Stenosis of the larynx in children: peculiarities of the course and methods of treatment
The child’s organism is susceptible to the influence of external factors, which can lead to a life-threatening condition. Especial danger is acute stenosis of the larynx, especially for children under 3 years of age. Parents should be able not only to recognize the symptoms of the disease in time, but also to know how to properly provide first aid to their child and what to do next.
Stenosis of the larynx in children is the narrowing of the lumen of the glottis, due to which there are signs of difficult passage of air and suffocation.
This phenomenon originally had the name of croup, which, in Scottish, means croaking. Doctors and medical workers of older age sometimes use this designation to this day. Modern medicine uses conditions to describe the condition: stenosing laryngotracheitis or acute stenosis of the larynx.
Anatomical features of the structure of the larynx and trachea in children contribute to the emergence of this life-threatening condition:
- Firstly, the mucous membrane and submucous space of the children’s larynx is rich in fatty tissue with lymphoid tissue, has a developed vasculature, which further contributes to the formation of edema and narrowing of the airway lumen;
- secondly, children have a small diameter of the lumen of the upper respiratory tract, and the larynx itself is short and narrowed, resembling a funnel in its shape. Vocal folds are much shorter and are much higher than in adults;
- third, nervous regulation in children is not completely formed. Parasympathetic mechanisms dominate, which is fraught with hyperexcitability and the presence of additional reflexogenic zones that may inadequately respond to any stimuli.
Stenosis of the larynx in children can extend to:
- a voice gap;
- podgolosovoye space;
- lower parts of the respiratory tract - long stenosis;
- the front wall of the organ - anterior stenosis;
- posterior wall of organ - posterior stenosis;
- circular section of the larynx - circular stenosis;
- the entire larynx is total.
Stenosis of the larynx in children can provoke a variety of factors. It is the cause of the disease that affects its duration.
The most common causes are:
- inflammatory processes - the development of inflammation of the anatomical structures not only of the larynx, but also of neighboring organs can provoke stenosis (angina, purulent laryngitis, inflammatory processes of the cartilage of the larynx);
- infectious diseases - except that the causative agents of scarlet fever, measles, diphtheria, influenza and parainfluenza, syphilis, abdominal and typhus, malaria affect the epithelium of the respiratory tract, their toxins cause allergic organism, and this is an additional component in the development of stenosis;
- traumas of the larynx, surgical manipulations, foreign bodies that damage the organ and promote the appearance of scars;
- Congenital anomalies of the organ, which are accompanied by an initially narrowed lumen;
- allergic reactions and edema of Quincke;
- purulent processes in the head and neck that, due to the anatomical features of these parts of the body, can spread to the larynx;
- violations of innervation of the larynx as a traumatic origin, and psychogenic (especially in adolescent girls);
- development of acute hepatic insufficiency. The disease is accompanied by the allocation of mucous membranes of all organs of such an exchange product as urea, which, when interacting with the microorganisms of the oral cavity and upper respiratory tract, is converted into an ammonium compound with carbon. Ammonium carbonate destroys the mucous membrane, causes ulcers and necrosis of the organs.
Stenosis of the larynx in newborns is accompanied by a loud cry of the baby and causes panic in the parents
IV stage of stenosis borders on death and, in addition to tracheotomy, resuscitation is necessary to restore respiratory activity, cardiac activity (indirect heart massage, adrenaline injections, intravenous infusions of metabolic drugs).
Since the cause of stenosis of the larynx in children is most often a viral or bacterial infection, then later there is development of laryngotracheitis, obstructive bronchitis and inflammation of the lungs, which do not depend on the degree of stenosis. In addition, complications from other ENT organs (acute otitis, sinusitis, lacunar sore throats) are possible.
Stenosing laryngotracheitis after first-aid treatment acquires subacute flow and requires further treatment and elucidation of the causes of its occurrence.
Conducting surgical treatment and staging a tracheostomy can cause a number of unpleasant consequences. Early complications occur during surgery (bleeding, damage to neighboring organs, stopping breathing). The development of cicatricial stenosis is attributed to late complications. It occurs as a result of gross damage to the respiratory tract during a tracheotomy.
Such unpleasant consequences, as a rule, arise in neglected cases. Correctly selected and timely treatment provides a chance for a favorable prognosis for recovery.