LARYNGEAL OBSTRUCTION

(Acute obstruction of the upper airway)

LARYNGEAL OBSTRUCTION is commonly seen in children because of smaller size and caliber of the larynx. Obstruction may be complete or incomplete.

CAUSES

  1. Laryngeal diphtheria.
  2. Oedema glottis from acute laryngitis, inhalation of poisonous and irritant gases or corrosive acids or alkali ingestion etc.
  3. Carcinoma of larynx.
  4. Foreign body in the larynx.
  5. Bilateral abductor paralysis of the larynx
  6. Angioneurotic oedema.
  7. Burns and cellulitis of the neck.
    8.Hanging and throttling.
  8. Spasm of laryngeal muscles as in tetanus, strychnine poisoning, Laryngismus stridulus.
  9. Fixity of the cord due to rheumatoid spondylitis.
  10. Aspiration of food and vomitus in comatose subjects.
    CLINICAL FEATURS
    When the obstruction is partial
    1.Inspiratory dyspnoea.
  11. Sucking in of the supraclavicular fossae and lower intercostal spaces
  12. Stridor
    4.Central cyanosis.
    5.Diminished air entry over both lungs.
    When the obstruction is complete
    1.Acute asphyxia.
    2.Deep cyanosis.
    3.No breath sound over the chest.
    3.Rapid coma.
    4.Death within 5-10 minutes.
    Treatment
    Lower tracheostomy is to be done. Treatment of the cause, e.g., tilting the patient or bronchoscopic aspiration if foreign body is present should be done.
    Stem inhalation in case of acute laryngitis gives relief. Adrenaline 0.5-1 cc (1:1000) parenterally, Betamethasone or Dexamethasone 0.5-1 cc (2-4 mg) parenterally will be helpful. In case of Angioneurotic oedema Steroids is to given.
    In cases of choking by food, Heimlich procedure should be adopted immediately.
    Symptomatic treatment should also be done.

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