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Pediatric Clinics of North America Apr 2022Croup refers to airway inflammation and edema leading to obstruction of the larynx, trachea, and bronchi. Croup is the most common cause of acute airway obstruction in... (Review)
Review
Croup refers to airway inflammation and edema leading to obstruction of the larynx, trachea, and bronchi. Croup is the most common cause of acute airway obstruction in young children. It is characterized by the onset of low-grade fever, barky cough, stridor, hoarseness, and respiratory distress. Croup is typically caused by a viral infection (viral croup) but can occur suddenly without a viral prodrome (spasmodic croup). Recurrent croup is defined as two or more episodes per year. Recurrent croup should be considered a symptom of an underlying structural or inflammatory airway abnormality and should prompt a work-up for the underlying cause.
Topics: Child; Child, Preschool; Cough; Croup; Humans; Infant; Larynx; Respiratory Sounds; Respiratory Tract Infections; Virus Diseases
PubMed: 35337542
DOI: 10.1016/j.pcl.2021.12.004 -
Advances in Respiratory Medicine 2019In about 3% of children, viral infections of the airways that develop in early childhood lead to narrowing of the laryngeal lumen in the subglottic region resulting in...
In about 3% of children, viral infections of the airways that develop in early childhood lead to narrowing of the laryngeal lumen in the subglottic region resulting in symptoms such as hoarseness, abarking cough, stridor, and dyspnea. These infections may eventually cause respiratory failure. The disease is often called acute subglottic laryngitis (ASL). Terms such as pseudocroup, croup syndrome, acute obstructive laryngitis and spasmodic croup are used interchangeably when referencing this disease. Although the differential diagnosis should include other rare diseases such as epiglottitis, diphtheria, fibrinous laryngitis and bacterial tracheobronchitis, the diagnosis of ASL should always be made on the basis of clinical criteria.
Topics: Acute Disease; Airway Obstruction; Bacterial Infections; Child; Croup; Dyspnea; Humans; Laryngitis; Respiratory Tract Infections
PubMed: 31680234
DOI: 10.5603/ARM.2019.0056 -
The Annals of Otology, Rhinology, and... 1978When dealing with acute laryngeal obstruction, the first important consideration is the differential diagnosis of the cause. The author considers the following six... (Review)
Review
When dealing with acute laryngeal obstruction, the first important consideration is the differential diagnosis of the cause. The author considers the following six types: acute laryngotracheobronchitis, acute epiglottitis, diphtheria, supraglottic allergic edema (angioedema), subglottic allergic edema (spasmodic croup) and foreign body in the larynx or trachea. He traces the development of the treatments that have in 50 years lowered the mortality rate from 70% to practically zero. High humidity, best supplied by an ultrasonic nebulizer, antibiotics, and corticosteroids in very high dose have been the prime effective measures. There still is controversy about the choice between tracheostomy and nasotracheal intubation if medical therapy is delayed or ineffective. The primary physician must know when and where to send these children in order to prevent the fatalities so frequent in previous years.
Topics: Acute Disease; Airway Obstruction; Child; Child, Preschool; Diphtheria; Epiglottis; Humans; Laryngeal Diseases; Laryngitis; Respiratory Hypersensitivity; Tracheotomy
PubMed: 363025
DOI: 10.1177/000348947808700502 -
Pulmonary Pharmacology & Therapeutics Jun 2019The larynx is one of the most highly innervated organs in humans, adapted to simultaneously deliver several key respiratory functions including airway protection,... (Review)
Review
The larynx is one of the most highly innervated organs in humans, adapted to simultaneously deliver several key respiratory functions including airway protection, swallowing and phonation. In some individuals the larynx can adopt a state that could be considered 'dysfunctional' or maladaptive; resulting in or contributing to a range of clinical disorders such as chronic refractory cough, inducible laryngeal obstruction (previously termed paradoxical vocal fold movement or vocal cord dysfunction), muscle tension dysphonia and globus pharyngeus. These disorders appear to display significant overlap in clinical symptomology and in many cases have features of concomitant or allied sensory dysfunction; often described as laryngeal hypersensitivity. The recognition and accurate assessment of both laryngeal dysfunction±hypersensitivity is important to ensure accurate diagnosis and effective delivery of targeted treatment and therapeutic monitoring. Accordingly, there is increasing in the methodologies proposed to assess laryngeal function. These range from simple questionnaires to targeted investigation(s), assessing both sensory function and the laryngeal motor response, under both resting and provoked situations. This review provides a brief overview of the current state of knowledge in the field of laryngeal dysfunction and hypersensitivity assessment.
Topics: Animals; Cough; Dysphonia; Globus Sensation; Humans; Laryngeal Diseases; Larynx
PubMed: 31004747
DOI: 10.1016/j.pupt.2019.04.003 -
Archivos Argentinos de Pediatria Jun 2022The larynx is at the aerodigestive crossroads; any pathology that involves it will have an impact on breathing, swallowing and/or the voice. It`s divided into three...
The larynx is at the aerodigestive crossroads; any pathology that involves it will have an impact on breathing, swallowing and/or the voice. It`s divided into three regions: supraglottis (includes epiglottis, ventricular bands and laryngeal ventricles), glottis (space limited by the vocal cords) and subglottis (narrowest area of pediatric airway and the only point of larynx completely surrounded by cartilage: the cricoid ring). Laryngeal obstruction can present as a potentially fatal acute condition or as a chronic process. The main symptom is inspiratory or biphasic stridor. The etiology varies widely according to age and it may be of congenital, inflammatory, infectious, traumatic, neoplastic or iatrogenic origin. We describe the pathologies that cause laryngeal obstruction, either those that occur very often or those which are important for their severity, their guiding symptoms to the presumptive diagnosis, additional studies and treatment.
Topics: Airway Obstruction; Algorithms; Child; Humans; Laryngeal Diseases; Larynx; Pediatrics
PubMed: 35533130
DOI: 10.5546/aap.2022.209 -
Respiratory Medicine Aug 1994
Topics: Aged; Airway Obstruction; Fatal Outcome; Humans; Laryngeal Diseases; Larynx; Male
PubMed: 7972982
DOI: 10.1016/s0954-6111(05)80340-3 -
The Journal of Laryngology and Otology Aug 2017Laryngeal injury after blunt trauma is uncommon, but can cause catastrophic airway obstruction and significant morbidity in voice and airway function. This paper aims to... (Review)
Review
BACKGROUND
Laryngeal injury after blunt trauma is uncommon, but can cause catastrophic airway obstruction and significant morbidity in voice and airway function. This paper aims to discuss a case series of sports-related blunt laryngeal trauma patients and describe the results of a thorough literature review.
METHOD
Retrospective case-based analysis of laryngeal trauma referrals over six years to a tertiary laryngology centre.
RESULTS
Twenty-eight patients were identified; 13 (46 per cent) sustained sports-related trauma. Most were young males, presenting with dysphonia, some with airway compromise (62 per cent). Nine patients were diagnosed with a laryngeal fracture. Four patients were managed conservatively and nine underwent surgery. Post-treatment, the majority of patients achieved good voice outcomes (83 per cent) and all had normal airway function.
CONCLUSION
Sports-related neck trauma can cause significant injury to the laryngeal framework and endolaryngeal soft tissues, and most cases require surgical intervention. Clinical presentation may be subtle; a systematic approach along with a high index of suspicion is essential, as early diagnosis and treatment have been reported to improve airway and voice outcome.
Topics: Adolescent; Adult; Airway Obstruction; Athletic Injuries; Dysphonia; Female; Humans; Larynx; Male; Middle Aged; Neck Injuries; Ontario; Retrospective Studies; Treatment Outcome; Wounds, Nonpenetrating; Young Adult
PubMed: 28595674
DOI: 10.1017/S0022215117001220 -
Annals of Allergy, Asthma & Immunology... Nov 2020
Topics: Airway Obstruction; Anti-Bacterial Agents; Drug Hypersensitivity; Female; Humans; Larynx; Middle Aged; Penicillins; Skin Tests; Vocal Cords
PubMed: 32598928
DOI: 10.1016/j.anai.2020.06.031 -
Auris, Nasus, Larynx Apr 2023We aim to explore the clinical features and influencing factors of curative effect in children harboring acute laryngitis with laryngeal obstruction.
OBJECTIVE
We aim to explore the clinical features and influencing factors of curative effect in children harboring acute laryngitis with laryngeal obstruction.
METHODS
There involved 237 children with acute laryngitis and 80 healthy children who required physical examination in our hospital between January and September in 2021. The healthy children who required physical examination were allocated into the healthy/control group. The clinical data and laboratory indexes of each group were compared. We also analyzed the risk factors for curative effect of acute laryngitis with laryngeal obstruction among children using univariate/multivariate logistic regression.
RESULTS
The incidence of barking cough, sore throat, dryness, pruritus, dyspnea, diffuse congestion and swelling of laryngeal mucosa and vocal cord congestion or covered with vascular striation in degree III laryngeal obstruction group were significantly higher than other study groups, with degree II laryngeal obstruction group higher than degree I group, and degree I group higher than no laryngeal obstruction group (P<0.05). Moreover, the levels of CRP, TNF-α, IL-6, IL-8 and WBC in degree III laryngeal obstruction group were higher than other three study groups, with degree II higher than degree I laryngeal obstruction group and no obstruction group, and degree I higher than no laryngeal obstruction group (P<0.05). Multivariate logistic regression analysis showed that CRP, TNF-α, IL-6 and IL-8 were the risk factors affecting the curative effect of acute laryngitis with laryngeal obstruction in children, and the differences were statistically significant (P<0.05).
CONCLUSION
The study revealed the incidence of barking cough, sore throat, dryness, pruritus, dyspnea, diffuse congestion and swelling of laryngeal mucosa vocal cord congestion or covered with vascular striation is highly associated with the severity of acute laryngitis with laryngeal obstruction in children. Additionally, higher levels of CRP, TNF-α, IL-6, IL-8 and WBC indicated serious condition of the disease among children. Hence the risk factors responsible for the efficacy of acute laryngitis in children are CRP, TNF-α, IL-6 and IL-8.
Topics: Child; Humans; Airway Obstruction; C-Reactive Protein; Interleukin-6; Interleukin-8; Laryngeal Diseases; Laryngitis; Tumor Necrosis Factor-alpha
PubMed: 35792017
DOI: 10.1016/j.anl.2022.06.005 -
La Revue Du Praticien May 2003Laryngeal dyspnea is a life-threatening emergency situation. The diagnosis is clinical and made from the association of: inspiratory bradypnea, intercostal and... (Review)
Review
Laryngeal dyspnea is a life-threatening emergency situation. The diagnosis is clinical and made from the association of: inspiratory bradypnea, intercostal and sus-sternal inspiratory depression, with or without stridor. The aetiologies are most often laryngeal tumours or inflammatory oedema; incidence of epiglottitis has decreased due to vaccine against Haemophilus influenzae. Airway obstruction due to foreign body includes acute laryngeal dyspnea and reflex paroxysmal coughing without fever. Management of a laryngeal dyspnea depends on the aetiology and the severity of clinical symptoms. Medical treatment associates racemic epinephrine aerosol, steroids, and oxygenation. In the presence of severe dyspnea, intubation after anaesthetising the patient and positive pressure ventilation is required.
Topics: Acute Disease; Airway Obstruction; Anti-Inflammatory Agents; Bronchodilator Agents; Dyspnea; Epinephrine; Humans; Intubation, Intratracheal; Laryngeal Neoplasms; Laryngitis; Oxygen Inhalation Therapy; Racepinephrine; Risk Factors; Severity of Illness Index; Steroids
PubMed: 12816038
DOI: No ID Found