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Laryngitis in children: signs, symptoms and treatment, prevention measures

In the system of ENT pathologies, laryngitis in children takes the leading place among pediatric diseases. It is caused by inflammatory reactions in the mucous membrane of the laryngeal membrane and in the structure of the elastic tissue of the vocal cords. The most prone to the disease are toddlers and preschoolers.

In almost 35% of small patients (up to 2 years of age), catarrhal ARD pathologies are accompanied by laryngitis. It rarely occurs independently and, as a rule, manifests itself in tandem with infectious tracheitis or with inflammation of the bronchi. But more often, with both of them at the same time - laryngotracheobronchitis.

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Causes of laryngitis in children

Laryngitis in children

Most often, the cause of the disease is caused by the effect on the body of various forms of viruses - influenza viruses and parainfluenza, adenoviruses, recryptor syncytial and measles viruses, herpes viruses and adenoviruses.

The disease of bacterial genesis infrequently affects babies, but if it does, it occurs in severe form. To provoke bacterial laryngotracheitis can:

  • Hemophilic infection (Afanasyev-Pfeiffer wand);
  • representatives of coccal infections (staphylococcus, streptococcus and pneumococcus);
  • pertussis pathogen - Bordetella pertussis.

The impetus for the development are many factors:

  • hypothermia (hypothermia);
  • nasal congestion;
  • vitamin deficiency;
  • weakening of immune functions;
  • exacerbation of ENT diseases.

The maximum susceptibility to laryngitis, in children under one year old, are children suffering from lymphatic diathesis. The most common allergic form of the disease.

The development of laryngitis allergic genesis in children and older children, often provoke:

  • chemicals - components of household chemicals;
  • paint pairs;
  • dust and pet hair;
  • uncontrolled use of medicinal sprays and aerosols for the treatment of nasopharynx;
  • strong shouting and choral activities at school causing vocal chords overstrain;
  • the impact of food allergens;
  • spasm of the larynx as a result of severe shock, trauma, aspiration, or the acidic environment of the stomach as a result of gastroesophageal reflux (the return throw of food).

Genesis of the disease

Genesis of the development of the disease in children

The genesis of the development of the disease is due to the anatomical feature of the structure of the children's breathing apparatus - a narrow lumen, funnel-shaped, rather than cylindrical, as in adults, a form of breathing tube (larynx), friability of the mucous layer and tissues of the internal environment (connective), their predisposition to edema, innervation capacity, failure of the respiratory muscle muscles.

It is precisely these physiological properties of the children's organism that explain the frequent development of obstruction processes and the ONE syndrome (acute respiratory failure), with laryngitis.

For example, if the edema provoked by the disease leads to at least one millimeter thickening of the upper mucous layer, the child's respiratory lumen will decrease by exactly half, which will create certain difficulties with breathing.

In the genesis of obstructive syndrome, a certain role is caused by a genetic factor - a predisposition to reflex muscle spasm or mechanical causes, blockage of the laryngeal cavity with foreign bodies, or inflamed mucus. Abnormal abdominal constriction of the respiratory tube and failure in breathing usually occur at night, due to changes in blood and lymphocirculation.

Given the nature of the clinical manifestations of the disease, it can manifest an acute course, chronic, complicated and uncomplicated condition.

Among the many varieties of manifestation, according to endoscopic classification, children are prone to catarrhal and hypertrophic type of laryngitis. If the catarrhal manifestation of the disease is noted only by inflammatory reactions in the upper (mucous) layer of the laryngeal tube covering, the hypertrophic variant is characterized by hyperplasia and proliferation of the basal layer.

According to the prevalence of inflammation reactions, laryngitis can be - laryngitis subchordalis (subglottic, the usual name is false croup), diffuse (diffuse), or laryngotracheobronchitis manifest.

Acute laryngitis in children

Clinic of acute course appears in children on the third day of the presence of cold infections. According to statistics, boys from 3 to 5 years are more often exposed to it. At this age, the disease, rapidly progressing, is accompanied by the development of acute inflammatory processes in the mucous structure of the larynx and trachea (laryngotracheitis).

Violations in the condition of the child are characterized by characteristic symptoms:

  • hoarseness and hoarseness;
  • unpleasant tickling (tickling) in the throat and difficulty swallowing;
  • swelling and narrowing of the airway, which provokes breathing difficulties;
  • the spread of inflammatory reactions to the tissues of the vocal cords, in many cases, there is a loss of voice;
  • barking cough exhausting baby;
  • appetite worsens and temperature rises (38.0 ° C and higher);

Heavy breathing is accompanied by a whistle. Delay in the treatment of the disease, with its acute manifestation, may be complicated by a sharp breathing disorder and lead to suffocation (laryngospasm). Usually such attacks are noted at night.

It can easily be noted that auxiliary, skeletal muscles are included in the breathing process - a sure sign of a lack of oxygen.

At the same time, marked intercostal and supraclavicular muscles. Self-treatment in such cases is unacceptable. The call of the ambulance crew and the treatment of laryngitis in children with a symptom of laryngospasm should be immediate.

In an uncomplicated form of the disease, the symptoms of the disease disappear within one, two weeks.

Chronic form is inherent in older children.

Appears:

  • persistent or periodic loss of voice (dysphonia);
  • rapid fatigue and weakness of voice;
  • sadness and unpleasant tickling in the throat;
  • dry paroxysmal cough.

Symptoms of laryngitis in children

Symptoms of laryngitis in children

In the acute process, the disease develops within a couple of hours, depending on the intensity of the inflammatory reactions, due to four stages of development.

First stage. At the first stage of the genesis of laryngitis in children, the symptoms manifest themselves in a mild and mild form, against the background of the anxiety of the little man or his natural activity.

Breathing becomes rapid and noisy, when you inhale shortness of breath is noted - this indicates a normal level of carbon dioxide in the blood and the absence of a violation of the blood. The duration of the first stage of the disease is up to two days.

Second phase. Characterized by increased symptoms. Signs of dyspnea at rest and constant manifestation during inhalation are associated with noisy breathing.

Only the increased respiratory muscle work compensates for the lack of oxygen. In the thoracic region, soft tissue is attracted, which increases with tension in the sternum. Wherein:

  • babies are restless, sleep is disturbed;
  • against the background of pale skin, a bluish halo is clearly visible around the lips;
  • heart palpitations.

Such signs may be permanent or periodic for 5 days. Treatment should be stationary.

At the third stage, the cough increases, becomes coarse, and subsequently superficial. Shortness of breath manifests itself in any breathing. It is constantly changing. That noisy, frequent and irregular, then quiet and superficial.

The deterioration of metabolic processes and blood circulation causes an increased work of the respiratory muscles. The condition is characterized as heavy, it is noted:

  • restlessness, lethargy and drowsiness;
  • decrease in a sound of a voice and its hoarseness;
  • signs of abdominal pulling while breathing;
  • drop in blood pressure and heart rate failure.

Final stage. Very serious and dangerous condition - asphyxia. Characterized by:

  • convulsive manifestations;
  • decrease in temperature indicators;
  • possible development of coma;
  • rapid breathing or its complete absence;
  • slow heart rate;
  • a change in the blood gas component to critical levels;
  • addition of toxicosis and other complications.

The symptoms speak for themselves, so urgent medical intervention is required, even if the child’s condition does not cause anxiety to the parents. You should not wait for increased symptoms and bring the child to loss of consciousness.

Features of the manifestation of the disease in children up to a year

laryngitis in infants and children under one year

Already at 3 months of age, babies may be prone to laryngitis. This is due to the fact that it is very difficult for a small organism, which is not quite adapted to the external environment, to prevent the penetration of a microbial infection to such a depth.

In older children, the respiratory system is more developed and they often suffer from rhinitis or tonsillitis, and less likely to undergo inflammatory processes in the laryngeal tube and tissues of the vocal cords.

The body of infants is untenable in the fight against such pathology, therefore, it is not recommended to neglect medical assistance under any circumstances. Especially when the temperature rises and a barking cough is observed. This can be a sign of a rapidly developing edema of the larynx and provoke the death of a baby.

What should alert the parents?

  1. Anxiety of the baby and a strange wheezing sound when breathing.
  2. Unreasonable snoring, frequent or difficult breathing.
  3. The presence of blue in the nasolabial area, especially in the morning.
  4. The appearance of a barking dry cough with subsequent sputum production.
  5. Signs of swelling and hyperemia of the larynx.
  6. Frequent cry that can talk about pain in the throat or in the head.
  7. Increased temperature, as a consequence of the inflammatory process.

Diagnostic examination

Diagnosis of laryngitis

In many cases, the pathology is diagnosed during the physical examination of the patient and his acquaintance with his history and clinical signs. Special otolaryngological studies include:

  • Methods of pharyngoscopy, otoscopy and rhinoscopy.
  • Palpated assessment of the state of the cervical lymph nodes.
  • Laryngoscopy, as the main instrumental method of diagnosis, which allows to detect hyperemia, swelling, see the state of the vessels, possible hemorrhages in the vascular cover of the larynx, thickening of their folds, changes in the closure of the vocal ligament apparatus, when testing for vocation (phonation).
  • The CRC examines a secret from the larynx to identify bacterial or viral pathogens.
  • The study of voice functions with the involvement of the phoniora and the speech therapist.

Treatment of laryngitis in children

To cure laryngitis in children helps the triad of the main activities - clinical recommendations, methods of drug and physiotherapy. The clinical recommendations are based on the necessary measures, the observance of which must be strictly followed.

  1. Restriction of the motor activity of the baby during the period of elevated temperature, if possible - bed rest (although it is difficult to limit it).
  2. Switch to silent mode. Unload your vocal cords as much as possible. Do not even communicate in a whisper. Take your child interesting business, show imagination.
  3. Provide your baby with a warm, non-irritating drink (milk with honey and butter, non-sour fruit drinks and compotes).
  4. Eliminate from the diet sour, salty and astringent foods and beverages.
  5. If the larynx edema, restrict fluid intake.

Drug therapy

Treatment with drugs is aimed at reducing symptoms and eliminating infection.

With the development of complications in the form of false croup (can occur in children up to 6 years of age), are appointed:

  • Diuretic drugs that promote the removal of edema ("Furosemide" and analogues).
  • Antispasmodics, for the relief of guttural spasticity - Papaverin, No-Spa, and others.
  • Antihistamines that eliminate allergic reactions, provoke puffiness of the respiratory tube - Tavegil, Suprarstin and many others.

When uncomplicated version of laryngitis is assigned:

  • Acceptance of antibacterial or antiviral drugs, depending on the causative agent.
  • Antibiotics for laryngitis in children is justified in the presence of a bacterial pathogen, in the presence of purulent sputum production, a rapid increase in temperature or fever. Cephalosporins and penicillin group drugs are prescribed for a week course.
  • Drugs that weaken or suppress the cough reflex.
  • Bromhexin or Lasolvan means to release mucus and sputum from the respiratory system.
  • Antiseptic local remedies in the form of aerosols or absorbable tablets.

If necessary, drugs can be administered by the method of endolaryngeal administration.

Physiotherapy measures

Physiotherapy methods are aimed at ensuring the outflow of blood from the sites of inflammation and to accelerate the removal of edema.

This can be achieved:

  • nebulizer therapy;
  • microwave and UV therapy;
  • UHF, electrophoresis and phonophoresis;
  • antiseptic mucous membrane treatment;
  • mustard applications on the feet and calves;
  • hot foot baths;
  • rubbing the feet with alcohol solutions.

As inhalation, with laryngitis in children, are used:

  • soda solutions (0.5 liters of warm water and 1 tablespoon of edible soda);
  • steam inhalation for 10-15 minutes, every 3 hours;
  • for kids 4-5 years old, herbal infusions can be prepared for rinsing.

All these manipulations are carried out only in the absence of elevated temperature.

Prevention and prognosis

In the process of neurulation (maturation of the CNS), a number of changes occur in the body of children, in particular, due to a structural change in the laryngeal tube - the looseness of its submucosa disappears, which allows the development of laryngotracheitis to successfully outgrow. To overcome this pathology in early childhood should:

  • prevent the action of allergenic pathogens;
  • time to carry out the rehabilitation of infections;
  • stimulate the immune system with immunomodulatory drugs that prevent the manifestation of infections;
  • vaccinate childhood infections.

The prognosis of uncomplicated laryngotracheitis is favorable. A decrease in the incidence is noted already in the school age group of children. With complicated forms, accompanied by the manifestation of a false croup, it all depends on the adequacy and timeliness of help from parents and physicians, because critical stenosis of the respiratory passage can cause asphyxiation and lead to mortality.

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