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Laryngeal Obstruction


Presentation

  • OBJECTIVES: To determine the clinical presentations and management of patients with acute laryngeal obstruction.[ncbi.nlm.nih.gov]
  • Abstract Cricoarytenoid arthritis, principally as a result of long-standing rheumatoid arthritis, is a disorder that may present to the emergency physician with a number of symptoms and signs referable to the larynx.[ncbi.nlm.nih.gov]
  • METHODS: We present a detailed description of the clinical presentation, management approach, and clinical outcome and tracheotomy status of a series of patients with laryngeal obstruction by LMs.[ncbi.nlm.nih.gov]
  • In infants and young children, laryngeal involvement can present a life threatening complication: obstruction of the patient's airway due to leukokeratosis can lead to severe respiratory distress.[ncbi.nlm.nih.gov]
  • We present the case of a 78-year-old woman who was treated with phenytoin for generalized tonic-clonic seizures for 4 months and who subsequently developed lingual hyperplasia that caused laryngeal obstruction eventually requiring a tracheotomy.[ncbi.nlm.nih.gov]
Cough
  • The hemorrhagic lesions appeared to be induced by coughing due to bronchitis for which the penicillin was given.[ncbi.nlm.nih.gov]
  • This report provides the first descriptions of rowing-associated EILO in two competitive rowers presenting with unexplained dyspnoea and cough.[ncbi.nlm.nih.gov]
  • […] experience the following symptoms: Shortness of breath Chest and/or throat tightness Feeling they are "breathing through a straw" Stridor/wheezing Difficulty with inhalation and/or exhalation Frequent throat clearing Intermittent hoarseness Chronic cough[nationaljewish.org]
  • The result is symptoms such as: Coughing with asthma Tightening of the chest Wheezing Unusual fatigue while exercising Shortness of breath when exercising The other interesting condition that turned up in my research is Exercise-Induced Laryngeal Obstruction[runningwithfaith.com]
  • Assessment A harsh, barking cough in a febrile, miserable, but otherwise well child suggests Croup. Absent cough with low pitched expiratory stridor (often snoring) and drooling suggests epiglottitis.[rch.org.au]
Dyspnea
  • But slight inspiratory dyspnea and stridor may occur during crying or on exertion 5 Laryngeal obstruction classification: Ⅱ slight inspiratory dyspnea during quiet respiration, and exaggeration on exertion.[slideplayer.com]
  • KEYWORDS: Athlete; dyspnea; exercise; larynx; swimming[ncbi.nlm.nih.gov]
  • Abstract A 49-year-old man presented with a two-day history of severe recurrent dyspnea and inspiratory stridor.[ncbi.nlm.nih.gov]
  • METHODS: We consecutively evaluated 37 adult subjects with exertional dyspnea and possible asthma referred over 6 months.[ncbi.nlm.nih.gov]
  • Exercise-induced laryngeal obstruction is a cause of exercise-induced dyspnea.[healio.com]
Hoarseness
  • Abstract A boy with junctional epidermolysis bullosa died from acute laryngeal obstruction at the age of 29 months, having been hoarse since early infancy.[ncbi.nlm.nih.gov]
  • At age 9 months, following an upper respiratory infection, she developed stridor and hoarseness and was found to have severe laryngeal obstruction, which was felt to be secondary to pachyonychia congenita based on direct laryngoscopy and laryngeal biopsy[ncbi.nlm.nih.gov]
  • RESULTS: The age ranges of the patient were between 1.5 years to 46 years (mean age 29.6 years with male/female ratio of 2:1 Breathlessness (83.3%), hoarseness (66.7%), and noisy breathing (50%) were the main symptoms at presentation.[ncbi.nlm.nih.gov]
  • […] with VCD and EILO may experience the following symptoms: Shortness of breath Chest and/or throat tightness Feeling they are "breathing through a straw" Stridor/wheezing Difficulty with inhalation and/or exhalation Frequent throat clearing Intermittent hoarseness[nationaljewish.org]
  • Tumors Foreign bodies Trauma Allergy Malformation Laryngeal paralysis 2 Laryngeal obstruction symptoms: inspiratory dyspnea inspiratory stridor depression of suprasternal fossa, intercostal and supraclavicular space or epigastrium while inspiration hoarseness[slideplayer.com]
Gagging
  • Cannot be used in awake patients, as it causes them to gag and potentially vomit.[learnpicu.com]
Purpura
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]
Tonic-Clonic Seizure
  • We present the case of a 78-year-old woman who was treated with phenytoin for generalized tonic-clonic seizures for 4 months and who subsequently developed lingual hyperplasia that caused laryngeal obstruction eventually requiring a tracheotomy.[ncbi.nlm.nih.gov]
Altered Mental Status
  • Upon admission to the emergency department, the patient was unable to provide any history due his altered mental status. Additionally, there was no medical history on file for this patient.[peertechz.com]

Workup

  • RESULTS: Of 88 athletes who completed a full workup, 31 (35.2%) had EILO and 38 (43.2%) had a positive bronchoprovocation or bronchodilator reversibility test.[ncbi.nlm.nih.gov]
Right Ventricular Hypertrophy
  • In addition, right ventricular hypertrophy and pulmonary artery atherosclerosis were found.[peertechz.com]

Treatment

  • In case of severe supraglottic collapse and pronounced symptoms during strenuous exertion, surgical treatment (supraglottoplasty) has been suggested.[ncbi.nlm.nih.gov]
  • Finally circulatory collapse may occur or may die of asphyxia or cardiac failure. 8 Laryngeal obstruction Treatment Ⅰ :etiological treatment, antibiotics and corticosteroid. 9 Laryngeal obstruction Treatment Ⅱ :etiological treatment. in case of tumors[slideplayer.com]
  • He traces the development of the treatments that have in 50 years lowered the mortality rate from 70% to practically zero.[ncbi.nlm.nih.gov]
  • The patients reported a better ability to breathe while exercising, after surgical treatment, as revealed by VAS scores.[bora.uib.no]
  • Leukokeratosis of her larynx was treated with CO(2) laser on three occasions, with improvement in her respiratory distress after each treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Overall prognosis is considered considered generally poor 6. tracheal atresia Promoted articles (advertising)[radiopaedia.org]
  • The prognosis is poor with squamous cell carcinoma of the trachea, which carries a 5-year survival of approximately 40% when resectable and 7% when unresectable.[clinicaladvisor.com]
  • […] especially when being prepared for children Consume food slowly and fully chew food before swallowing, which is an effective preventative method Closely watch very young children while they play with toys and small play items (toy parts) What is the Prognosis[dovemed.com]

Etiology

  • CONCLUSIONS: In athletes with unexplained respiratory symptoms, EILO is an important differential diagnosis not discerned from other etiologies by clinical features.[ncbi.nlm.nih.gov]
  • The decreased mechanosensitivity was detected in the majority of participants, suggesting that laryngopharyngeal reflux can be an important etiological factor.[ncbi.nlm.nih.gov]
  • Finally circulatory collapse may occur or may die of asphyxia or cardiac failure. 8 Laryngeal obstruction Treatment Ⅰ :etiological treatment, antibiotics and corticosteroid. 9 Laryngeal obstruction Treatment Ⅱ :etiological treatment. in case of tumors[slideplayer.com]
  • A consensus nomenclature, which will allow for better characterization of patients, coupled with new diagnostic techniques, may further define the epidemiology and etiology of ILO as well as enable objective evaluation of therapeutic modalities.[ncbi.nlm.nih.gov]
  • The etiology is unknown, although sporadic, genetic (3) and vascular causes (4) have all been proposed.[fetalultrasound.com]

Epidemiology

  • This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO.[ncbi.nlm.nih.gov]
  • A consensus nomenclature, which will allow for better characterization of patients, coupled with new diagnostic techniques, may further define the epidemiology and etiology of ILO as well as enable objective evaluation of therapeutic modalities.[ncbi.nlm.nih.gov]
  • In total, 172 out of 252 articles met the inclusion criteria, summarised in sections on diagnostic approach, aetiology, comorbidities, epidemiology and treatment.[ncbi.nlm.nih.gov]
  • “Acute epiglotitis: epidemiology, clinical presentation, management and outcome”. J Laryngol Otol. vol. 122. 2008. pp. 818-23.[clinicaladvisor.com]
Sex distribution
Age distribution

Pathophysiology

  • See Figure 2 for a comparison of what 1 mm of circumferential edema does in terms of airway resistance to an infant and an adult Pathophysiology Upper airway obstruction can occur for a variety of causes, but fundamentally, leads to increased airway resistance[learnpicu.com]
  • Palliative interventions for patients with chronic upper airway obstruction include: balloon dilatation airway stenting laser therapy electrocautery and argon plasma coagulation cryotherapy nocturnal, noninvasive, positive-pressure ventilation Pathophysiology[clinicaladvisor.com]

Prevention

  • The primary physician must know when and where to send these children in order to prevent the fatalities so frequent in previous years.[ncbi.nlm.nih.gov]
  • Airway secretions, edema, and downward folding of the epiglottis cause complete laryngeal obstruction, preventing endotracheal intubation.[anatomicaljustice.com]
  • The American Thoracic Society and the European Respiratory Society define refractory asthma as asthma that requires treatment with high-dose inhaled corticosteroids (ICS) plus a second controller and/or systemic corticosteroids to prevent it from becoming[figshare.com]
  • Prompt evaluation and management of suspected UAO may prevent subsequent complications including cardiac arrest, anoxic brain injury, and negative pressure pulmonary edema.[accessmedicine.mhmedical.com]
  • There are no definitive methods to prevent Acute Upper Airway Obstruction. However, proper precautions may be taken to reduce risks.[dovemed.com]

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