In children, laryngitis is an inflammatory disease of the upper respiratory tract (larynx) that is a pathological condition characterized by disorders of the vocal cords and respiratory system. In children, laryngitis is characterized by coughing, hoarseness, fever, and difficulty breathing.
Diagnosis of laryngitis in children is made by a pediatric otolaryngologist on the basis of clinical signs, laryngoscopy, virological or bacteriological examination. Less talk in the treatment of laryngitis in children is carried out with the help of antihistamines, antiviral drugs or antibiotics, inhalation and physiotherapy treatments.
In children, laryngitis is an inflammation of the mucous membranes of the larynx and vocal cords. Laryngitis is more common in young children and preschoolers. Laryngitis is rarely seen as a single disease in children, and is often accompanied by tracheitis and bronchitis - laryngotracheobronchitis.
In children, acute laryngitis can lead to obstruction (closure) of the upper respiratory tract, which requires immediate medical attention. The symptoms of laryngitis mentioned above should not be ignored by parents, pediatricians and pediatric otolaryngologists.
Causes of laryngitis in children
In children, laryngitis can be caused by infection, allergies, diathesis, psycho-emotional and other factors. In most cases, laryngitis is caused by viruses: parainfluenza, flu, herpes simplex virus, measles, adenovirus and others. Bacterial laryngitis is rare in children, but very severe. In these cases, the main causative agents are hemophiliac type b, staphylococcus, pneumococcus, hemolytic streptococcus, group A bacteria (scarlet fever), Bordeaux bacillus (whooping cough), and others. As a result of prophylactic vaccinations against diphtheria (diphtheria), diphtheria laryngitis is almost non-existent in children.
The peak period of laryngitis in children is winter. The most common causes of illness are colds, nasal breathing disorders, hypovitaminosis, immunosuppression, rhinitis, pharyngitis, adenoiditis, and tonsillitis. Children with lymphatic-hypoplastic diathesis are particularly prone to laryngitis.
Allergic laryngitis in children is caused by inhalation of various chemical vapors (paint), dust, animal dander into the respiratory tract, improper use of certain aerosol preparations, and allergic reactions to food. Occasionally, laryngitis is caused by tension in the vocal cords (loud screaming, singing children, etc.), laryngeal spasms caused by strong emotional states, laryngeal injuries, foreign body aspiration, re-elevation of the acidic mass in the stomach, and passage to the respiratory tract (gastroesophageal reflux). reflux, reflux laryngitis).
Pathogenesis of laryngitis in children
The development of laryngitis in children depends on the anatomical and physiological characteristics of the child's airways, as well as the age of the child, the narrowing of the laryngeal cavity and the funnel-shaped larynx, the innervation of the larynx, the weakness of the respiratory muscles. This is why laryngitis causes acute airway obstruction and acute respiratory failure.
It is important to remember that in children, swelling of the mucous membranes of the larynx and even a thickness of 1 mm can lead to a half-narrowing of the laryngeal cavity. In addition, reflex muscle spasms and mechanical blockages (inflammatory secretions or foreign bodies) also play a role in upper airway obstruction. Narrowing of the larynx and difficulty breathing occur mainly at night, due to changes in the lymphatic and circulatory system of the larynx at night, and a decrease in the number of breaths during sleep.
By laryngitis in children: acute and chronic; uncomplicated and complicated forms are distinguished. Based on endoscopic examination, laryngitis in children is divided into otolaryngology - acute catarrhal, edematous and phlegmonous, chronic catarrhal, hypertrophic and atrophic laryngitis. In catarrhal laryngitis, the inflammatory process occurs only in the mucous membrane of the larynx, and in the form of phlegmon, it also affects the submucosa, musculature, ligaments and joints. In hyperplastic laryngitis, thickening and hyperplasia of the laryngeal mucosa is observed. Atrophic laryngitis is characterized by thinning of the mucous membrane. Catarrhal and hypertrophic forms of the disease are common in children.
Inflammatory processes occur in the form of laryngitis - longitudinal, diffuse laryngitis and laryngotracheobronchitis.
Symptoms of laryngitis in children
Clinical signs of laryngitis in children appear 2-3 days after acute respiratory infection. Children complain of weakness, pain when swallowing, difficulty swallowing, fever (up to 37,5 C), headache, difficulty breathing and shortness of breath. In children with laryngitis, the voice may change: the voice may be muffled, hoarse, weak, or completely silent (dysphonia or aphonia develops). The tail develops a cough-like cough, which after 3-4 days turns into a wet cough. Uncomplicated laryngitis can usually last 5-10 days.
Exacerbation of laryngitis in young children leads to narrowing of the larynx and the development of acute laryngotracheitis. In addition, children have a false KRUP, the symptoms of which appear in the form of a triad: "snoring" cough, hoarseness, inspiratory shortness of breath (difficulty breathing). The fake KRUP usually appears at night. The child wakes up suddenly, has difficulty coughing and shortness of breath, and the child is restless and very agitated. Auscultatory examination reveals wheezing, tachypnea, tachycardia, cyanosis of the oral triangle, acrocyanosis, the child sweats profusely. In severe cases, cardiovascular failure and asphyxia may occur.
Chronic laryngitis is more common in older children. Symptoms may include transient or persistent dysphonia, excessive tiredness, itchy throat, and reflex cough. When laryngitis attacks, the above symptoms are most pronounced.
Diagnosis of laryngitis in children
For the diagnosis of laryngitis in children, it is sufficient for a pediatric otolaryngologist to collect a medical history and refer to clinical signs. Special otolaryngological examinations include pharyngoscopy, rhinoscopy, otoscopy, and palpation of the lymph nodes in the neck.
The main method of examination in the diagnosis of laryngitis in children is laryngoscopy. Examination reveals hyperemia of the mucous membrane of the larynx, edema, increased vascular velocity, or petechial vascular rupture in the mucous membrane. When you make a sound, the vocal cords thicken and do not close completely. Bacteriological, virological, or PCR scans may be performed to remove the pathogen from the upper respiratory tract.
Voice changes caused by laryngitis in children require specialist examinations, such as by a phonist, speech therapist and phonoped.
In children, pseudo-CRUP should be differentiated from diphtheria, laryngeal foreign body, pharyngeal abscess, laryngeal papilloma, laryngeal allergic tumor, epiglottitis, and laryngospasm resulting from spasmophilia.
Treatment of laryngitis in children
In the treatment of laryngitis in children, therapeutic and protective measures are carried out: bed rest, quiet vocal cords, comfortable room temperature, adequate humidity. Children's diets should be limited to cold, hot, spicy foods and fizzy drinks.
Effective methods for laryngitis include drinking warm fluids, creating a dry warmth in the neck area (wrapping the neck area with a jute cloth), medicated inhalation, and putting in jars and mustard paper.
Physiotherapy also plays an important role in the treatment of laryngitis in children. Speech therapy exercises are used if the voice changes are preserved.
In the treatment of laryngitis in children, antiviral drugs or antibiotics, nonsteroidal anti-inflammatory drugs, antihistamines, antitussives or expectorants are used. In most cases, topical antiseptics are prescribed - aerosols, suction tablets. When necessary, drugs are administered endolaryngally.
In the event of a false croup, immediate medical attention should be sought to relieve swelling and spasm in the larynx and to restore normal breathing. Prior to the ambulance, the child should be kept upright, provided with fresh and moist air, used an inhaler, and given distracting measures (hot foot baths). In the hospital, the child is given oxygen therapy and inhalation, antispasmodics, hormones, antihistamines. In severe stenosis of the larynx, intubation or tracheostomy is performed and artificial lung ventilation is performed.
Consequences and prevention of laryngitis in children
The outcome of uncomplicated laryngitis in children is positive. Most children recover completely by school age, but if the inflammation recurs, the disease becomes chronic. In cases of false croup, the outcome of the disease depends on the quality of prompt medical care, and in severe stenosis of the larynx, asphyxia can lead to death.
Prevention of laryngitis in children includes timely treatment of ENT diseases, restriction of allergic products, avoidance of contact with sick children, observance of sound hygiene, general stimulation of immunity.
