Overview of Laryngeal Inflammations in Pediatric Patients
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INFLAMMATIONS OF LARYNX
By: WAM, MD.
PAEDIATRIC LARYNGITIS
1.
Laryngotracheitis:
Viral in origin, Parainfluenzae virus in
50%.
Affects children less than 3ys.
Air way obstruction and stridor.
On exam. Erythematous and
oedematous mucosa.
Sec. bacterial infection…….
Membranous croup
due to Heaemophilus influenzae.
Treatment: Hydration, humidified
oxygen and corticosteroids.
2. Supraglottitis ( Epiglottitis):
Life threatening infection of
supraglotic larynx caused by
H.influenzae type B.
Affects children above 3ys.
Rapid onset, fever, sore throat,
inspiratory stridor, child is generally
ill, drooling.
Treatment: - secure safe air way.
- antibiotics ( 2
nd
or 3
rd
generation cephalosporin).
- supportive care.
3. Diphtheria:
Caused by Corynebacterium
diphtheriae.
Febrile illness, slow onset,followed by
progressive air way obstruction.
Thick greyish membranous exudate
over tonsils, pharynx and laryngeal
structures.
Treatment: - establish safe air way.
- antitoxin.
- penicillin.
CHRONIC NON SPECIFIC LARYNGITIS.
Arises due to faulty use of voice,
irritation by dust and fumes.
Laryngeal appearances:
1.
hyperaemic:
cords are injected.
2.
Hypertrophy
: thickening of all tissues
of larynx.
3.
Oedematous:
true cords are swollen
and pale.
Treatment: - vocal rest -
antibiotics.
- elimination of irritating factors.
- stripping of vocal cords in
resistant oedematous cases.
CHRONIC SPECIFIC INFECTIONS OF LARYNX
1.
T.B:
Today is frequently unassociated with
active pulm.disease.
Nowadays true vocal cords to be most
commonly involved.
Clinically……. Dysphonia and odynophagia.
Laryngeal mucosa may be diffusely
oedematous, hyperaemic,
hypertrophic.
Or the process may be nodular or
ulcerative.
If left untreated………cicatricial laryngeal
stenosis or fixation of vocal folds.
2. Scleroma:
Caused by K.rhinoscleromatis
Three stages of disease……catarrhal, granulomatous and sclerotic.
Involve subglottic region and trachea.
Diagnosis……..Mikulicz cells, Russel bodies.
Treatment……….. Qunilones antibiotics
Laryngeal dilatation.
Endoscopic resection.
Tracheostomy.
VOICE INDUCED DISORDERS
1.
Vocal nodules:
Due to excessive use of voice.
Common in singers, teachers and
mothers of young children.
Pathology: Localised hyperkeratosis
at junction of ant.1/3 and post.2/3 of
the free edge of one or both cords.
C/P: dysphonia, nodules are bilateral
and symmetrical.
Treatment: -voice rest.
-endoscopic removal.
-speech therapy.
2.VOCAL FOLD POLYP
Caused by vocal trauma.
Usually unilateral.
Sessile or pedunculated.
ttt: removal through direct laryngoscopy.
F.B INHALATION
F.B passed larynx may lodge anywhere in
trachea or bronchi, more commonly in
Rt.main bronchus.
Initial symptoms: cough, dyspnoea,
choking followed by latent period.
Cough returns if object changes its
position
Atelectasis if lobe of lung is completely
obstructed
Emphysema in case of partial obstruction.
Vegetable F.B……intense inflammatory
reaction in mucosa.
Ttt: removal through bronchoscope
This comprehensive overview covers various inflammations of the larynx in pediatric patients, including laryngotracheitis, supraglottitis, diphtheria, chronic non-specific laryngitis, tuberculosis (TB), scleroma, and voice-induced disorders. It discusses causes, symptoms, diagnostic features, treatment options, and clinical implications for each condition. The content also includes helpful images for visual reference.
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Presentation Transcript
INFLAMMATIONS OF LARYNX By: WAM, MD.
PAEDIATRIC LARYNGITIS 1. Laryngotracheitis: Viral in origin, Parainfluenzaevirus in 50%. Affects children less than 3ys. Air way obstruction and stridor. On exam. Erythematous and oedematous mucosa. Sec. bacterial infection . Membranous croup due to Heaemophilusinfluenzae. Treatment: Hydration, humidified oxygen and corticosteroids.
2. Supraglottitis ( Epiglottitis): Life threatening infection of supraglotic larynx caused by H.influenzae type B. Affects children above 3ys. Rapid onset, fever, sore throat, inspiratory stridor, child is generally ill, drooling. Treatment: - secure safe air way. -antibiotics ( 2ndor 3rd generation cephalosporin). -supportive care.
3. Diphtheria: Caused by Corynebacterium diphtheriae. Febrile illness, slow onset,followed by progressive air way obstruction. Thick greyish membranous exudate over tonsils, pharynx and laryngeal structures. Treatment: - establish safe air way. -antitoxin. -penicillin.
CHRONIC NON SPECIFIC LARYNGITIS. Arises due to faulty use of voice, irritation by dust and fumes. Laryngeal appearances: 1. hyperaemic: cords are injected. 2. Hypertrophy: thickening of all tissues of larynx. 3. Oedematous: true cords are swollen and pale. Treatment: - vocal rest - antibiotics. - elimination of irritating factors. - stripping of vocal cords in resistant oedematous cases.
CHRONIC SPECIFIC INFECTIONS OF LARYNX 1. T.B: Today is frequently unassociatedwith active pulm.disease. Nowadays true vocal cords to be most commonly involved. Clinically . Dysphonia and odynophagia. Laryngeal mucosa may be diffusely oedematous, hyperaemic, hypertrophic. Or the process may be nodular or ulcerative. If left untreated cicatriciallaryngeal stenosis or fixation of vocal folds.
2. Scleroma: Caused by K.rhinoscleromatis Three stages of disease catarrhal, granulomatousand sclerotic. Involve subglottic region and trachea. Diagnosis ..Mikulicz cells, Russel bodies. Treatment .. Qunilones antibiotics Laryngeal dilatation. Endoscopic resection. Tracheostomy.
VOICE INDUCED DISORDERS 1. Due to excessive use of voice. Common in singers, teachers and mothers of young children. Pathology: Localised hyperkeratosis at junction of ant.1/3 and post.2/3 of the free edge of one or both cords. C/P: dysphonia, nodules are bilateral and symmetrical. Treatment: -voice rest. -endoscopic removal. -speech therapy. Vocal nodules:
2.VOCAL FOLD POLYP Caused by vocal trauma. Usually unilateral. Sessile or pedunculated. ttt: removal through direct laryngoscopy.
F.B INHALATION Click to see larger picture F.B passed larynx may lodge anywhere in trachea or bronchi, more commonly in Rt.mainbronchus. Initial symptoms: cough, dyspnoea, choking followed by latent period. Cough returns if object changes its position Atelectasis if lobe of lung is completely obstructed Emphysema in case of partial obstruction. Vegetable F.B intense inflammatory reaction in mucosa. Ttt: removal through bronchoscope Click to see larger picture
