As children grow up, parents have to go through a lot - from sleepless nights to many different diseases. And it is very important to act as soon as possible to provide the necessary assistance to the child. That is why mom will become, if not a doctor, then at least a nurse. Among the many diseases common in children, laryngitis can be noted. To overcome him, parents must know what kind of disease it is, its symptoms and treatment, medicines that help alleviate the patient's condition. If laryngitis appears in children, what are the symptoms and treatment?
What is laryngitis?
Laryngitis Is an inflammation of the vocal cords located in the larynx. The larynx is located at the border of the mouth and trachea. In the same area there is an epiglottis, its function is to prevent food and saliva from entering the larynx when swallowing.
The larynx contains the vocal cords - 2 folds of the mucous membrane that cover the muscles as well as the cartilage. Usually, the ligaments close and open very smoothly, creating sounds through vibration and movement. But when a child has laryngitis, these ligaments become irritated or inflamed. This inflammation or swelling causes distortion of the sounds, which makes the voice hoarse. There are some serious cases of laryngitis where the voice actually disappears.
Laryngitis is very common in children. It is difficult to meet a child who has not got sick at least once. This disease often occurs in autumn and spring - at the junction of cold seasons.
Due to age, the child's nasopharynx cannot properly contain the pathogen that has penetrated inside. And these harmful organisms fall below - right into the throat. For an adult, laryngitis is only uncomfortable, but for a child, inflammation leads to big problems, since his throat is too narrow.
Why is laryngitis dangerous?
One of the frequent complications of the acute course of laryngitis is the acquisition of a chronic course. Constantly recurring illness can lead to complete loss of voice.
Doctors warn of potential complications that really threaten the patient's life:
- inflammation of the epiglottis;
- laryngeal stenosis;
- abscess.
The chronic course of the disease is the cause of circulatory disorders and laryngeal functions. Pathology can lead to the transformation of mucosal cells into cancerous tumors.
Causes and risk factors
Of course, it is impossible to clearly establish the true cause, because each child has individual characteristics.
Often the disease occurs under the influence of several factors:
- colds of various etiologies (atypical pneumonia, influenza, adenovirus, measles);
- reaction to inhaled elements. These are allergic components of the environment (new furniture, all varnishes, paint, new appliances made of low-quality plastic), animal dander, dust. In practice, most pediatricians encounter family laryngitis when the family moved to an apartment where the furniture was repaired or replaced;
- anatomical and physiological structure of the respiratory system (narrow throat and nasopharynx). Any inflammation of the respiratory system causes swelling (edema) of the tissues, and the larynx is significantly narrowed in the child, which complicates the passage of air;
- reduced air quality where the child is (hot dry air, dust, exhaust gases, smoky rooms);
- mechanical factors - damage to the larynx, overexertion of the voice when singing, screaming, due to a loud long conversation;
- gastroesophageal reflux disease and foreign body aspiration can cause laryngitis.
The risk group includes children who have chronic diseases of the nasopharynx (as a result of which breathing through the nose is impaired) or who have diseases of the oral cavity.
Laryngitis symptoms in children
The disease has pronounced symptoms, so it is not difficult to recognize the onset of the disease in a child.
Main features:
- redness of the larynx and edema of the mucous membrane in the area of inflammation;
- barking and dry cough;
- hoarse or absent voice;
- headaches and rhinitis;
- the temperature rises, but not significantly;
- swelling of the mucous membrane is accompanied by a spasm of the larynx, which leads to difficulty breathing;
- tickling in the larynx and dry mouth.
Other signs of the disease are loss of appetite, shortness of breath.
At night (closer to morning), the cough in a child with laryngitis becomes more frequent and is sometimes accompanied by attacks of suffocation.
Signs of laryngitis in children under one year old
Children 4 - 5 years old can explain to adults what worries them and where it hurts, but in infants it is difficult to determine the signs of illness. The child will not be able to complain about feeling unwell.
It is important to pay attention to the physical condition and behavior of the child. Contact a specialist immediately if you observe the following manifestations of laryngitis in infants:
- the baby has a serious cold;
- the child is lethargic and restless;
- the baby is moody, and his cry is accompanied by wheezing and dry suffocating cough;
- noises and whistles are heard in the lungs;
- bluish nasolabial triangle (this is one of the most important signals, since blue indicates the progression of the disease).
When laryngitis is found in infants, only a qualified pediatrician will prescribe treatment.
Laryngitis forms
Laryngitis can be classified as acute or chronic. Symptoms for each type are similar but vary in duration.
Chronic laryngitis develops over a long period and lasts for weeks or months, while acute laryngitis usually comes on suddenly and goes away within a few days (up to a week).
Types of acute laryngitis:
- catarrhal laryngitis. The mildest and most common form of the disease, since only the laryngeal mucosa is inflamed;
- phlegmonous laryngitis. The inflammation affects the adjacent tissues of the larynx;
- stenosing laryngitis. The inflammation affects the subglottic region.
Very often the upper trachea is involved in the inflammatory process. Then laryngotracheitis already takes place.
Types of chronic laryngitis:
- catarrhal form. The mucous membrane of the throat thickens, the vocal cords do not close completely, the voice becomes muffled and hoarse;
- atrophic form. With this form of the disease, a pronounced feeling of dryness in the throat is observed, an unproductive cough, sometimes wet with extremely difficult sputum production, worries;
- chronic hypertrophic laryngitis. This form of the disease is characterized by the appearance of a clear edema that can cover the tissues of the entire larynx. In this case, nodules form on the tissues, their appearance sometimes leads to an absolute loss of voice.
Acute laryngitis
Has an abrupt onset and, as a rule, is a short-term inflammation. May have multiple sources.
Viral laryngitis in children
The most acute cases of laryngitis are caused by viral infections, the most common of which are rhinovirus, influenza virus, parainfluenza virus, adenovirus, coronavirus. In patients with weakened immune systems, other viruses such as herpes, HIV, and coxacivirus can also be potential causes.
Bacterial laryngitis
This is another important cause of acute laryngitis and can be associated with a viral infection.
Common bacterial strains:
- group A streptococcus;
- streptococci pneumonia;
- corynebacterium diphtheria;
- moraxella catarrhalis;
- haemophilus influenzae;
- bordetella pertussis;
- bacillus anthrax;
- mycobacterium tuberculosis.
Fungal laryngitis
Fungal laryngitis is common but not often diagnosed and can account for up to 10% of cases of acute laryngitis. Patients with both functional and weakened immune systems can develop fungal laryngitis, which sometimes results from past use of antibiotics or inhaled corticosteroids.
Certain strains of fungi that can cause laryngitis:
- histoplasm;
- blastomycosis;
- candida (especially in immunocompromised individuals);
- cryptococcosis;
- coccidioidomycosis.
Laryngitis due to trauma
Often develops due to overexploitation of the vocal folds (excessive screaming, singing). While this often results in damage to the outer layers of the vocal cords, subsequent healing can lead to changes in the physiology of the vocal cords. Injury to the larynx can also lead to inflammation of the ligaments.
Symptoms
Acute laryngitis begins with fever, scratching, and a painful tickling in the throat. Then there is a barking cough, which soon softens and is accompanied by phlegm. The voice becomes rough and hoarse or disappears altogether. Children prone to allergies have difficulty breathing and wheezing. Soreness when swallowing is possible.
Stenosing laryngitis in children
Stenosing (obstructive) laryngitis, which develops due to diphtheria, is called true croup. Cases of obstructive laryngitis of another infectious origin are combined into the concept of "false croup".
This disease is especially common in young children. This is due to the small size of the larynx, the abundance of loose fiber in the subglottic region. This anatomical specificity of the larynx in children favors the rapid formation of inflammation and edema.
About half of cases of false croup occur in children 1 to 3 years old. Children from 6 years of age rarely get sick, they account for only 9% of the total number of cases. The seasonal prevalence of false croup is pronounced; its peak is in late autumn and early winter.
False croup is often a complication of acute rhinitis, adenoiditis, pharyngitis, influenza, SARS, measles, chickenpox, scarlet fever and other infections. False croup is sometimes caused by an exacerbation of the chronic course of tonsillitis.
Obstructive laryngitis differs in that inflammation is accompanied by stenosis.
Laryngeal stenosis is caused by multiple pathogenic mechanisms. Firstly, inflammation of the larynx with stenosing laryngitis is characterized by strong swelling of the subglottic space, the larynx narrows the gap in this place. Secondly, there is a reflex spasm of the laryngeal muscles, which is worsened by stenosis. Thirdly, due to inflammation, the secretory activity of the laryngeal mucosa increases, forming a large amount of viscous mucus. The phlegm greatly narrows the lumen of the larynx.
Due to the above mechanisms, obstructive syndrome develops - a violation of the air passage into the respiratory tract.
At the onset of obstructive laryngitis, insufficient oxygen supply to the body is compensated for by increased functioning of the respiratory muscles and more intense breathing.
With an increase in the level of stenosis and obstruction, a period of decompensation is observed. As a result of severe stenosis with hypoxia (oxygen starvation), the work mainly of the nervous and cardiovascular systems, as well as other tissues and organs, is disrupted.
Symptoms
An audible barking cough, hoarseness and stridor - noisy breathing caused by narrowing of the larynx. There is inspiratory shortness of breath (hard to breathe). The child is restless. The degree of fever depends on the type of pathogen and the body's response. Possible low-grade fever (often with parainfluenza infection) and an increase in temperature up to 40 ° C (mainly with influenza).
Stenosis degrees
The clinical signs of obstructive laryngitis are directly related to the degree of laryngeal stenosis:
- I degree. Shortness of breath manifests itself only with tension and excitement of the child. On auscultation, lengthened breathing and the presence of single wheezing rales in the lungs, manifested mainly on inspiration, are heard;
- II degree. It is characterized by dyspnea at rest. Auscultation reveals dry wheezing. A bluish (cyanotic) color of the nasolabial triangle is present, indicating oxygen starvation. Tachycardia, restlessness, sleep disturbance are present;
- III degree. Severe inspiratory dyspnea. There is a pronounced large "barking" cough, dysphonia (voice disturbances), diffuse cyanosis, tachycardia. Childhood anxiety gives way to lethargy, confusion, drowsiness. In the lungs, on inhalation and exhalation, non-uniform dry and moist wheezing is heard;
- IV degree. The typical croupous "barking" cough and noisy breathing are absent. There is irregular shallow breathing, bradycardia (decrease in heart rate), hypotension (decrease in blood pressure). There are seizures. Confused consciousness goes into a hypoxic coma. Obstructive laryngitis with grade IV stenosis is fatal due to asphyxiation.
Chronic laryngitis
Chronic laryngitis is a fairly common disease in which inflammation of the mucous membrane of the larynx region is recurrent.
The disease is often accompanied by the development of repeated inflammation that spreads to the upper respiratory tract.
Causes
Many factors can cause chronic laryngitis, including:
- frequent acute laryngitis;
- diseases associated with metabolic disorders;
- complications of influenza or chronic infectious diseases;
- exposure to dust, food, or chemical allergens;
- repetitive high loads on the vocal apparatus;
- a place of residence characterized by heavy pollution and dusty air;
- sudden temperature changes;
- weakening of protective functions;
- allergic reaction;
- gastroesophageal reflux.
Symptoms
The symptoms of chronic laryngitis are nonspecific, and their expression directly depends on the severity of pathological changes in the vocal cords.
Common symptoms include hoarseness, loss of voice, sore throat, and dry cough. Cough appears due to stimulation of tactile receptors located in the larynx region, or the formation of zones of inflammatory lesions in the trachea and bronchi.
The child may have a fever, swelling of the lymph nodes in the neck and difficulty swallowing.
Hoarseness manifests itself in varying degrees. In some children, this symptom occurs only in the morning and disappears during the day. But sometimes patients have persistent dysphonia.
When should you call an ambulance?
- Breathing disorder. It becomes intermittent, irregular, sometimes accompanied by shortness of breath.
- Occurrence of obstructive laryngitis, especially in infants.
- Complicated degrees of laryngitis.
- The presence of diseases of the nervous system of a chronic nature, allergic reactions and other factors that worsen the condition.
- If a child experiences fear when coughing, shortness of breath, the temperature is kept above normal for more than a day, an ambulance should be called immediately.
With the development of obstructive laryngitis, all efforts should be made to reduce spasm and laryngeal edema, to restore normal breathing. Before the doctors arrive, do an alkaline inhalation, place the child vertically in a humid room, a distracting procedure is possible - a hot foot bath.
Diagnostics
A medical professional can diagnose laryngitis in a doctor's office with a little testing. The examination is often brief and limited to examining the ears, nose, throat, and looking for other potential causes of colds.If the throat is red and there is a suspicion of a strep throat infection, a rapid strep test may be ordered.
If a hoarse voice becomes a chronic condition, the specialist should conduct a detailed survey and examination to find out why the larynx remains sore for such a long time.
In most cases, no additional tests are required to confirm the diagnosis of laryngitis. In patients with chronic laryngitis, the need for blood tests, x-rays, and other diagnostic tests will depend on the outcome of the patient's examination and the potential concern for the doctor about hoarseness.
Laryngoscopy is the most common test performed to look directly at the vocal cords and assess their function. The procedure uses a thin tube containing an illuminated fiber-optic camera, which is inserted through the nose and into the lower throat.
The doctor performing this procedure can see if the vocal cords are inflamed, have polyps or growths, and if the vocal cords are moving properly with breathing and speaking. This test is often performed by an otorhinolaryngologist, but many other doctors and specialists are trained in direct laryngoscopy.
Treatment. Regime moments
Comprehensive treatment in the early stages of the disease involves the implementation of the following recommendations.
- Strict bed rest.
- Limiting the load on the vocal apparatus. The child should talk less. It is difficult, but this measure is the key to a quick recovery. For young children who develop laryngitis, limiting overexertion is especially important, since the vocal cords are at a developmental stage, and excessive stress can lead to irreparable voice impairments.
- Constant air control. The best option is moderately humid air in the room. This can be achieved by using a humidifier and regularly ventilating the room.
- Drink plenty of drinks - fruit drinks, herbal teas, milk, bottled water. The main goal is to prevent dry cough, reduce intoxication.
- Balanced diet, vitamins, avoidance of irritating foods. The food is dietary and healthy.
How to treat laryngitis in children?
Standard preparations
The standard complex of treatment involves the use of several groups of medicines:
- Antihistamines. This group of medicines is always prescribed for laryngitis in children. They not only reduce the swelling of the mucous membrane, but also have a calming effect on the child, especially if you give these funds at night (Suprastin, Zirtek, Tsetrin, Zodak, Claritin).
- Expectorant and antitussive medicines. There are countless such drugs on the pharmacy market. But the choice should only be made by a pediatrician. With a severe paroxysmal cough, the doctor may recommend antitussives or a combination of drugs in a dose according to age (Gerbion, Sinekod, Stopussin phyto, Libeksin). When the cough becomes wet, the doctor may prescribe expectorant medicines for wet coughs (Alteika, Thermopsis), drugs with the active ingredient bromhexine (Solvin, Bronchosan), acetylcysteine (Fluimucil), ambroxol (Lasolvan, Ambrobene).
- Preparations in the form of sprays. Among the most effective sprays are Lugol spray, Hexoral, Miramistin, Faringosept, Stopangin.
- Antipyretic. At high temperatures exceeding 38.5 ° C, Paracetamol or Ibuprofen recommended for children can be given.
Antibiotics for laryngitis
The use of antibiotic therapy for laryngitis is justified only for the following reasons:
- Bacterial inflammation is present, which is detected only after diagnosis (laboratory tests, taking a smear from the laryngeal mucosa).
- Intoxication - severe fever, chills, weakness, lack of appetite.
Often pediatricians are reinsured, prescribe antibiotics for uncomplicated laryngitis to avoid the consequences.
Only in some cases is laryngitis bacterial, often a viral infection that cannot be treated with antibiotics.
Antibiotics that are often used for laryngitis:
- a series of penicillins (Amoxiclav, Flemoklav Solutab, Augmentin);
- cephalosporin syrups (Cefadox, Cefixim, Suprax), injections (Fortum, Ceftriaxone);
- for severe laryngitis, azithromycin (Zetamax retard, Sumamed, Hemomycin, Azitrox, Ecomed) and other macrolides (Clarithromycin, Macropen) are prescribed.
Inhalation with laryngitis
A picture familiar to many from early childhood: a pot of freshly boiled potatoes or a hot kettle with a closed spout and a large towel, carefully prepared. For decades, steam inhalation has been a favorite folk way to combat inflammation of the respiratory tract of an infectious genesis. To replace household appliances, technological inventions have appeared that affect the focus of the disease in the most efficient and safe way.
Inhalation for laryngitis is one of the most effective methods of treatment.
The course of treatment is 5-10 procedures.
Contraindications
Limitations include:
- acute sinusitis;
- inflammation in the nasopharynx of a purulent nature;
- otitis;
- bacterial infection;
- allergy to ingredients of drugs used for therapy;
- weak immune defense;
- certain systemic diseases.
Inhalation types
Inhalation is conventionally divided:
- according to the temperature regime - cold (treatment at room temperature) and hot (the inhaled drug is preheated);
- according to the method of obtaining a medicinal substance - steam (dry or wet) and hardware (inhalers, nebulizers).
Cold inhalation involves the use of aerosols and sprays with medicinal ingredients fortified with herbal extracts and aromatic oils. They are prescribed only by a specialist and are part of a therapy consisting of antibiotics, antiviral drugs and other types of inhalation.
Hot methods include steam inhalation, which is done in a variety of ways.
Breathing should be soft, deep breaths are unacceptable so as not to burn the lining of the larynx.
Inhalation using sea salt and baking soda gives a positive result. Alkaline inhalation with baking soda is used to relieve the disease. This procedure takes no more than 8 minutes to complete. The use of soda solutions leads to a decrease in edema of the mucous membrane of the throat, reflex activation of cough with copious sputum. Inhalation should be done no more than 2 - 3 times a day.
When there is no allergy, you can inhale with essential oils (cedar, pine, juniper, eucalyptus). You only need a few drops of oil in a glass of water.
Hardware methods of inhalation
You can now easily purchase steam inhalation devices from pharmacies and specialty stores. With their use, the treatment procedure is much easier. One such device is a nebulizer (nebulizer). The device generates steam at room temperature. This aerosol condenses on the walls of the larynx and on the vocal cords. Thus, the drug acts directly at the center of the inflammation process.
Today, inhalation spraying is carried out both in the hospital and at home.
There are three types of nebulizers:
- ultrasonic;
- compressor;
- mesh nebulizers.
Ultrasonic nebulizers are mainly used in hospital settings. A medical aerosol of a liquid drug is formed by exposure to ultrasonic waves.
Compressor nebulizers, compressing air in a special chamber, convert liquid medicines into therapeutic vapors. The structure of the drug is not disturbed. This enables you to use all medications suitable for this device. The large size of the device and a lot of noise that frighten children are its disadvantages.
The third type of nebulizer (mesh inhalers) combines the best of compressor and ultrasonic inhalers. Under the action of ultrasonic waves of a lower frequency, a finely dispersed aerosol is created. At the same time, the devices do not create noise, are small, and do not degrade the drug. The main disadvantage is the high price.
Inhalation with a nebulizer
Procedure rules:
- the procedure is performed while sitting, the device should be upright;
- during inhalation, silence must be observed;
- the procedure should begin no later than six hours after eating;
- after the procedure, you need not talk for hours or eat;
- if a sore throat does not allow you to inhale and exhale the medicine through your mouth, do it in a special mask;
- you can dilute the drug with saline according to the directions;
- the duration of the procedure is not more than 10 minutes;
- after inhalation, the device is washed with distilled water and wiped dry.
For children 3 to 4 years of age, inhalation therapy is included in the treatment plan only with a prescription, as the risk of potential obstruction is greater than the benefit. From 3 to 7 years, exposure to steam is possible, but only with great care. After 8 - 10 years, the effectiveness of inhalation for children is similar to that for adults.
Prevention
Walk regularly with your child in the fresh air, ventilate the house, observe the correct daily routine and monitor the correct diet.
In the rooms where the child sleeps and spends time, create a cool, humid microclimate with a temperature of 18 degrees Celsius.
Prevention also includes preventing the development of acute colds, avoiding close contact with the sick, and washing hands after being outdoors and before eating.
Hardening is desirable.
Keep your vocal cords warm.
