THROAT - Laryngeal oedema

Oedema of the laryngeal mucosa can accompany any inflammatory reaction of the larynx and is therefore, not a specific disease but a sign.

What are the causative factors of  Laryngeal oedema?

Causative factors:
a) Trauma
b) Infection
c) Tobacco
d) Radiation

                                      Clinical types
 

 


Reinke’s Oedema                              Angioneurotic Oedema
-Accumulation of fluid                      Characterised by recurrent attacks
Under the epithelium of                    of swelling in face, larynx, extremities
True vocal cords
-Allergy, infection tobacco,
Chronic sinusitis are major
Contributing factors

 


          Allergic                                                       Hereditary
Accompanied by urticaria                           Non allergic in origin
Allergic reaclion to food                              rarely leads to laryngeal
obstruction                                                  due to serum deficiency
of C1 esterase
inhibitor protein
- Autosomal dominant
Inheritance

What are the clinical features of causes of laryngeal oedema?

a) Age between 30 and 60 years
b) Common in males
c) On examination: Vocal cords are red and swollen
d) Polypoidal projection from vocal cords
e) Stridor can be present with dry cough

 

Hereditary angioedema :Presents with triad of  abdominal pain
peripheral non-pitting oedema and laryngeal oedema. Laryngeal oedema being least common.
                                      Treatment
 

 


Reinke’s Oedema                              Angioneurotic Oedema
Steam inhalation,                   
Oral steroids in                       
tapering doses,
Antibiotics.
If no improvement,
Microlaryngoscopy
With stripping
Of vocal cords
 


Allergic                                                                          Hereditary
Antihistaminics
And corticosteroids
In severe cases
Subcutaneous                                    Acute Attack         Long term Prophylaxis
Injection of  adrenaline (1:1000)       Intravenous          36,000 units
Can be given Identification of           Injection of           of CI-INH
The  Allergen                                    CI-INH 36000      Fibrinolytic inhibitor
                                                                      Units                    Epsilon Aminocaproic                                                                      Acid (EACA)
Stimulates the
Production of CI-INH

 

 

 




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