Throat obstruction
Introduction
Introduction Laryngeal obstruction is a condition in which the lesion of the larynx or adjacent organs narrows the airway of the throat so that breathing difficulties occur. It is not an independent disease, but a group of syndromes. Because the laryngeal obstruction can cause hypoxia, if the treatment is not timely, it can cause suffocation and endanger the patient's life. Due to the acute and slow onset of the disease, the laryngeal obstruction is divided into acute and chronic.
Cause
Cause
1. Inflammation: such as acute epiglottis, pediatric acute laryngitis, acute laryngotracheal bronchitis. Inflammation in the vicinity of the larynx, such as posterior pharyngeal abscess, pharyngeal infection, submandibular cellulitis, etc.
2. Throat foreign bodies: especially large incarcerated foreign objects, such as plastic bottle caps, glass balls, large Chinese medicine pills, etc.
3. Laryngeal trauma: such as laryngeal contusion, bruise, crush injury, cut injury, injury, burn, laryngotracheal intubation injury, endoscopic injury.
4. Allergic edema or neurovascular edema.
5. bilateral recurrent laryngeal nerve paralysis (more common in thyroidectomy).
Examine
an examination
Related inspection
Otolaryngology CT examination breath test
(1) Inspiratory dyspnea: The reason is that the vocal cord is tilted in the flat and downward direction. Under normal circumstances, the airflow pushes the slanting door inward and downward when inhaling, but the vocal cord is abducted, the glottis is opened, and the breathing is smooth. However, when the glottis is narrowed, the inhaled airflow pushes the vocal cords downward, so that the free edges of the vocal cords on both sides are close to each other, so the glottis is narrower and the inhalation is difficult.
(2) Inspiratory larynx: The sound that occurs due to the vibration and eddy current generated by the airflow through the narrow throat. When the mucosa under the glottis is swollen, a canine-like cough can be produced.
(3) Inspiratory soft tissue depression: due to the negative pressure generated in the chest cavity during inhalation, the soft tissue of the chest wall is invaded and the inspiratory depression of the sternal upper fossa, supraclavicular fossa, intercostal space, upper abdomen, etc. occurs.
(D), hoarseness: lesions in the vocal cords, due to vocal cord activity disorders and hoarseness symptoms.
(5) According to the severity of the disease, the laryngeal obstruction can be divided into four degrees: once: asymptomatic when crying, crying, and mild inspiratory difficulty during activities. Second degree: There is mild inhalation dyspnea in quiet, increased during activities, but does not affect sleep and eating, and the symptoms of hypoxia are not obvious. Third degree: The breathing difficulty is obvious during the inhalation period, the throat sound is louder, and the soft tissue in the upper sternal fossa and supraclavicular fossa is obviously inflated. Due to lack of oxygen, irritability, difficulty falling asleep, and reluctance to eat. The patient's pulse is accelerated, the blood pressure is increased, and the heartbeat is strong and powerful, that is, the circulatory system compensatory function is still good. Four degrees: breathing is extremely difficult. Due to severe hypoxia and carbon dioxide accumulation in the body, the patient is restless, with cold sweat, pale or cyanosis, incontinence, weak pulse, irregular heartbeat and decreased blood pressure. If you do not rescue in time, you may die due to suffocation and heart failure. According to the symptoms, detailed medical history, the condition allows the person to undergo throat examination, such as indirect laryngoscope, direct laryngoscope, fiber laryngoscope, laryngeal X-ray film, CT throat scan, etc., to find out the cause, diagnosis of acute laryngeal obstruction is easy No need to identify.
Diagnosis
Differential diagnosis
The diagnosis should be differentiated from the following symptoms:
1. Throat . Laryngospasm refers to the reflex spasm of the larynx muscle, which allows the vocal cords to adduct, and the glottis is partially or completely closed, resulting in varying degrees of dyspnea or even complete airway obstruction.
2. Itchy throat and cough. Itching of the throat is characterized by itchy throat, itching cough, the more cough, the cough point above the glottis, the chest through the lungs without lesions.
3. Laryngeal muscle weakness. Vocal cord insufficiency refers to a disease in which the laryngeal muscles are incapable of causing hypokinetic glottic dyskinesia during vocalization, as well as laryngeal muscle weakness and vocal fatigue.
4. There is a phlegm in the throat. A sputum in the throat is a clinical manifestation of chronic pharyngitis. The main symptoms of patients with chronic laryngitis are hoarseness, dry throat, sore throat when speaking, and often sputum adhesion due to increased secretion from the throat.
5. The throat is stinging. Throat in the throat is a symptom of a hard infarction. Throat in the throat may also be a local manifestation of chronic pharyngitis.
6. The throat is enlarged. Throat enlargement is one of the symptoms of the boy's voice change period. The change period: the change period refers to the 14-year-old DD16-year-old teenager, because of the hoarseness, narrow range, pronounced fatigue, local congestion and edema, and increased secretions accompanying the growth of the throat and vocal cords. As a result, the voices of speaking and singing are different from those of childhood and last for six months to one year.
