only be made by a doctor based on the patient’s complaints. The collected medical history and the results of the research procedures performed. The first step is laryngoscopy (examination of the larynx).

In accordance with the clinical picture of the disease, the specialist determines its form:

1. acute catarrhal laryngitis is mild form diseases that are accompanied by an inflammatory process;
2. the diffuse form is accompanied by redness and swelling of the mucous membrane in the larynx area;
3. in a limited form, signs of the inflammatory process are present in only one part of the larynx;
4. the hemorrhagic form is accompanied by the appearance of pinpoint hemorrhages in the mucous membrane;
5. For fibrous form Characteristic is the appearance of a whitish coating in the larynx area.

To confirm the diagnosis, general urine and blood tests are prescribed, which makes it possible to determine the increase in ESR and leukocytes in the body. X-ray examination is not very informative, but allows you to differentiate the diagnosis.

Therapeutic measures

Acute laryngitis in children, treatment that is started in a timely manner, as a rule, does not produce complications. It is imperative to ensure that the vocal cords are rested. Even in a whisper vocal cords They get tense, so there’s no point in talking at all. It is important to exclude such traumatic factors as tobacco smoke, dust and fumes. The air in the room should be humidified and fresh. It is recommended to follow a diet devoid of spicy, alcoholic and spicy foods.

If laryngitis occurs against the background of ARVI. Then the patient is prescribed antiviral drugs. Suitable for these purposes are: local antiseptics, like Dekvaliey and Timol. If necessary, the doctor prescribes oral antibiotics. Among the most safe drugs Bioparox can be distinguished.

If there is a cough, expectorant medications are prescribed. It is recommended to give the patient to drink alkaline mineral water and use potassium iodide.

When carrying out antibacterial therapy, it is important to prescribe drugs intended to restore intestinal microflora(Linex, Bifiform or Lactovit). Paracetamol, Aspirin and Ibuprofen help reduce high fever. Sore throat is relieved with aerosols such as Orasept, Ingalipt, Hexasprey.

Elimination of mucosal edema

At false croup swelling and spasm in the larynx should be eliminated:

1. Oral inhalation using a nebulizer with 5% ephedrine, 0.1% atropine and adrenaline, hydrocortisone, diphenhydramine and chymopsin.
2. Injections of the corticosteroids dexamethasone or prednisolone.
3. Introduction « lytic mixture", which includes an antihistamine (suprastin, diphenhydramine), an antispasmodic (papaverine, drotaverine) and analgin (added for fever).

In case of laryngeal stenosis, the patient must be hospitalized in a hospital where resuscitation measures. In order to prevent the development of laryngitis, infectious diseases should be treated in a timely manner, avoid contact with infected person, prevent burns and injury to the mucous membrane in the larynx, control the load on the vocal cords.

Acute laryngitis is the most common inflammatory disease of the larynx. People encounter it different ages and floors. For what reasons can laryngitis occur and how to identify it? Why is he dangerous? How to treat it correctly? You will learn the answers to these and other questions from this article.

Features of the disease

Laryngitis

Laryngitis can appear on its own, but in most cases it occurs against the background viral diseases upper respiratory tract. It is often accompanied by inflammation of the trachea, bronchi and pharynx (,).

Acute laryngitis occurs:

• (the mucous layer becomes inflamed). This form is the most common and easiest;
• edematous (inflammation affects the submucosal layer, the course of the disease is more severe);
• . Most dangerous look laryngitis, found in in rare cases.

Inflammation begins in mucous layer, then moves to the submucosal, and in severe cases- on muscle layer. This may happen due to improper treatment or its absence, as well as due to the body’s weak resistance.

Inflammation of the larynx is accompanied by redness and swelling of the tissue. Laryngitis can be isolated (for example, it affects only the epiglottis) or affect all parts of the organ, which sometimes leads to stenosis, which is life-threatening.

The duration of acute laryngitis is 1-2 weeks. If the disease drags on, then there is a possibility of transition to.
Occurs in children special shape laryngitis, which is called false croup. This disease is very dangerous and requires immediate appeal in hospital.

Causes of acute laryngitis

What causes laryngitis? The causative agents of this disease are usually various infections. These can be viruses (measles, scarlet fever, diphtheria), bacteria (staphylococci, streptococci, etc.) and, extremely rarely, fungi. Sometimes several infections are present at once.

It is known that the microflora of the larynx contains opportunistic bacteria and microorganisms (pneumococci, Haemophilus influenzae, Moraxella catarrhalis, Neisseria). IN normal conditions our body is able to fight them on its own, but when the immune system is weakened, they begin to actively multiply and cause diseases. That is, the main cause of laryngitis is weak body defense.

There is also a list of factors that influence the development of inflammation in the larynx:

• polluted, dusty air. This problem is faced by people in large cities with poor environmental conditions and those who work in hazardous industries;
• eating food that is too hot or spicy food and drinks that irritate the walls of the throat;
• overstrain of the vocal apparatus (for example, when shouting or working in people of vocal professions);
• drinking alcohol and smoking;
• injuries and tumors of the throat, microcracks in the mucous membrane;
• talking in the cold and hypothermia of the throat;
• chronic diseases of the upper respiratory tract.

At risk are people who, for some reason, have difficulty breathing, increased sensitivity of the mucous membrane of the larynx, metabolic disorders, caries or other dental diseases.

Also, acute laryngitis in adults can appear as a result allergic reactions, constant heartburn, and in rare cases it becomes a complication of tuberculosis, syphilis, cancer (Wegener's granulomatosis, scleroma) and rheumatoid arthritis.

For coughs, drugs that reduce the excitability of the cough center are prescribed:

1. Kodilak. The tablets contain codeine, a substance that affects the cough center. Sodium hydrocarbon reduces the viscosity of sputum, and licorice root and thermopsis herb help to expectorate it;
2. Glycodin. It contains Dextromethorphan, which reduces the excitability of the cough center, Terpinhydrate (reduces the viscosity of sputum and promotes its release), and Levomenthol (reduces irritation and soothes the mucous membrane). Sold as syrup;
3. Gederin syrup. This is a drug plant origin, which is made from ivy leaf extract. It has an antiseptic, wound-healing, anti-inflammatory, expectorant and tonic effect;
4. Libexin. Its antitussive effect is due to prenoxdiazine. Libexin is available in tablets.

Additionally, gargle 3-4 times a day.

How to gargle for acute laryngitis? For this purpose, decoctions from various medicinal plants: chamomile, sage, calamus root, nettle, St. John's wort, calendula, fennel. Soda and saline solutions not recommended.

In advanced cases, for the treatment of acute laryngitis in adults, use steam inhalations with the addition of drugs. Inhalations with laryngitis have a pronounced anti-inflammatory and anti-edematous effect.

To distribute the medication evenly and enhance the therapeutic effect, a device called a nebulizer is used. This is an inhalation device that converts liquid preparations into an aerosol. nebulizer helps relieve inflammation and unpleasant symptoms, moisturize the mucous membrane of the larynx and reduce the viscosity of sputum. You can also use a special inhaler or simply breathe in the steam from the medicinal solution.

What products can be used for inhalation:

• miramistin or dioxidin (antibacterial);
• alkaline mineral waters, for example, Essentuki. Help eliminate dry throat;
• mucolytics (chymopsin);
• aromatic oils of mint, menthol, eucalyptus (to relieve irritation, soreness and pain, as well as treat cough);
• herbal decoctions (chamomile, oregano, sage) with antimicrobial, analgesic, soothing, and anti-inflammatory properties.

Inhalations for acute laryngitis are carried out three times a day, their duration is 5-10 minutes.

In addition to treatment, physical procedures may be prescribed, for example, UHF, microwave therapy for the throat area, electrophonophoresis.

Compresses on the throat for laryngitis are not so effective and, according to some reports, can lead to complications, so it is better not to use them.

Antibiotics for acute laryngitis are prescribed if diagnosed severe swelling larynx and severe intoxication of the body. They are also prescribed if, after 4-5 days of treatment with other methods, the disease continues to develop. Antimicrobial therapy is usually carried out in a hospital setting. Used with clavulanic acid (), fluoroquinolones or macrolides (Azithromycin). Antimicrobials for acute laryngitis they are used together with medicinal installations.

When injections are performed antihistamines: Tavegil, Histidil. And glucocorticosteroids: Dexamethasone, Prednisolone.

Surgical treatment of acute laryngitis in adults is carried out with the development of purulent complications.

During the treatment of acute laryngitis, treatment for diseases of the upper respiratory tract, gastroesophageal reflux and sanitation of the oral cavity should be carried out (if necessary).

Acute laryngitis: treatment with folk remedies

Folk remedies can be used to treat laryngitis as aid. What is used to treat acute laryngitis at home:

• honey. Prepare a solution from warm water and a couple of spoons of honey and gargle with it 2-3 times a day. For greater effectiveness, add a little lemon juice or cranberries - they are also useful;
• gargling with herbal decoctions (chamomile, sage, calamus root, nettle, St. John's wort, calendula, fennel), which are carried out every hour;
• warm milk and eggnog. To prepare the latter, you need to take 2 yolks and grind them with sugar and butter. Some people add honey and milk. This drink coats the throat and eliminates pain, burning, cough;
• vodka compresses. Moisten the gauze - cotton bandage in vodka, apply to the throat. Cover the top with plastic and wrap it with a warm scarf. Leave overnight;
• decoction of anise seeds, which is consumed internally. To prepare it you will need 250 ml of water and 100 g of seeds. Boil water and add anise, wait another 15 minutes, then remove from heat and let cool. You can add honey to the mixture. Drink up to 7 times a day;
• foot baths with mustard.

Important! Before using any product, consult your doctor!

Informative video

Disease prevention

To prevent laryngitis you must:

• carry out treatment in a timely manner inflammatory diseases upper respiratory tract;
• avoid hypothermia, too cold and hot food;
• to refuse from bad habits;
• take medications to prevent flu and colds;
• avoid straining the throat;
• increase immunity (harden yourself, drink vitamins, eat healthy food);
• ventilate the room in which you live and maintain normal air humidity. Don't forget about wet cleaning.

It is also important to follow basic hygiene rules, such as washing your hands and brushing your teeth, and to prevent complications, do not self-medicate and do not prescribe antibiotics for yourself!

– acute or chronic inflammatory process in the mucous membrane of the larynx and vocal cords, most often of a viral nature. It manifests itself as a feeling of dryness, scratching in the throat, hoarseness or lack of voice, and a “barking” cough. In children younger age There is a danger of developing false croup - swelling of the laryngeal mucosa, blocking the flow of air. The prognosis is generally favorable; the acute form of the disease may transition to chronic.

General information

– acute or chronic inflammatory process in the mucous membrane of the larynx and vocal cords, most often of a viral nature. It manifests itself as a feeling of dryness, scratching in the throat, hoarseness or lack of voice, and a “barking” cough. In young children, there is a danger of developing false croup - swelling of the larynx, blocking the flow of air. The prognosis is generally favorable; the acute form of the disease may transition to chronic.

Acute laryngitis

Acute laryngitis rarely develops as an independent disease. Usually it is one of the manifestations of ARVI, measles, influenza, whooping cough, scarlet fever and a number of other diseases. It is seasonal.

The risk of developing acute laryngitis increases with general or local hypothermia, inhalation of dusty air and irritants, overstrain of the vocal cords, smoking, gastroesophageal reflux, alcohol abuse. Risk factors may include age-related changes larynx (deformation of the vocal cords, insufficient hydration of the mucous membrane, muscle atrophy).

Classification

Depending on the nature and depth of the lesion, two forms of acute laryngitis are distinguished:

• Acute catarrhal laryngitis. The process involves the mucous membrane, submucosal layer and internal muscles larynx.
• Acute phlegmonous laryngitis. Purulent lesion superficial layers, muscles and ligaments of the larynx. Sometimes cartilage and periosteum are affected.

Symptoms

The disease begins acutely against the background of complete health or slight malaise. Patients complain of dryness, burning, tickling, and scratching in the larynx. Sometimes there is a sensation of a foreign body, a convulsive superficial cough or pain when swallowing. The voice “sits down”, becomes rough and hoarse.

It is possible to develop aphonia, in which the patient can only speak in a whisper. Body temperature is normal or subfebrile. After some time, the cough becomes wet and separates when coughing. a large number of mucous or mucopurulent sputum. The duration of acute laryngitis is 7-10 days. In most cases, recovery occurs. Possible transition to subacute or chronic laryngitis.

Complications

When the inflammatory process spreads to the subglottic space, acute laryngeal stenosis develops. In young children, acute laryngitis is sometimes accompanied by severe swelling of the laryngeal mucosa (false croup). Air access becomes difficult, the child suffocates, worries, and cries. At severe course Due to hypoxia, brain function may be disrupted. Loss of consciousness and even coma are possible. Symptoms of false croup are an indication for urgent hospitalization.

Diagnostics

The diagnosis of acute laryngitis is established by an otolaryngologist based on the characteristic clinical picture and the results of a laryngoscopic examination. Laryngoscopy reveals swelling and diffuse hyperemia of the laryngeal mucosa, thickening and hyperemia of the vocal folds. There are pieces of sputum on the surface of the vocal cords. With the flu, hemorrhages sometimes appear in the mucous membrane.

IN general analysis leukocytosis is determined in the blood. If the bacterial nature of the infectious agent is suspected, a bacteriological examination of the discharge and swabs from the oropharynx is carried out.

Treatment

Treatment of acute laryngitis is carried out on an outpatient basis. In case of acute laryngitis that occurs against the background of ARVI, the patient is prescribed bed rest. In other cases, exemption from work is issued only to persons whose work requires constant performances (presenters, artists, teachers, lecturers, etc.).

Patients with acute laryngitis are advised not to talk if possible. When speaking, you should speak as quietly as possible, but not in a whisper, pronouncing the words as you exhale. Spicy, cold and hot foods are excluded from the diet. Smoking or drinking alcohol is prohibited. For thick, viscous sputum, expectorants (liquid thyme extract, potassium bromide, marshmallow root extract) and sputum thinners (ambroxlol, bromhexine, acetylcysteine) are prescribed. It is recommended to drink warm alkaline water. To reduce inflammation, steam inhalations and warming semi-alcohol compresses are used on the neck area. Aerosol antibiotics are used locally. Perform distracting procedures (mustard plasters, moderately hot foot baths). If acute laryngitis lasts for a long time and treatment is ineffective, antibiotic therapy is performed.

The prognosis is favorable. IN in some cases transition from acute laryngitis to chronic is possible.

Chronic laryngitis

Chronic laryngitis can be the outcome of acute laryngitis or develop as a result of prolonged exposure to irritating factors (dust in the air, inhalation of irritating substances, smoking, etc.). In people of certain professions (speakers, lecturers, artists), laryngitis occurs as a result of constant overstrain of the muscles and ligaments of the larynx.

Classification

Based on the nature of the lesion, catarrhal, hyperplastic (limited or diffuse) and atrophic chronic laryngitis are distinguished. People in vocal professions develop limited hyperplastic laryngitis (vocal cord nodules, also called singers' nodules or screamers' nodules).

Symptoms

The general condition is not disturbed. Patients report hoarseness, a feeling of rawness and sore throat, fatigue vote. Cough with sputum appears periodically. Symptoms intensify as the process worsens.

Diagnostics

The basis for the diagnosis of “chronic laryngitis” is clinical picture and data from laryngoscopic examination. Laryngoscopy of a patient with chronic catarrhal laryngitis reveals congestive edema and hyperemia of the laryngeal mucosa.

The characteristic laryngoscopic picture of diffuse hyperplastic laryngitis includes swelling, hyperemia, thickening of the mucous membrane, fusiform thickening of the free edges of the vocal cords. With limited hypertrophic laryngitis, symmetrical nodular formations are observed. The lumen of the larynx is filled with thick mucus.

A laryngososcopic examination of a patient with chronic atrophic laryngitis reveals dryness and thinning of the laryngeal mucosa. The larynx is covered with thick mucus that forms crusts.

Treatment

Factors that support inflammation should be excluded and the correct voice mode should be observed. Patients are advised to give up smoking, drinking alcohol, spicy, hot and cold foods. Warm drinks, physiotherapy (quartz, UHF, magnetic therapy), alkaline and oil inhalations are prescribed.

Areas of hypertrophy in chronic hypertrophic laryngitis are cauterized with 5% silver nitrate, large nodules are removed surgically. Surgery is performed to remove excess vocal fold tissue. Patients suffering from chronic atrophic laryngitis are recommended to lubricate the larynx daily with Lugol's glycerin solution. To soften the crusts and facilitate the process of their removal, aerosol preparations of proteolytic enzymes (chymotrypsin, chymopsin) are prescribed.

Upper respiratory tract diseases are widespread among all segments of the population. Respiratory infection Anyone can get sick. But it proceeds differently, depending on the level of damage. One of these options is acute laryngitis. It is more common than others in the structure of laryngeal pathology. This means that it would be useful to consider the features of the disease: what is laryngitis, how does it manifest itself? acute form and how to treat inflammation.

Laryngitis is an inflammation of the mucous membrane of the larynx. An acute process occurs under the influence of an infectious agent, that is, various microbes: bacteria, viruses, fungi or their associations. But a damaging stimulus can also have completely different effects. Therefore, in the mechanism of development of laryngitis great importance is paid to non-infectious factors:

• Eating food that is too hot or cold.
• Bad habits (smoking, drinking alcohol).
• Occupational hazards (dust, chemical aerosols).
• Overstrain of the vocal cords (singers, speakers, teachers).
• Traumatic injuries to the larynx and pharynx.
• Allergic reactions.
• General hypothermia.
• Gastroesophageal reflux.
• Reducing the body's immune reactivity.

Quite often, laryngitis develops as a result of activation of flora, which is already found in a person’s nasopharynx and laryngopharynx. These microbes are saprophytes, but when favorable conditions capable of becoming pathogenic. And a decrease in local and general defenses of the body only contributes to this.

Inflammation can also spread from other parts of the upper respiratory tract with nasopharyngitis and rhinitis. Often the laryngeal lesion is part of the structure common infections(measles, rubella, influenza). Even ordinary ARVI with laryngitis is a fairly common condition.

Classification

Laryngitis, as an inflammatory process in the upper respiratory tract, varies in clinical course. According to the generally accepted classification, damage to the mucous membrane of the larynx has acute or chronic form. The latter is characterized by long-term inflammation. But acute laryngitis occurs against the background of complete well-being. In turn, it has several varieties:

1. Catarrhal.
2. Infiltrative.
3. Phlegmonous (purulent).
4. Subglottic (false croup).

This division is based on the principle of the prevalence of the inflammatory process, and therefore its severity. A separate form of laryngitis is represented by false croup, in which a narrowing of the airway lumen occurs. It occurs in childhood and is caused by the anatomical features of the subglottic space - the presence of loose fiber, which gives a pronounced reaction to the introduction of an infectious agent.

According to the generally accepted classification, there are several variants of acute laryngitis, which have their own characteristics.

Clinical picture

Symptoms of laryngitis by and large determined by the prevalence of the inflammatory process. It can affect the entire mucous membrane or a separate area of ​​it: the interarytenoid, or subglottic space, epiglottis, vestibular region, vocal cords. If we consider the typical course of the disease, the most common symptoms of acute laryngitis will be the following:

• Feeling of soreness and soreness in the throat, feeling of a foreign body.
• Pain that worsens when swallowing solid food (dysphagia).
• Hoarseness and hoarseness of the voice (dysphonia), up to its complete absence (aphonia).
• Dry hacking cough (“barking”).
• Discharge of viscous mucopurulent sputum.
• Temperature increase.
• Malaise and general weakness.

During a medical examination using an ENT speculum or a laryngoscope, the reddened and swollen mucous membrane of the larynx is visible, the vocal folds are thickened and do not close completely. Even when only marginal hyperemia of the vocal cords is present, acute laryngitis is diagnosed ( limited form). Regional The lymph nodes(angle-maxillary, cervical) are palpated enlarged, densely elastic and painful. If the pathology occurs against the background of respiratory viral infection, then there will be other symptoms: both local (nasal discharge, sneezing) and general (intoxication syndrome).

Phlegmonous or purulent laryngitis is accompanied by a sharp increase in sore throat, significant deterioration general condition (heat). During laryngoscopy, infiltration is detected in any area. If in its center you can see yellow spot, then we can talk about the formation of an abscess. Most often it forms in the area of ​​the epiglottis or arytenoid cartilages.

False croup (stenotic laryngitis) appears due to acute infection upper respiratory tract. Against the background of its usual symptoms - runny nose, cough, sore throat, low-grade fever– a sudden attack of difficulty breathing (choking) occurs. Most often this occurs at night and is accompanied by a “barking” cough, blueness or cyanosis of the facial skin. Due to swelling and spasm of the larynx, it is difficult for the child to inhale, i.e., inspiratory dyspnea develops. He takes a forced position: sitting, leaning his hands on the edge of the bed. Accessory muscles are involved in breathing, as can be seen from the retraction of the intercostal spaces, supra- and subclavian zones, the jugular notch, and the epigastrium. This attack lasts up to 30 minutes, after which the child falls asleep again.

Acute laryngitis manifests itself quite vivid symptoms caused by a violation of all functions of the larynx.

Additional diagnostics

The diagnosis of laryngitis in most cases is based on the results clinical examination: complaints, medical history, laryngoscopic signs. But often you have to use additional research, for example, a blood test and a nasopharyngeal swab for flora. This will clarify the origin of the inflammatory process in the larynx.

Cases of acute laryngitis in children (false croup) require differential diagnosis with such a formidable infectious disease like diphtheria. It differs in that difficulty breathing does not occur due to swelling or spasm, but due to a mechanical obstacle - fibrinous films. In this case, the mucous membrane will be cyanotic in color, and toxic swelling of the neck is characteristic. With false croup, there will be no hoarseness of the voice, and diphtheria does not manifest itself as a “barking” cough. Dangerous diagnosis can be assumed based on the clinical and laryngoscopic picture, and confirmed based on the results of the analysis of smears and films on the Loeffler stick. And only when diphtheria is completely excluded, treatment of acute laryngitis can be carried out. Otherwise, the tactics will be completely different.

Treatment

Probably, the question of how to treat laryngitis is relevant for every patient. Therapeutic tactics are determined by the type and nature of the inflammatory process, its prevalence and concomitant conditions. The structure of treatment measures includes both general and more specific ones.

When acute laryngitis is diagnosed, treatment must be accompanied by compliance with certain rules. First of all, patients need a gentle voice regime. It involves complete silence until subsidence active inflammation. Rest of the larynx is important during the first 5–7 days. For decreasing negative impact on the mucous membrane, you must also adhere to a diet. Dishes must be at the optimal temperature (hot and cold are contraindicated); it is not recommended to eat hot and spicy, salty and smoked foods. It is recommended to abstain from smoking and drinking alcohol while acute laryngitis is being treated. It is better to maintain relatively high humidity in the room.

With stenosing laryngitis in children, copious amounts of alkaline drink, for example milk or mineral waters. Distractive procedures, such as foot baths or mustard plasters, are indicated as first aid. To suppress a hacking cough, you can call vomiting reflex by pressing the spoon on the root of the tongue.

Medicines

The basis of therapeutic measures for laryngitis is the use of medications. Medications aimed at suppressing the inflammatory process and destroying the infectious factor. Even when laryngitis is acute, you can limit yourself to local forms of medication in the form of irrigation and inhalation. For this purpose they use the following groups drugs:

1. Antiseptics (Givalex, Faringosept).
2. Antibacterial (Bioparox, Chlorophyllipt).
3. Anti-inflammatory (Cameton, Proposol).

If laryngitis is purulent, then you will have to take medications with a systemic effect. Antibiotics, antiviral or antifungal – necessary drug will be prescribed by a doctor, taking into account the cause of inflammation. For dry cough and sticky sputum, mucolytics (ACC, Lazolvan) will help, and for false croup, antispasmodics (No-shpa) are indicated. Take off allergic component allow antihistamines(Suprastin, Tavegil), and glucocorticoids (hydrocortisone, dexamethasone) have an anti-edematous and powerful anti-inflammatory effect. Also, to activate the body's defenses, immunostimulants (Laferon, Taktivin) and vitamins are used.

Laryngitis is mainly treated with medication. Usually the drugs are taken as local forms, and sometimes there is a need for systemic therapy.

Invasive treatment

In some cases, acute laryngitis must be treated using invasive techniques. If an abscess develops in the larynx, the abscess will still have to be opened. This is done by an ENT doctor as an emergency. Under local anesthesia it opens the infiltrate and evacuates its contents. The cavity is washed with antiseptics. At the same time, detoxification and powerful antibacterial therapy are carried out, painkillers and antiallergic drugs are used.

If conservative treatment in case of false croup it was not effective, and external respiratory disorders increase, then the child is given tracheal intubation for several days. If necessary, a tracheostomy is even performed. The latter technique is also indicated for large processes in the larynx (including abscesses).

Almost anyone can experience acute laryngitis. This disease is characterized by damage to the mucous membrane of the larynx, has an inflammatory nature and manifests itself quite brightly. clinical signs. But to avoid complications, you should seek treatment as early as possible. medical care. The attending physician will diagnose and prescribe treatment for laryngitis, which will relieve the patient of acute inflammation.