Laryngeal edema
| Classification according to ICD-10 | |
|---|---|
| J38.4 | Laryngeal edema |
| ICD-10 online (WHO version 2019) | |
Under a laryngeal edema is meant an edematous swelling in the area of the larynx . Laryngeal edema is usually not an independent disease, but rather the result of various diseases or harmful effects in the larynx area. Because of the fundamental possibility of suffocation , laryngeal edema is in any case a serious clinical picture that may require rapid action.
Causes and development
The most common causes of laryngeal edema are inflammations in the vicinity of the larynx (e.g. peritonsillar abscess , tongue abscess ), foreign body injuries or impaled foreign bodies, deep neck wounds, broken larynx, as well as burns and chemical burns. Other causes include Quincke's edema , insect bites, allergic edema, malignant tumors in the larynx and radiation as part of radiation therapy .
The laryngeal edema primarily affects the structures of the larynx, i.e. the epiglottis , the area of the aryan cusps and the aryepiglottic fold. The pocket folds and the subglottis, i.e. the tissue directly under the vocal cords , can also be affected .
A distinction is made between the rapidly onset, acute laryngeal edema and chronic laryngeal edema, which develops slowly.
Diagnosis and symptoms
The laryngeal edema itself is not painful (but the underlying inflammation is very common), there is a sensation of a foreign body, especially when swallowing, and an occasional urge to cough. The voice is primarily not impaired, as the vocal cords are not affected by the edema, but a possible restriction of movement of the arytenoid cartilage results in a certain hoarseness. With increasing constriction of the larynx, shortness of breath occurs, which in acute laryngeal edema can quickly become life-threatening. Objective signs of narrowing of the larynx are stridor and the retraction of the yielding parts of the neck, e.g. B. Jugulum .
If a laryngoscopic examination is possible, yellowish or reddish, glassy-cloudy, bulging swellings of the larynx with a smooth mucous membrane can be found. The epiglottis can be swollen. It is usually not possible to look inside the larynx.
treatment
In the case of laryngeal edema, the patient must be closely monitored, if possible under inpatient hospital conditions. Since intubation is often not possible, an emergency cricothyrotomy or tracheostomy must be provided. On conservative measures, corticosteroids are given and inhalations with adrenaline . In the further course the cause of the laryngeal edema must be clarified and specific treatment initiated.
literature
- E. Lüscher: Textbook of nose and throat medicine , Springer-Verlag, Vienna 1956
- AK Lalwani (Ed.): Current Diagnosis & Treatment in Otolaryngology - Head & Neck surgery . Lange Medical Books, New York, 2004
