With the medical term Glottic edema is an acute swelling of the larynx lining. With advanced glottic edema, there is a risk of suffocation.
What is glottic edema?
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Glottic edema is a life-threatening swelling of the mucous membrane (edema) in the larynx. The glottic edema can also be called Larynx edema are designated.It can be caused by infection, allergies, or medication. Typical symptoms of glottic edema are hoarseness and increasing shortness of breath.
Therapy depends on the cause. Quick action is necessary, since a complete relocation of the larynx threatens death from suffocation. If there is an acute risk of suffocation, intubation or tracheotomy is performed.
causes
Infection is one of the possible causes of laryngeal edema. These can be caused by bacteria or viruses. Epiglottitis is particularly feared in small children. It is an inflammation of the epiglottis, usually caused by the bacterium Haemophilus influenzae type B. But diphtheria, especially laryngeal diphtheria, can result in glottic edema.
The diphtheria is caused by the pathogen Corynebacterium diptheriae. Glottic edema occurs less frequently in the event of an infection with Streptococcus pneumoniae, Staphylococcus aureus or other beta-hemolytic streptococci. Another cause of glottic edema is an acute allergic reaction. In the case of an allergy, the body reacts to non-infectious foreign substances with an inflammatory reaction.
While rashes are more likely to be considered a mild allergic symptom, glottic edema is a severe anaphylactic allergic reaction. Such an allergic reaction can be caused, for example, by the consumption of nuts or other allergens. Various medications can also cause glottic edema. It occurs more frequently when taking ACE inhibitors.
Glottic edema is also a complication of radiation therapy. Radiotherapy is mostly used in patients with cancer. Laryngeal edema can also develop after trauma. For example, edema from choking would be conceivable.
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➔ Medication for shortness of breath and lung problemsSymptoms, ailments & signs
The cardinal symptom of glottic edema is hoarseness. Those affected have hoarse voices and get increasingly poor air (dyspnoea). They may also complain of difficulty swallowing. If the glottic edema is infectious, it can be accompanied by a fever. The more pronounced the swelling, the easier it is to hear a so-called inspiratory stridor.
A stridor is a diseased breathing noise that is caused by a narrowing of the airways. A stridor located in the region of the larynx sounds like a whistle or a hiss. The increasing narrowing of the airways worsens the shortness of breath, so that acute attacks of suffocation can occur in an emergency.
If the glottic edema is based on epiglottitis, the swelling of the mucous membrane is often announced beforehand. The disease begins quite suddenly and takes a brilliant course. The affected patients suffer from a severe sore throat and a high fever. Lumpy language is typical of epiglottitis with glottic edema. Since swallowing is extremely painful for those affected, the saliva runs out of their mouth.
Large amounts of saliva are also produced (hypersalivation). The allergic glottic edema can be announced by scratching and itching in the throat. Affected patients often have to clear their throat. A swollen tongue and redness in the mouth area after consuming potential allergens can also indicate an allergy as the cause of the glottic edema.
diagnosis
The diagnosis can be made fairly quickly based on the characteristic symptoms. If glottal edema is suspected, the patient should always be transferred to a hospital. A diagnostic measure to secure the suspected diagnosis is an inspection of the throat. Possibly this can be done through a fiber optic inserted into the nose. In the case of inflammation, the local finding is a crimson and inflamed epiglottis.
The swelling of the mucous membranes can be seen in all forms of glottic edema. Caution is advised when examining the mouth and throat. The objects of investigation can irritate the tissue in such a way that the mucous membrane swells even further. There is a risk of death from suffocation.
Complications
In the worst case, the glottic edema leads to suffocation or swallowing. Children in particular are exposed to an increased risk of suffocation, which can lead to death relatively quickly. The person concerned primarily suffers from a deep voice and hoarseness.
In most cases, speaking and swallowing are painful. It is not uncommon for the difficulty swallowing to result in a reduced intake of fluids and food, which can lead to dehydration or malnutrition. The tongue swells and a sore throat may become noticeable. If breathing is difficult, hyperventilation can also occur and the patient's throat itches.
Treatment of the glottic edema is usually causal and is carried out with the help of antibiotics. When taking medication, in most cases, there are no further complications and the disease disappears. In severe cases, the affected person may have to rely on artificial respiration in order not to suffocate. Furthermore, there are no special consequential damages and life expectancy is not reduced by the glottic edema.
When should you go to the doctor?
Since the glottic edema can in the worst case lead to death of the person concerned, treatment is definitely necessary. As a rule, a doctor should be consulted if the patient has difficulty swallowing and cannot breathe easily. Even strenuous activities or sports may no longer be possible, so that the patient's quality of life is significantly reduced. Furthermore, abnormal breathing noises often indicate glottic edema and should be examined by a doctor.
In severe cases, the disease can lead to suffocation. Many patients complain of persistent sore throats and a scratchy or itchy throat. A swollen tongue also usually indicates glottic edema and needs to be examined by a doctor. First and foremost, the person concerned can contact a general practitioner or a hospital. Treatment is always carried out in a hospital. In acute emergencies or in a serious condition, the emergency doctor can also be called.
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Treatment & Therapy
The treatment of glottic edema depends on the cause. Anti-inflammatory glucocorticoids are used in high doses so that the mucous membranes swell as quickly as possible. Attempts are also made to prevent further swelling by putting on a so-called ice tie. An ice tie is a closable tube that is filled with pieces of ice. The cold leads to a narrowing of the blood vessels and thus to a reduced blood flow.
This means that less fluid escapes into the tissue. If the edema was caused by a bacterial infection, antibiotics are given. In epiglottitis, third and fourth generation antibiotics have been shown to be particularly effective. Glottic edema caused by allergies is treated with antihistamines.
If there is a risk of suffocation, intubation can be performed. Here, an endotracheal tube is pushed into the windpipe between the vocal folds of the larynx. This widens the airways and enables external ventilation. A tracheostomy may also be required. This surgically gains access to the windpipe. The windpipe is opened between the second to fourth tracheal cartilage.
This creates a connection between the windpipe and the outer air space. This is also known as a tracheostoma. The patients can be artificially ventilated through this tracheostoma until the mucous membranes are swollen and independent breathing is possible again.
Outlook & forecast
The prognosis of glottic edema is linked to the course of the disease and the use of timely medical care. In the acute form, there is a risk of premature death without emergency medical services and immediate treatment. The edema triggers a reduced air supply, so that the affected person threatens to death by suffocation. Usually, the edema develops slowly and continuously. The person concerned should consult a doctor if the throat feels tight or if swallowing becomes more and more difficult. This usually avoids acute situations.
Without medical treatment, an increase in symptoms can be expected. If the glottic edema is treated with medication, the prognosis is good. There may be a need for temporary artificial ventilation, which has a severe negative impact on wellbeing and quality of life. However, after the swelling has receded due to the medication and the causal triggers have been treated, a complete healing can be expected.
The experiences and the treatment can lead to complications such as anxiety or sore throat. Normally, the physical irregularities gradually regress until the symptoms are free. In the case of emotional problems, follow-up treatment may be necessary to process what has been experienced so that the quality of life is completely restored and anxiety states are reduced.
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➔ Medication for shortness of breath and lung problemsprevention
Not all glottic edema can be prevented. There is a vaccination against the causative agent of epiglottitis. This is also recommended by the Standing Vaccination Commission (STIKO). The allergic glottic edema can only be avoided by strictly avoiding known allergens.
Aftercare
As a rule, no special follow-up options are possible or necessary in the case of glottic edema. The patient must first and foremost identify and treat the cause of the glottic edema. Without treatment, in the worst case scenario, the affected person can suffocate, so treatment is definitely necessary.
The symptoms are usually treated with medication, although surgical interventions may also be necessary. The medication should be taken as directed by a doctor and, above all, regularly. Possible interactions with other drugs must also be taken into account. After surgery, the person affected should always rest and take care of their body.
A stay in a hospital is usually necessary. You should refrain from strenuous activities or other stressful activities during this time. Often those affected are also supported with their breathing. If the glottic edema is not treated in a timely manner, in the worst case scenario the patient can die. In an emergency, a doctor should therefore always be called or the hospital should be visited directly to prevent further complications. Some variants of glottic edema can be prevented with the help of vaccinations.
You can do that yourself
People around whom this disease occurs can be vaccinated against the pathogen. An allergy-related condition should be addressed by limiting contact with the allergens. In general, it should be noted that there are only a few possibilities for self-help available with this disease.
Nevertheless, it is possible to bring about relief by cooling the affected area. However, the ice must not touch the skin directly to avoid cold burns. In the case of allergies, taking antihistamines can have a positive effect on the course. If the disease leads to difficulty swallowing, the patient often has to rely on the help of other people to take food and liquids.
Especially the care by your own family or friends has a positive effect on the course of the disease. Possible psychological complaints or depression can also be prevented by talking to the family or other affected persons.
Because of the breathing difficulties, the affected person should refrain from strenuous activities or sporting activities and take care of the body. This should especially be taken into account if the disease occurs as a result of cancer.
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