LARYNX

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:
  1. Voice rest.
  2. Steam inhalation.
  3. Speech therapy for proper voice production.
  4. Oral steroids in tapering doses.
  5. Antibiotics.
  6. Microlaryngoscopy with stripping of vocal cords done in Reinke’s Oedema.
  7. Antihistaminics given in allergic angioneurotic oedema. In severe cases, subcutaneous injection of adrenalin (1:1000) can be given.
  8. Intravenous injection of C1-esterase inhibitor 36000 unit given in acute and   long-term prophylaxis of hereditary angioneurotic oedema.
  9. Fibrinolytic inhibitor and Epsilon Amino Caproic Acid can be given in long term prophylaxis of hereditary angioneurotic oedema.
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