A hoarse voice is one of the signs of laryngitis in a child

Mechanism of disease development

Acute laryngitis is an inflammation of the mucous membrane of the larynx. The larynx is located in the front region of the neck. It connects the pharynx to the trachea and performs three vital functions:

• sound-producing (the vocal apparatus is located in it);
• respiratory;
• protective (prevents food and foreign particles from entering the trachea).

Under the influence of a number of factors (hypothermia, overstrain of the vocal cords, allergies, infectious diseases, etc.), the mucous membrane of the child’s larynx becomes inflamed. As a result, a sharp dilation of blood vessels occurs, edema develops, the lumen of the glottis narrows (or completely closes), speech function is impaired and breathing becomes difficult.

Causes of laryngitis

The frequent occurrence of laryngitis in children is associated with the structural features of the ENT organs of a growing organism.
The child’s nasopharynx is not yet fully formed; it is significantly narrower than the nasopharynx of an adult and has a funnel-shaped appearance. The mucous membrane itself is quite loose and prone to swelling. In connection with all this, in most cases, inflammation of the larynx, which does not pose a particular problem for adults, turns out to be a real torment for young children. The main reason for the development of laryngitis is the entry of pathogenic organisms and viruses into the larynx. Normally, local immunity is able to independently cope with pathogenic microflora. The development of the disease is associated with a decrease in the child’s immune defense. The situation can arise due to hypothermia, the presence of concomitant diseases (influenza, measles, pneumonia, tuberculosis, etc.), dusty premises, and passive smoking. All this contributes to damage to the laryngeal mucosa and the development of inflammation.

It should be noted that laryngitis can have not only viral and bacterial origin. Other causes of pathology:

• allergic reactions;
• mechanical damage to the larynx (due to burns or injury to the walls);
• overstrain of the vocal apparatus;
• prolonged exposure to dry, dusty air.

Causes of acute laryngitis in children

In order for assistance to a child with acute laryngitis to be as effective as possible, you must first find out what caused the development of the disease. The main provoking factors include:

• ARVI, influenza;
• bacterial respiratory tract infections caused by pneumococcus, staphylococcus, streptococcus, hemophilus influenzae;
• complications after scarlet fever, measles;
• inflammation of the paranasal sinuses;
• local/general hypothermia of the body;
• inhalation of cold, smoky air;
• congenital weakened resistance of the respiratory tract;
• unfavorable environmental conditions;
• contact with allergens;
• uncontrolled use of sprays and aerosols for the throat, leading to a reflex spasm of the larynx in a child;
• overstrain of the vocal cords (strong screaming, loud singing);
• infectious diseases of the oral cavity;
• stress factors.

Diagnosis of laryngitis

SM-Doctor otolaryngologists have many years of experience in diagnosing and treating children with laryngitis.
Specialists are able to relieve a small patient from discomfort in a short time, eliminating the unpleasant symptoms of the disease. At the initial appointment, the otolaryngologist carefully listens to the complaints of the patient and his parents, identifies possible causes of the inflammatory process (presence of respiratory tract diseases, allergic reactions, etc.). Then the doctor begins to examine the oral cavity. For this, a classic visual examination of the pharynx or an instrumental examination using a special laryngoscope device can be used. The end of this instrument contains a light source, which helps the specialist to thoroughly examine the ENT organs, determine the cause of symptoms and, if necessary, take biomaterial for further laboratory research. After examining the nasopharynx, the doctor gives directions for further examinations to confirm the diagnosis. Diagnosis of laryngitis is carried out using the following methods:

• Taking general clinical blood and urine tests to identify the presence of an inflammatory process.
• Taking a swab from the pharynx to determine the type of infectious agent.

Based on the diagnostic results, the specialist makes a final diagnosis and selects the most optimal treatment in a particular case.

Symptoms of acute laryngitis

In childhood, acute laryngitis develops quite rapidly. At an early stage of the disease caused by a virus, the child experiences:

• general weakness,
• nasal congestion,
• soreness,
• redness of the throat,
• painful swallowing.

In some cases, body temperature may rise to 38–39°C.

Further added to the above symptoms are:

• rhinorrhea (excessive mucus discharge from the nasal passages);
• dry barking cough;
• hoarseness or complete loss of voice.

Over time, during intensive complex treatment of laryngitis, the cough becomes more rare and productive, that is, accompanied by the discharge of sputum.

Prevention of laryngitis

In order to reduce the likelihood of relapse of the disease to a minimum, it is necessary to follow preventive measures:

• carefully monitor oral hygiene;
• harden the body;
• avoid hypothermia;
• eat a balanced diet, include more fresh vegetables and fruits in your diet;
• spend enough time outdoors;
• engage in physical activity;
• avoid excessive stress on the vocal apparatus.

Treatment of laryngitis at SM-Doctor means the professionalism of doctors, modern equipment, an individual approach and an affordable price. Trust your children's health only to qualified specialists!

Complications of acute laryngitis in children

One of the most dangerous complications of acute infectious laryngitis, characteristic of early and preschool childhood, is stenosis (narrowing of the lumen) of the larynx. It is also called false croup or acute airway obstruction. This complication may be due to the structural features of the child’s respiratory tract. Most often it develops against the background of influenza, parainfluenza, adenovirus, measles infection or chickenpox.

When the space under the vocal cords swells, the lumen of the larynx narrows, acute obstruction of the airways occurs, and oxygen deficiency develops. Symptoms of laryngeal stenosis are:

• heavy wheezing,
• barking cough
• hoarseness or complete loss of voice,
• excessive excitement of the child,
• enlarged lymph nodes,
• increase in body temperature,
• the appearance of light dry wheezing.

If you notice these symptoms, you should immediately consult a doctor. But it’s better not to let this happen and start treating acute laryngitis on time.

Why does Quincke's edema occur?

Histamine is a special substance in the human body. It is found in mast cells of connective tissue, spleen, lymph nodes, and bone marrow. After inflammation has occurred, mast cells are activated and release a charge of histamine into the blood. Histamine increases the permeability of vascular walls and dilates capillaries. Blood flow slows down, swelling of the skin tissue appears. For example, with Quincke's edema, the process involves the deep layers of the skin, and with urticaria, only the upper ones. In both cases, accumulations of inflammatory cells (lymphocytes and neutrophils) appear at the site of histamine action.

Quincke's edema appears as a result of non-allergic, allergic and mixed mechanisms:

• Non-allergic reactions occur most often in children. Histamine is released due to exposure to food dyes, medications, and after an insect bite.
• With the allergic mechanism, an allergen enters the body, which is accepted by the body as hostile and launches an attack of immunoglobulins (antibodies) against it. These antibodies attach to the mast cell membrane. Antibodies have a good specific memory; they know exactly what the antigen looks like. If the allergen enters the body again, it binds to the antibody and the mast cell releases histamine. Therefore, Quincke's edema develops precisely when the allergen is repeatedly exposed.
• The mixed form includes hereditary angioedema. The nature of this manifestation may be hereditary, if one of the relatives has previously experienced swelling of the larynx and other organs.

Diagnosis of the disease

Diagnosis of acute laryngitis is not particularly difficult. The diagnosis is based on the presence of acute respiratory infections symptoms, as well as hoarseness, shortness of breath, and barking cough. Call a doctor: he will listen to complaints, examine the child, measure the temperature, listen to the lungs and make a diagnosis.

Diagnostics

In the acute period, the doctor prescribes laboratory research methods:

• Study of the complement system.
• Determination of specific IgE in blood serum using a multiple allergosorbent test and ELISA.
• Determination of IgE in blood serum.

After a few months, other studies will be scheduled:

• Carrying out skin tests.
• Immunogram study.

If the swelling is non-allergic in nature, a bacteriological, general clinical, and biochemical blood test will be required.

Non-drug therapy

Treatment of acute laryngitis depends on the age of the child. This may include:

• compliance with bed rest;
• limiting vocal load (for 5–7 days it is better for the baby to remain silent or talk as little as possible);
• maintaining the optimal temperature (+18…+20°C) and air humidity (50–70%) in the room where the sick child is located;
• drink plenty of fortified drinks (the liquid should be warm and unsweetened);
• following a hypoallergenic diet - if there are symptoms of laryngitis, it is strictly not recommended for a child to give sour, spicy, too hot or cold foods and carbonated drinks.

When treating inflammation of the mucous membrane of the larynx, children are allowed to apply wet and dry warming compresses to the neck area and gargle with a warm infusion/decoction of chamomile or sage, if recommended by a doctor.

IRS®19 in the treatment and prevention of the problem

With chronic laryngitis in childhood, there is a decrease in the immune function of the laryngeal mucosa1. Therefore, when treating chronic laryngitis, it is important to reduce the risk of subsequent infections. IRS®19 nasal spray can help with this. The drug is indicated for the treatment of acute and chronic laryngitis, as well as for the prevention of chronic laryngitis and other chronic diseases of the upper respiratory tract5. It begins to act immediately after contact with the nasal mucosa, activating local mucosal immunity. Protection against viruses and bacteria is formed in the nose. After all, IRS®19 contains 18 bacterial lysates - decay products of microorganisms that most often cause acute and chronic diseases of the upper respiratory tract and bronchi7.

IRS®19 is approved for children from 3 months and is suitable for the whole family4. The drug helps fight chronic laryngitis or can be an effective means of preventing infection. After a course of prophylaxis, the effect lasts up to 3-4 months7.

Drug therapy

How to fight infection?

Drug therapy for laryngitis that appears in a child against the background of an acute respiratory infection includes the use of antiviral and immunomodulatory drugs.
Antihistamines, which are usually prescribed for allergies, help relieve swelling of the mucous membrane and calm the baby. They should be given before bedtime, strictly according to the recommendation of the attending physician. What to do if you have a cough?
Remedies for this symptom are another essential component of treatment.
In the early stages of laryngitis, if a child has a dry hacking cough, drugs that block the cough center are used. Next, at the first signs of coughing, mucolytics are prescribed to thin the mucus and improve expectoration of sputum. Doctor MOM® cough syrup has similar properties. This complex herbal medicine, containing extracts of 10 medicinal plants, helps not only to liquefy mucus, but also to relieve swelling and inflammation. Herbal syrup is approved for long-term use in the treatment of laryngitis in children over 3 years of age. Actions at temperature.
If a child has a hard time tolerating a high temperature, he is prescribed an antipyretic. Treatment of laryngitis with antibiotics is justified only in the presence of serious bacterial complications and only as prescribed by a doctor.

In children, as well as in adults, it occurs for the same reasons. However, due to a weak immune system, children get sick much more often. All parents should be familiar with the symptoms of laryngitis and know how to properly treat it.

Symptoms and treatment of laryngitis in a child

How to identify symptoms of laryngitis in a child? In most cases, laryngitis is diagnosed in children only with the onset of changes in the voice. It is necessary to ensure that the child does not become hypothermic and does not scream in the cold while playing. The doctor should examine the child's ligaments, as well as the throat and larynx for inflammation. The latest technology allows you to examine your sore throat in detail using a tube with a camera that is inserted into your mouth or nose. A child's complaints of a sore throat and difficulty breathing are the first symptoms of laryngitis. Children of preschool age get sick more often, since the cartilage of the larynx is still weak and cannot withstand deep breaths. In infants, laryngitis manifests itself through a cough with an increase in body temperature above 38.0 C.

Acute laryngitis can begin suddenly with an upper respiratory tract infection. The most common viruses that cause laryngitis in children are Haemophilus influenzae and Branchhamella catarrhal. It is these viruses that cause pain during speech.

Laryngitis in children - treatment

How do you start treating laryngitis in children? First, you need to determine the cause. If laryngitis occurs against the background of a viral infection, then doctors recommend drinking plenty of fluids and resting the vocal cords. Of course, during this period, parents will have to force the child to be silent for some time.

Other treatment is resorted to if laryngitis is caused by improper functioning of the alimentary sphincter. In such situations, you should follow a certain diet that will exclude from the child’s diet some foods that cause increased acidity.

During the period of treatment of the child, the correct drinking regime should be observed. The liquid is needed to wet the larynx. Plain water can be replaced with herbal teas or nutritious juices. Hot tea with milk and honey is useful in case of laryngitis. Warm drinks soothe the throat, and honey works as an antiseptic, preventing the growth of bacteria. To achieve the fastest results, doctors recommend a traditional remedy - steam inhalation.

Remember that timely contact with specialists will help your child get rid of illness and discomfort faster. Our clinic offers the services of experienced specialists with extensive experience.

Laryngitis in a child: symptoms and features of the course of the disease

Laryngitis is commonly understood as inflammation of the larynx, which is the narrowest point of the respiratory tract. During the acute respiratory infections season, many children suffer from this disease. Unfortunately, very often it gives complications in the form of breathing problems. Let's figure out how you can help your child.

Signs of laryngitis

The characteristic symptoms of laryngitis are directly related to the place of its localization, because the ligaments actually suffer, as a result of which the voice changes. Signs of the disease are:

• hoarseness or hoarseness of voice;
• a short, rough, hacking cough, which is also called “barking.”

Laryngitis can be viral, bacterial or allergic in nature. In order to identify the cause of the disease, its other symptoms should be analyzed.

For example, with allergic laryngitis there is no increase in body temperature and lethargy, and a coughing attack is preceded by contact with an irritating substance.

Viral laryngitis is most often accompanied by a runny nose, sneezing, hyperthermia and other usual signs of ARVI. By the way, sometimes this disease occurs with measles, rubella, chickenpox and other non-respiratory infections.

Bacterial laryngitis is considered the most dangerous for a child. Often it is a companion to diphtheria.

It is worth noting that very rarely inflammation of only the larynx occurs; in most cases, the trachea also suffers, that is, laryngotracheitis is diagnosed.

Croup

Quite often, inflammation of the larynx leads to the fact that air cannot pass through it freely, that is, stenosis occurs. Breathing becomes noisy, heavy, very difficult, and a whistling sound is heard when inhaling. This condition, combined with hoarseness, barking cough and symptoms of an infectious disease, is called croup (from the English word “croak”).

There are true croup, which occurs with diphtheria, and false croup, which develops against the background of ARVI. Today, true croup is rare, unlike false croup.

As a rule, children from six months to five years old suffer from viral croup, and boys experience it twice as often as girls. Many children grow up not knowing what croup is, while others get it several times a year. Medical science cannot explain why this happens. It all depends on the structure of the larynx and the immunity of each individual child.

Prevention of croup and first aid for a child

In most cases, viral laryngitis begins with a runny nose, fever, hoarseness and a barking cough. Breathing problems most often occur at night: the child coughs and cannot breathe air. Therefore, the first symptoms of laryngitis are a reason to call a doctor.

In addition, it is advisable to give a baby who has contracted ARVI plenty of water and feed according to his appetite. It is very important to put him to sleep in a cool room with high humidity. If an attack of croup occurs, you should call the emergency room or take the child to the hospital.

While waiting for medical help, it is recommended:

• do not panic and calm the baby;
• dress him warmly and give him the opportunity to breathe outside (cool) air;
• turn on the hot water in the bathroom and bring the child there so that he can breathe the steam.

Direct treatment of laryngitis depends on its nature and is prescribed by a doctor. It is worth noting that only bacterial infections require antibiotics.

Laryngitis in a child requires special vigilance from parents, because it can result in croup, characterized by difficulty breathing. This disease requires mandatory consultation with a doctor and strict adherence to the principles of treatment of acute respiratory viral infections: drinking plenty of fluids and proper air conditions in the children's room.

Publications in the media

Chronic laryngitis is a chronic inflammation of the mucous membrane of the larynx, submucosal layer and internal muscles. For etiology, see acute catarrhal laryngitis, acute phlegmonous laryngitis.

Classification • Catarrhal • Atrophic • Hyperplastic •• Diffuse •• Limited ••• Vocal cord nodules (singers' nodules, screamers' nodules) ••• Pachyderma of the larynx ••• Chronic subglottic laryngitis ••• Prolapse of the Morganian ventricle ••• Contact ulcer.

CHRONIC CATARHRAL LARINGITIS Clinical picture • Hoarseness • Voice fatigue • Change in voice timbre and its transition to rough, weak and low-pitched.

Laryngoscopy ( indirect) • Hyperemia and congestive swelling of the laryngeal mucosa • Chronic catarrhal laryngitis, associated with cervical muscular pathology, is accompanied by tension in the anterior cervical muscles and their soreness, the formation of painful compactions (triggers) in the muscular-ligamentous apparatus of the larynx.

Treatment • Elimination of the etiological factor • Reduction of vocal load • Infusion into the larynx of a mixture consisting of 150 thousand units of benzylpenicillin, 250 thousand units of streptomycin, 25 mg of hydrocortisone, 4 ml of 0.9% sodium chloride solution, 2 ml 1-2 times /day for 10 days • For viscous mucus, hydrocortisone can be replaced with 25 mg of chymopsin • Daily inhalations of 2% citral oil solution 1–2 times a day for 10 days • Climatotherapy.

CHRONIC ATROPHIC LARINGITIS Clinical picture • Dryness in the larynx • Hoarseness • Rapid voice fatigue. Laryngoscopy. The mucous membrane of the larynx is thinned, smooth, shiny, in places covered with viscous mucus and crusts. The vocal folds are flaccid, thin, and do not close completely during phonation, leaving an oval-shaped gap. The lumen of the larynx may be narrowed due to the accumulation of crusts with the possible development of laryngeal stenosis of degrees II–III. Treatment • Elimination of the cause of the disease • Stop smoking, avoid irritating foods • Gentle voice mode • Irrigation of the pharynx and inhalation of a mixture consisting of 200 ml of 0.9% sodium chloride solution and 5 drops of 10% iodine tincture, 2-3 times a day (per procedure - 40-60 ml) for 5-6 weeks or more • Alkaline-oil inhalations for 5 days - in the presence of viscous mucus and crusts in the larynx • Intralaryngeal infusions of 1-2% menthol oil solution daily for 10 days • Potassium iodide (30% solution, 8 drops) orally 3 times a day for 2 weeks.

CHRONIC HYPERPLASTIC LARINGITIS (diffuse form) Clinical picture • Persistent hoarseness and fatigue of the voice, sometimes aphonia • Cough with mucous discharge. Laryngoscopy • The mucous membrane is edematous, hyperemic, which leads to a narrowing of the lumen of the larynx, its surface is uneven, which is clearly visible when examining the free edges of the vocal folds. They are fusiformly thickened, which prevents complete closure of the glottis during phonation.

CHRONIC HYPERPLASTIC LARINGITIS (limited forms) is characterized by the locality of the process and the presence of thick mucus both in the interarytenoid space and throughout the mucous membrane and in the lumen of the larynx. Nodules of the vocal folds (nodules of singers, nodules of screamers) occur when the vocal apparatus is overloaded, more often in people of vocal-speech professions (singers, announcers, tour guides, etc.) and in children who cry or scream a lot.

Laryngoscopy • The mucous membrane is pink, on the border between the anterior and middle thirds of the vocal folds there are symmetrical formations in the form of nodules on a wide base with a diameter of up to 1 mm (connective tissue outgrowths resembling calluses) • Vocal fold nodules occur equally often in patients with weakness (atony) vocal folds and with their excessive tension • Nodules located symmetrically along the edges of the vocal folds prevent the complete closure of the glottis, as a result of which the voice becomes hoarse.

Features of various clinical forms. • Pachyderma of the larynx •• Laryngoscopy. Pachyderma is limited outgrowths of the mucous membrane of the larynx, externally resembling tubercles or granulations, localized in the posterior third of the vocal folds and the interarytenoid space (posterior commissure). Their surface is often smooth, but can also be rough; characteristically viscous discharge in the lumen of the larynx •• Differential diagnosis ••• Laryngeal fibroma (on a broad base, light gray in color) ••• Laryngeal papilloma (has a papillary structure and gray color) ••• Granulation in tuberculosis (history of tuberculosis, presence of infiltrates with an ulcerated surface).

• Chronic subglottic laryngitis •• Laryngoscopy. In the subglottic space - hypertrophy of the mucous membrane, reminiscent of the picture of false croup •• Differential diagnosis - acute subglottic laryngitis (various degrees of laryngeal stenosis, paroxysmal course, children are mainly affected).

• Prolapse of the Morganian ventricle •• Chronic inflammatory process of the mucous membrane of the Morganian (laryngeal) ventricle can lead to its hypertrophy. This is facilitated by trauma and irritation of the ventricular mucosa •• Laryngoscopy. During forced exhalation, phonation, and coughing, the hypertrophied mucous membrane protrudes from the ventricle of the larynx and partially covers the vocal folds. Edema formations, protruding beyond the edge of the vocal fold, prevent the complete closure of the glottis, causing the hoarse sound of the voice.

• Contact ulcer •• Elongated vocal processes of the arytenoid cartilages during phonation injure the mucous membrane of the opposite vocal fold •• Laryngoscopy. At the border between the middle and posterior thirds of the vocal folds, a defect (“saucer”) is formed on one side, and a “pestle” on the other, which prevents complete closure of the glottis and is expressed in loss of voice sonority •• Differential diagnosis ••• Laryngeal neoplasm ( biopsy followed by histological examination) ••• Granulomas in chronic specific infections (tuberculosis, syphilis, scleroma).

Treatment • Elimination of the etiological factor • Emollients and anti-inflammatory drugs, for example, daily infusions into the larynx of 1.5–2 ml of 1% oil solution of menthol, sea buckthorn oil, daily inhalations of chlorobutanol for 10 days • Astringents and cauterizing agents: infusions into the larynx 1 .5–2 ml of 1–3% collargol solution, 2% protargol solution, 0.5% resorcinol solution daily for 10 days, 0.5 ml of 0.25% silver nitrate solution every other day (for hypersecretion), 1 ml of 1% haloscorbine solution for 10 days • Lubricating the laryngeal mucosa with 1–2% silver nitrate solution after 1–2 days, as well as Lugol’s solution • To thin viscous mucus - infusion into the larynx, 1.5–2 ml of a solution of chymotrypsin or trypsin (0.5–1:1,000), sea buckthorn or peach oil • In case of insufficiency of the functions of the neuromuscular apparatus of the larynx - electrophoresis with 5% solution of calcium chloride on collar area (12–15 procedures for 15–20 minutes).

Clinical examination. The diffuse form of chronic hypertrophic laryngitis and dyskeratosis of the laryngeal mucosa are classified as precancerous conditions. Patients should be examined twice a year using modern diagnostic methods. Forecast . With systematic and adequate treatment of chronic laryngitis, the outcome is favorable.

ICD-10 • J37.0 Chronic laryngitis.