Laryngeal stenosis in children

In Pediatrics there are many reasons for the development of stenosis of the larynx. These include congenital malformations, acquired stenosis. What is the actual stenosis? This narrowing of the lumen of the larynx, leading to the fact that air barely passes through the respiratory tract. Acquired stenoses are acute and chronic. Chronic stenosis develops slowly, because of this the body manages to adapt to hypoxia, and the effects are not so noticeable.

In acute stenosis narrowing of the larynx is very fast, instantly come to signs of hypoxia. This condition in children can be linked to the peculiarities of the anatomical structure of the larynx. On top of it is covered with a soft epiglottis, subglottic Department, she developed very prone to swelling and having a plurality of blood vessels, connective tissue. The lumen of the larynx is very narrow and has a funnel shape. The adult larynx in the form of a cylinder, wider. It should be remembered that the younger the child, the harder the disease.

Causes of stenosis of the larynx may be:

· Diphtheria (true croup),

· Acute laryngotracheitis (croup false),

· Epiglottis (inflammatory disease of the epiglottis),

· Foreign body of the larynx.

Most often pediatricians face in their practice with acute laryngotracheitis. It is believed that false croup is a complication of viral infectious diseases (SARS, influenza). Why is there a division of false and true croup, what is their difference? In true croup the larynx clog specific film. When false croup symptoms are the same, but the reason is different. Here, the lack of air caused due to an instantaneous spasm of the larynx due to swelling.

Adult with a diagnosis of false croup you will not meet. More common in children from six months to three years, at least – the children of the other age categories.

What are the main manifestations of acute laryngotracheitis? The disease usually develops at 2-3 days from the beginning of the underlying disease, hoarseness appears. Then joins the sonorous barking cough and noisy breathing. All three of these symptom and characterized as a triad of symptoms. Croup usually develops at night or in the morning, unexpectedly. In addition to the core symptoms, the child will experience anxiety, fear, excitement. During physical activity and anxiety, the condition can worsen. In severe cases, the child begins to turn blue, choke, may lose consciousness.

There are four degrees of stenosis of the larynx:

1. First degree (compensated)– the symptoms appear only during exercise and strong emotions. Hypoxia is absent.

2. Second degree (subcompencirovanna) – symptoms appear and the alone. Notes the concern of the kid, when viewed from the visible signs of participation of auxiliary muscles in the act of breathing (retraction of the intercostal spaces, under - and supraclavicular fossae).

3. Third degree (decompensated) – all symptoms are pronounced, there are signs of hypoxia (blue lips and fingertips, pale skin, palpitations). Appears irregular breathing, asphyxiation may result.

4. Fourth degree (terminal). At this stage, the condition is very severe, the child is unconscious, breathing frequent, superficial. The heart rate is reduced, up to stopping of the heart. Although sometimes it may seem that the child is better due to the fact that there is no shortness of breath, barking cough and noisy breathing.

Diagnosis of acute laryngotracheitis is based on data of the clinic, is direct laryngoscopy. Necessary to conduct a laboratory study no. X-rays in this disease plays a supporting role for the differential diagnosis of possible complications (pneumonia).

What to do in acute stenosis of the larynx? The main thing is not to get lost. Immediately call an ambulance. Questions Manager answer correctly and clearly. Thus, you can send the relevant team and will provide assistance. Before the ambulance try to do to help your child. First of all you need to calm down and reassure the child. Become an example for the baby, with your hysterical concern will be the child. Alone it will be much easier.

Your actions:

1. You can give in the absence of allergies natural sedative (tincture of motherwort, Valerian).

2. Give more warm alkaline drink to thin the mucus in the respiratory tract (milk or tea with honey, mineral water without gas).

3. The propensity to allergies give any anti seizure medication. It should be in the house for those parents whose children are prone to allergic reactions.

4. Open the window (window), hang it in the room with wet towels or sheets. These activities will moisturize the air, the child will be easier to breathe.

5. For hands or feet can make a warm bath.

All of your actions will help blood flow, relieve edema of the larynx. The arrival of the ambulance the baby will be given emergency medical care proposed by admission to the hospital. It is advisable not to abandon it, as the child will be under the supervision of a physiciansome time in the Department will conduct the necessary diagnostic procedures. And most importantly, make a swab from a pharynx and nose for the exclusion of such terrible diseases as diphtheria.

Stenosis of the pulmonary artery in children and infants.

In this disease the child will also be manifestations of hypoxia and shortness of breath. Especially in advanced and severe cases. The degree of symptoms will depend on the degree of stenosis. If the narrowing is small, then the manifestations will be almost. This disease is relatively rare. Due to the narrowing of the lumen of the pulmonary artery, the difficulty of the transition of blood into the pulmonary artery from the right ventricle. Over time it increases in size at the expense of muscle tissue, because every time the blood is necessary to overtake all with greater force.

In newborns the pulmonary artery stenosis is manifested by symptoms of congestive heart failure (shortness of breath at rest, cyanosis).

For diagnostic use the following methods:

· ECG revealed right ventricular hypertrophy;

· FCG – study of a heart murmur (stenosis of the pulmonary artery in children marked murmur diamond-shaped or fusiform;

· X-ray – detects enlargement of the heart.

If the stenosis is expressed slightly and symptoms virtually no special treatment is required, only symptomatic. With the progression of the disease, the increase of the degree of stenosis of the child is carried out surgical treatment. The optimal age for the treatment of 5-10 years.