In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
Swelling of the larynx can appear suddenly and be life-threatening, although its causes are seemingly innocent. It is enough that we are allergic to peanuts, milk or fish, as well as certain drugs or insect venoms.
The larynx is the part of the respiratory system that connects the throat to the trachea, where the vocal apparatus is located. Laryngeal edema is a situation in which, due to the accumulation of fluid within the soft tissues that make up this organ, its lumen is narrowed or completely closed, through which air travels to and from the lungs during breathing.
The symptoms of laryngeal edema depend on its severity and the speed of its increase. There may be a feeling of scratching and itching in the throat at first. This may be followed by hoarseness, difficulty speaking, or other sudden changes in voice. Another characteristic symptom is an attack of dry, exhausting cough resulting from the feeling of irritation in the throat. Sometimes it is called barking cough, common in children. Swallowing problems may also arise. Eventually, shortness of breath occurs, the severity of which depends on the degree of laryngeal closure. It mainly consists of problems with inhaling. The air, squeezing with difficulty through the swollen larynx, can cause the characteristic wheezing known as the laryngeal stridor. Sometimes, however, when the swelling develops rapidly, breathlessness may be the first symptom.
Laryngeal edema can have many causes, the most common being an allergic reaction. It is observed in more than half of the cases of anaphylactic shock. The cause of allergic laryngeal edema may be allergy to insect venoms (e.g. wasps, bees, hornets), drugs (e.g. antibiotics, drugs for the treatment of high blood pressure, non-steroidal anti-inflammatory drugs) or food (e.g. fish, seafood, peanuts). Less commonly, the cause may be exposure to inhaled allergens or parenteral protein substances or sera used in medicine.
Another cause of laryngeal edema may also be the so-called angioedema, also known as Quincke’s edema. In this disease, due to the increased permeability of blood vessels, swelling occurs in various locations, including the larynx. The disease may be congenital or acquired, and some cases are allergic and coexist with urticaria. Foods (peanuts, walnuts, chicken eggs, milk), drugs (non-steroidal anti-inflammatory drugs), as well as non-specific stimuli in the form of stress or trauma can be triggering the cascade of complex allergic-immune reactions.
Laryngeal edema is also a complication of respiratory infections, both viral (influenza virus, parainfluenza, rhinovirus, enterovirus) and bacterial (Haemophilus influenzae). Laryngitis in children can be especially dangerous. Due to the different structure of the larynx in the youngest, it is more prone to the occurrence of inflammatory edema. Sometimes in children, shortness of breath and stridor appear suddenly and are not preceded by other symptoms and complaints.
Another, less common cause of laryngeal edema are injuries (e.g. during the removal of the endotracheal tube, prolonged intubation), injuries of the laryngeal soft tissues and thermal burns (e.g. as a result of inhalation of hot air during a fire) and chemical burns (e.g. as a result of inhalation of irritants).
Keep in mind that laryngeal edema is a potentially life-threatening situation. Sudden onset of inspiratory dyspnea, stridor and hoarseness, especially in children, requires urgent medical consultation. The management and treatment of laryngeal edema depends on its cause (adrenaline, glucocorticosteroids, fresh frozen plasma). The priority is to keep the airways open. Sometimes intubation is necessary, and in extreme cases, when the larynx is completely closed and intubation is not possible, life-saving tracheotomy or cricothyrotomy procedures are performed.
Text: lek. Paulina Jurek
Read also: Acute laryngitis in children