What is laryngeal edema? – Definition, Symptoms, Causes, Treatment

What is Laryngeal Edema?

Swelling is medically referred to as “edema.” Inflammation and damage cause swelling in several body parts. It can be localized or systemic, meaning it can affect one part or the whole of the body. Numerous medical conditions, including medications, pregnancy, and infections, can induce edema. When the tiny blood arteries in the surrounding tissues leak fluid, edema develops. This excess fluid accumulates, causing the tissue to expand. It can take place almost anywhere in the body.

Edema is a condition that can manifest itself anywhere in the body. However, the lower extremities (legs and feet) are the most likely sites of manifestation. Edema can be caused by medications as well as pregnancy. Diseases like congestive heart failure, renal illness, venous insufficiency, or cirrhosis of the liver are some examples of conditions that can lead to this complication. Edema is frequently treated by wearing compression clothes and limiting salt intake. Edema-causing illnesses also require medical attention.

Laryngeal edema is an acute, neuro-allergic condition characterized by spasms of the vocal cord muscles and an enlargement of the laryngeal mucosa. It typically develops with other diseases, worsening the course of those diseases. It starts at the newborn stage and happens at any age. This disorder carries a high chance of suffocation, which can lead to swelling and the person’s death within a few minutes, and it is dangerous because of this risk. According to causative pathology, immediate medical care is essential.

What is laryngeal edema - Definition, Symptoms, Causes, Treatment

Laryngeal Edema Symptoms

Dysphagia, a lump in the throat, a feeling of pressure in the throat, changes in the voice, such as hoarseness and roughness, and dyspnea are all clinical indications of laryngeal edema. The most common fears in patients with advanced laryngeal edema are asphyxiation and aphonia.

Symptoms are primarily determined by the source, location, and severity of the edema. Patients typically express the following complaints:

  • Breathlessness that worsens with inhalation.
  • A dry cough.
  • A sudden appearance of a hoarse voice.
  • Foreign bodily feeling.
  • Problems with swallowing.

When inflammation is responsible, other symptoms like temperature and pain manifest.

Quincke’s edema is characterized by the sudden enlargement of skin, subcutaneous tissue, and mucous membranes. It occurs most frequently in the areas of the face, arms, and trunk, as well as the neck, mouth, larynx, and tongue.

There are rare instances of allergic edema, such as those brought on by insect venom. Some symptoms are more common, like urticaria, nausea, diarrhea, stomach pain, and angioedema. It’s also possible to experience anaphylactic shock. Even though shock only happens to about 0.5–5% of patients, it’s important to remember that it’s a life-threatening condition that needs medical help right away.

Laryngeal Edema Causes

Laryngeal edema happens when too much fluid builds up between the cells of the larynx’s tissues (e.g. epiglottis, epiglottis).

Inflammation is the most common cause of laryngeal edema. This includes inflammation that occurs within the larynx, such as acute laryngitis, subglottic laryngitis, laryngitis, cartilage inflammation, and epiglottitis, as well as inflammation that runs in surrounding structures, such as abscess of the parapharyngeal region and peritonsillar abscess. 

Toxic-allergic laryngeal edema is another kind of this condition. The following stimuli are sometimes responsible:

  • Medications (antibiotics, painkillers).
  • Venoms of insects (wasps, hornets, bees, bumblebees).
  • Foods (peanuts, fish, eggs).

Laryngeal Edema Treatment

The preferred method of treating post-extubation laryngeal edema is with nebulized or intravenous corticosteroids in combination with nebulized epinephrine, whereas there is no information on the most effective treatment regimen. Rapid reintubation is necessary in cases of respiratory failure.

The majority of the time, the cause of the swelling influences the doctors’ treatment decisions. Antibiotics are prescribed when a bacterial infection is suspected as the cause. Surgery is usually needed after an injury. Glucocorticosteroids are anti-inflammatory medications. The major treatment is administered in stationary conditions, however, first assistance must be administered as soon as feasible. Before addressing the underlying cause of the edema, it is necessary to ensure that the airway is open and functioning properly. A timely start to treatment improves the prognosis. Childhood edema of the larynx is the most deadly type.

If the swelling is the result of a concomitant systemic ailment, the doctors are expected to focus largely on treating that condition. Intravenous steroids, antihistamines, and adrenaline are used to treat allergic or angioedema conditions. In dire situations, tracheotomies are the only option.

Laryngeal edema can develop quite quickly. These situations call for the insertion of a permanent breathing tube, like an endotracheal tube, to ensure the patient can breathe normally. If an endotracheal tube doesn’t work to keep the airway open, a surgical airway is needed. This is usually done with an emergency cricothyrotomy.

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