1: Laryngitis and Epiglottitis Flashcards
What is laryngitis
Inflammation of the larynx
How can laryngitis be divided
Acute and Chronic
What is acute laryngitis
Less than 3W
What is chronic laryngitis
More than 3W
What causes acute laryngitis most commonly
Viral Infection
What are two other causes of acute laryngitis
Bacterial
Systemic
What is the most common cause of chronic laryngitis
GORD
What are two other causes of chronic laryngitis
Smoking
Post-nasal drip (Viral)
What is reinke’s oedema
Type of chronic laryngitis seen in smokers. Where due to poor lymphatic drainage - they have oedema of the vocal cords
How does laryngitis present clinically
Hoarse voice Dry cough Dysphasia Fever Painful lymphadenopathy
What is a common feature of laryngitis in children
Stridor in children
How is laryngitis usually diagnosed
Clinically
What is second-line investigation for laryngitis
Laryngoscopy
What is the management of laryngitis
- Vocal rest
- Smoking cessation
- Antibiotics if suspect bacterial infection
What is epiglottis
Inflammation of the epiglottis and surrounding tissue
What age does epiglottitis occur
2-4
What causes epiglottitis
Haemophillus Influenza B
What are two risk factors for epiglottitis
- Unvaccinated
- Immunocompromised
Explain clinical presentation of epiglottitis
- Tripod position + resp distress
- Dysphagia and drooling
- Fever (38-40)
- Muffled voice
- No cough
Why is epiglottitis now rare
Due to haemophilluis Influenza B being part of the immunisation schedule
Explain investigation of epiglottis
If suspect epiglottitis do not examine their mouth as this can lead to airway obstruction. Refer straight to ENT
What is first line management for epiglottitis
- Neb adrenaline
- IV Dexamethasone
- IV antibiotics
- IV Fluids
- Take to theatre for examination under anaesthesia and intubation
What may be seen on pharyngoscopy in epiglottitis
Cherry-red epiglottis
What may be seen on lateral x-ray in epiglottitis
Thumb-print sign
What is complication of epiglottis
Respiratory arrest
Define stridor
High-pitch inspiratory breathing caused by obstruction of larynx or large airways
What does inspiratory stridor usually indicate
Laryngeal obstruction
What does expiratory stridor usually indicate
Tracheobronchial obstruction
What is concerning about stridor
All stridor is a red-flag. Particularly concerning is when volume of stridor decreases - as this means individual is suffering from airway obstruction
What are 4 causes of stridor in children
Croup
Epiglottitis
Laryngomalacia
Foreign Object
What is the most common cause of acute stridor in infants
Croup
How will inhaled foreign body present
Repeated coughing prior to onset stridor
What is laryngomalacia
Congenital anomaly of the larynx
How will laryngomalacia present
New-onset stridor at 4W
