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.
Causative factors:
a) Trauma.
b) Infection.
c) Tobacco.
d) Radiation.
e) Inhalation of toxic fumes
f) Allergic.
Clinical features:
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:
In all cases patient is advised to take:
- Voice rest.
- Steam inhalation.
- Speech therapy for proper voice production.
- Oral steroids in tapering doses.
- Antibiotics.
- Microlaryngoscopy with stripping of vocal cords done in Reinke’s Oedema.
- Antihistaminics given in allergic angioneurotic oedema. In severe cases, subcutaneous injection of adrenalin (1:1000) can be given.
- Intravenous injection of C1-esterase inhibitor 36000 unit given in acute and long-term prophylaxis of hereditary angioneurotic oedema.
- Fibrinolytic inhibitor and Epsilon Amino Caproic Acid can be given in long term prophylaxis of hereditary angioneurotic oedema.
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