Small child, by virtue of insufficient development of the immune system, in more susceptible to the development of various kinds of viral and bacterial infections.

However, some of them can be quite harmless, while others pose a serious danger to child health and even life, lead to the development of serious complications, one of which is stenosis of the larynx in children, that is, the narrowing of its lumen.

That is why, in the presence of any deviations in the state of health of the child, it is necessary to provide him with timely medical assistance. This will prevent the development dangerous conditions life threatening crumbs.

How to treat laryngitis in children? Learn about it from ours.

Characteristics of the disease

Laryngeal stenosis is a condition in which partially or completely narrowed its lumen. This leads to difficulty in the flow of air into the lower sections. respiratory system, which, in turn, causes the development of oxygen starvation, suffocation.

Oxygen - the most important element necessary for the normal functioning of all internal organs and systems.

Even a slight decrease in its intake into the body leads to irreversible consequences that occur at the cellular level, and, ultimately, to a violation of the functionality of internal organs.

This process develops gradually. And with a complete narrowing of the lumen of the larynx, oxygen deficiency arises rapidly, with lightning speed, and within a few minutes can lead to the death of a child.

The disease develops mainly in children. younger age(up to 3 years), this is due to functional features structures of the larynxsmall child, such as:

1. A large number of nerve receptors located on the mucous membrane of the organ.
2. The funnel-shaped form of the larynx (over time, it straightens, becomes cylindrical).
3. The larynx of a child has a physiological area of ​​narrowing, in the area of ​​\u200b\u200bwhich are located mucous glands, prone to frequent inflammation.
4. The epithelial layer in the area vocal cords much thinner than that of an adult, respectively, it is easy to damage it.
5. The tissues of the organ have a loose structure, are supplied with a large number of blood vessels, so even a slight infection can lead to swelling and narrowing of the lumen.

Causes

Stenosis of the larynx - dangerous state, in which the child need emergency medical attention.

It can only be done by knowing reason, which provoked the development of the disease. These reasons include:

1. Inflammatory processes in the larynx that occur as a result of diseases such as, for example,.
2. Infectious diseases (, tuberculosis,).
3. Injuries to the larynx (, injuries when a foreign object hits).
4. Congenital anomalies in the structure of the organ.
5. Tumors localized in the larynx.
6. Suppuration in the mouth, throat.
7. Intoxication of the body, accompanied by the release of urea.

Why is laryngotracheitis dangerous for a baby? find out right now.

Classification and forms of pathology

There are several classification criteria according to which it is customary to allocate various varieties and forms of the disease.

Criterion	Varieties
Development time	Sharp form. It is considered the most dangerous, since the symptoms of the disease occur and develop within a few minutes. The child's body does not have time to adapt to conditions of lack of oxygen, which can lead to death. Chronic form. The lumen of the larynx narrows gradually. This process can take several months. The body does not experience obvious oxygen deficiency, however, if you do not take necessary measures and do not correct the situation, all internal organs and tissues that need oxygen to perform their functions suffer.
Etiological factor	paralytic form. The lumen of the larynx narrows as a result of impaired conduction nerve impulses in organ tissues. As a result, paralysis of muscle tissue develops; Scarred form. This variety is characterized by the formation of scars in the tissues of the larynx, as a result of which its lumen is partially narrowed. The provoking factors are damage to the tissues of the organ, prolonged use artificial ventilation lungs, infectious diseases. The tumor form is characterized by the presence of benign or malignant formations in the region of the larynx.
Localization	Stenosis of the glottis. Narrowing of the lumen in the region of the subvocal space. extended (in pathological process the trachea is also involved). Anterior or posterior (narrowing is observed in the anterior and rear wall organ, respectively). Circular (circular narrowing in a particular part of the organ). Total (the pathological process covers all parts of the larynx).

Symptoms and stages of development

Stenosis of the larynx develops gradually, everything is known 4 stages of development ailments, each of which has its own clinical picture:

1. Stage 1 compensation. During physical exertion, the child develops respiratory failure, shortness of breath develops. AT calm state breathing is normal, there are no clinical manifestations of the pathology.
2. Stage of incomplete compensation. Difficulty in breathing develops even at rest. When you inhale, you can hear a characteristic noise. There is blanching of the skin. The child may experience restlessness and anxiety.
3. Stage of decompensation(serious condition). The anxiety of the baby increases, he experiences fear, panic. The pallor of the skin is more intense, in the area of ​​the nasolabial triangle there is cyanosis of the skin. There is a violation of the heart rate.
4. Asphyxia(extremely serious condition). The skin of the child acquires a grayish tint, cyanosis of the nasolabial triangle increases, cyanosis of the nails is noted. There is a sharp drop in blood pressure, which can lead to loss of consciousness. There is also involuntary urination, the development of a convulsive state.

If the child is not provided with emergency assistance, death is inevitable.

First aid

The rapid development of laryngeal stenosis requires urgent action to provide emergency care. Of course, child need to call ambulance, however, before her arrival, it is necessary to take measures that may save the baby's life.

First of all, you need to calm down and calm the child, as nervous tension only exacerbates the situation.

1. give to a child depressant on the plant-based(if the baby has no allergies). This will help prevent panic.
2. Give an antihistamine appropriate for age and according to age dosage(to reduce swelling of the larynx).
3. Offer the baby a drink. As a drink, you can use warm non-carbonated mineral water, tea with milk. The drink should not be hot or cold, only a warm drink is suitable.
4. It is necessary to release the child from tight clothing, ventilate the room.
5. The bathroom needs a strong pressure to open hot water, stand there with the child for a few minutes. Humid air has a positive effect on the condition respiratory tract.
6. You can give your child a hot foot bath. Blood will flow to the heated areas of the body (legs) and drain from the larynx area.

Complications and consequences

Laryngeal stenosis is a dangerous condition that can lead to to the worst consequences..

For example, in the chronic form of the disease develops oxygen starvation, lack of oxygen negatively affects the state of all internal organs and tissues, as a result of which their functionality is impaired, which leads to the development of numerous serious diseases.

At acute form within a few minutes, suffocation develops, which can provoke loss of consciousness, death.

Diagnostics

On the initial stage doctor makes diagnostics examination and questioning of the patient(or his parents) palpates the throat.

For a more accurate picture, you need additional diagnostic methods , such as the:

• laryngoscopy (visual examination of the larynx);
• fibrolaryngoscopy (examination of an organ using a special endoscope);
• radiography of the area chest to assess the condition of the heart;
• Ultrasound of the thyroid gland;
• swab from the pharynx to determine a possible pathogen.

For first aid for children with Quincke's edema, you will find on our website.

Treatment

Therapy for laryngeal stenosis is aimed at elimination of suffocation, normalization of oxygen supply into the body. For these purposes, depending on the severity of the pathology and the state of health of the patient, conservative or surgical treatment is used.

Medications

Having established the cause of the pathology, the doctor selects the appropriate one in this case. drug treatment. Depending on the provoking factor, the following are prescribed drug groups:

• antibacterial agents;
• antiviral, anti-inflammatory drugs;
• antihistamine;
• hormonal agents of the corticosteroid and glucocorticosteroid group;
• dehydration agents.

Surgery

At stages 3 and 4 of development ailment, the child is prescribed surgery.

There are currently 4 known options. throat cuts, each of which is effective in one form or another of pathology:

• tracheotomy (dissection in the trachea) is indicated for stage 3 of the disease, conicotomy (dissection of the conical fold) is used at the stage of asphyxia;
• thyrotomy (dissection in the thyroid gland);
• cricotomy (an incision in the region of the cricoid cartilage);
• intubation (use of a tube to expand the lumen).

The opinion of Dr. Komarovsky

The possibility of developing stenosis of the larynx is influenced by 2 main factors. It's anatomical features of the structure of the larynx a small child, and his lifestyle and living conditions.

In particular, the air in the children's room. If the child sleeps in a warm and dry room, the risk of developing stenosis increases significantly.

Therefore, it is important to ensure that the child breathes moist air, especially at night, since it is at night that stenosis attacks occur most often.

Forecast

The prognosis depends on the form of the course of the disease. In the chronic form more favorable, since the symptoms develop gradually, and it is easier to eliminate them.

However, if you delay treatment, the onset of adverse effects can't be avoided. In acute cases, the likelihood of death is high.

Prevention measures

In order to reduce the likelihood of developing stenosis of the larynx, it is necessary eliminate the causes that may lead to its development.

The main reason is considered infections therefore it is very important to protect the child from viral and bacterial diseases, and if the baby is still sick, it is necessary to start treatment as soon as possible in order to prevent the development of dangerous complications.

Stenosis of the larynx is a narrowing of its lumen, as a result of which the process of oxygen entering the body, a vital element necessary for all organs and systems of the body, is disrupted.

Pathology is the most common in young children, which is associated with the structural features of the larynx of a small child. Lead to the development of a dangerous disease various diseases, inflammation, damage to the larynx.

Pathology can proceed in a chronic or acute form. The second option is most dangerous may lead to the death of the child. Therefore, it is important to provide first aid to the crumbs in time.

How to stop an attack and how to treat stenosis of the larynx? Adviсe in this video:

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Diseases

The narrowing or blockage of various structures and channels in the body is commonly called stenosis. It can occur in the spinal zone, vessels and arteries, larynx, heart and other cavities. Such pathological change is quite dangerous, because in some cases it can affect the functioning of the whole organism. Diagnosis of the disease in children and infants is difficult because they cannot tell what and where it hurts. So a large share Responsibility falls on the shoulders of parents: they must carefully monitor the condition of the child, especially when the baby is sick or does not feel well.

Symptoms

The disease can develop in children and adults, while the latter are much more likely to seek medical help at early stages ailment. Since newborns cannot express their well-being with almost anything other than crying, stenosis is diagnosed in them much later. The manifestation of the clinical picture of the disease directly depends on the localization of the narrowing or blockage of the hollow channel. However, there are a number of signs that make it possible to determine that the child needs urgent medical intervention. Parents can observe this state of the baby:

• pronounced shortness of breath;
• difficult, noisy breathing;
• belching, vomiting;
• intense crying;
• moodiness or lethargy;
• impaired motor skills, coordination of movements;
• lack of response to some manipulations.

At the first signs of stenosis in children, you need to call an ambulance, or contact the nearest hospital department. They appear when short-term ischemia of the affected organ occurs. Multiple and long course symptoms can mean the transition of the disease to the extreme stage, when there is a risk of death.

In babies and adults different reasons occurrence of the disease. In children, this pathology is usually congenital, but there are cases of exposure external factors. It should be understood that in infancy There are several types of stenosis that are most common. This is a lesion of the spine, arteries and blood vessels, larynx. In the first case, the disease may occur due to:

• congenital deformation of the vertebrae;
• operations to remove a hernia;
• other surgical interventions.

The occurrence of the disease in the vessels and arteries carries the greatest danger, since in the case of late diagnosis it has the highest mortality rate. The disease is explained by an intrauterine malformation of the fetus and occurs in medical practice quite rare. Damage to the larynx or trachea can occur for reasons such as:

The causes of stenosis in children partially determine the manifestation of symptoms. Before the treatment of the disease begins, the necessary studies are necessarily carried out to determine the factor that provoked it. Depending on the affected organ, the child needs to be monitored by an appropriate specialist.

From the moment the child is born, his health is mainly dealt with by one doctor, until the baby reaches certain age. Therefore, if you notice that your child is naughty, crying, breathing hard, or does not always respond to your words and gestures, seek advice from:

It will help determine why the child began to behave strangely. After a thorough examination, the specialist may refer you to one of such specialists as a neurologist, cardiologist, orthopedist, otolaryngologist, ophthalmologist. If children are suspected of having some organ, the doctor usually asks the parents what symptoms they observed in the baby. During the appointment, he can also clarify:

1. How long ago did the first signs appear?
2. How often does the baby cry?
3. Does he have spontaneous lacrimation?
4. How does he breathe? Are there wheezing, noises?
5. How active is the child?
6. Does he have a tendency to stay in one position?
7. How well does gastrointestinal motility work?

After listening to complaints about the baby’s well-being, examining and taking a full history, the doctor determines the type and localization of the disease, after which he proceeds to develop a treatment regimen.

Complications of the disease

The disease consists not only in the narrowing of the lumen of various channels and structures, but also in the complete blockage of the passage. If symptoms of stenosis appear in children, and treatment is not started, there is a high likelihood of complications, up to death. Moreover, each type of disease can be deadly. With prolonged damage to the larynx, it can develop:

• chronic acid starvation;
• disruption of the central nervous system;
• inability to fight infections.

Damage to the arteries and blood vessels can be no less difficult. In this case, there is a risk of stopping the work of a vital organ - the heart. This type diseases can lead to:

• heart failure;
• arrhythmias;
• chest pain;
• violation of blood circulation;
• cardiac arrest.

In the case of spinal stenosis, there is a risk of developing serious neurological diseases, pinched nerves and damage spinal cord. Regardless of the type of disease, its complications involve disruption of the most important organs in the body of a child, which can lead to death. The only way out protect your baby from dire consequences, it is timely to seek medical help.

Treatment of stenosis in children

Despite all the complications that this disease can cause, it responds well to treatment, especially when early diagnosis. fledgling children's body it is much harder to endure the disease than an adult, but at the same time, he does not express a more vivid clinical picture. General treatment pathology such as stenosis in children can be carried out using:

It should be noted that the choice of one or another therapy largely depends on the stage of the disease. There are several of them:

• the first, passes almost imperceptibly;
• the second, is manifested symptomatically;
• third, irreversible complications are possible.

Drug treatment is effective for some types of stenosis in the first and uncomplicated second stages. Also, a developed disease can be defeated with the help of combination therapy: drugs and physiotherapy. In the event of complications, as well as in the third stage of the disease, the baby may be shown an operation. Each method is effective in its own way and is prescribed by a doctor based on the complexity of the course of the disease, the cause of its occurrence, and the age of the patient.

What to do with signs of stenosis in the baby?

Considering all the danger this disease It is appropriate to talk about the provision of emergency care for a small child. If you notice he has difficulty breathing, wheezing and shortness of breath, accompanied by lethargy, you need to call an ambulance. If the condition is not so acute, the child is just capricious, whiny, you need to contact the local doctor as soon as possible or call him to the house. What exactly can not be done, how to wait and hope that everything will pass by itself. Newborns are most vulnerable to various diseases, because they have neither strengthened immunity to fight them, nor the opportunity to talk about what worries them. If stenosis is suspected, it is also not recommended:

• try to help yourself;
• give medication without first consulting a doctor;
• apply the methods of traditional medicine;
• listen to advice on treatment from friends;
• delay visiting a specialist.

After the medical officer has examined the child and diagnosed the stenosis, all treatment measures must be followed, as well as the recommendations issued by him. If the doctor insists on the operation, then you should not refuse it, it can cost the life of the child. In any case, you can ask the opinion of a specialist from another clinic.

Prognosis for the disease

What prognosis is observed with stenosis in children, it is impossible to say unequivocally. It all depends on the location of the disease and on the stage that he managed to reach. With certainty, we can only say that in the vast majority of cases, the defeat of the larynx ends favorably. Spinal stenosis in the presence of nerve damage significantly reduces the chances of full recovery and sometimes has a poor prognosis. Also, a vascular lesion may result in a fatal outcome, so the following measures can be applied when diagnosing an ailment by ultrasound during pregnancy.

What is stenosis of the larynx in children, fortunately, not all parents know. But this is only partially pleasing, because this ailment is not only dangerous for the baby's life, but also very "insidious", as it can manifest itself at any moment. Therefore, each parent should have information about what this disease is, what are its symptoms and the rules for providing first aid to a child who is struck by this disease.

What is the danger?

To date, the most complex sections of pediatrics, otolaryngology and surgery are sections that specialize in the treatment of children with various violations patency of the larynx (stenosis). How dangerous the disease is for the health and life of the crumbs, one can even judge by the fact that an ambulance arrives many times faster for such calls than for patients with heart attacks. After all, the "insidiousness" of stenosis of the larynx lies in the rapid development. And if the child is not provided with qualified medical care in time, asphyxia may occur.

General information

Stenosis of the larynx is the condition of the patient, in which there is a complete or partial narrowing of the already narrowest part of the respiratory system - the larynx. At the same time, the passage of air into the lungs is difficult, as a result of which the patient begins hypoxia. This condition can develop against the background of any respiratory diseases or as a reaction of the body to irritants (allergy). That is why stenosis of the larynx in children and adults in medicine is not isolated in individual disease, but they call concomitant symptom or state.

Forms of stenosis

Depending on the causes of occurrence and the speed of the course, the disease is divided into acute and chronic forms. At the first narrowing of the lumen of the larynx develops for a very short period time and threaten the health and life of the patient. A condition occurs, as a rule, against the background of such diseases as laryngotracheobronchitis, false and true croup, phlegmonous laryngitis, as well as with swelling of the respiratory tract. Acute stenosis of the larynx in children can also develop due to ingestion foreign body into the trachea, chondroperichondritis or injury.

The chronic form of the disease is characterized by slow development against the background of diphtheria, formations and tumors of the larynx after injuries and other diseases of the respiratory tract. In general, such an ailment does not pose a danger to the health and life of the patient. However, it is worth remembering that a chronic form of the disease can be transformed into an acute one due to injury or an inflammatory process in just a couple of hours.

Why does stenosis develop?

There are a lot of reasons for the narrowing of the larynx and in medical practice they are divided into two groups: infectious and non-infectious. The first includes diseases caused by RSV, influenza, parainfluenza and adenoviruses. Also quite often the causes of stenosis are infectious diseases bacterial origin, such as: diphtheria, epiglottitis, peritonsillar and pharyngeal abscess.

Before considering non-infectious causes stenosis of the larynx in children, it is worth saying that they are much less likely to provoke an ailment than viral diseases. But, despite this, the consequences of non-infectious stenosis can be many times more difficult, since a narrowing of the larynx develops due to the ingress of a foreign body into the respiratory tract, allergic reaction or injury.

Symptoms of stenosis

The first signs of an illness in a crumb may not be noticed even by the most attentive parents. This is explained by the fact that the symptoms of stenosis are very similar to clinical manifestations ordinary ORZ. The baby may have a slight increase in body temperature, as well as a runny nose. In addition, do not forget that each baby is individual, so if stenosis of the larynx begins, the symptoms in children may be different.

The next stage in the development of stenosis, which is characterized by a strong paroxysmal cough, hoarse voice and rapid noisy breathing, cannot leave adults indifferent. Parents should also be afraid that the child's condition is rapidly deteriorating, he becomes lethargic and irritable, which indicates the onset of hypoxia.

In such a situation, it is important not to panic, immediately call an ambulance, and before the arrival of a team of professionals, provide first aid to your baby.

Degrees of stenosis

In order to provide effective help sick child, it is necessary to assess the stage of development of the disease. How to do this, not only doctors, but also parents should know. Focusing on the situation, they will be able to help their baby before the arrival of the ambulance team, to save his health and life.

1. So, the first degree of the disease - compensated - appears only with a strong emotional and physical activity. In this case, there are no signs of hypoxia. The child's breathing becomes frequent and slightly noisy.
2. As for the second (subcompensated) degree of stenosis of the larynx in children, its signs can be seen even when the baby is at rest. He, as a rule, shows anxiety due to discomfort he does not understand. In addition, when examining a patient, pronounced signs of the work of auxiliary muscles are observed. In other words, the retraction of the supraclavicular and subclavian fossae, as well as the intercostal spaces, is visible on the back of the crumbs.
3. The clinical picture of the third (decompensated) degree of the disease is characterized by pronounced signs of hypoxia, such as pallor of the skin, blue fingertips and lips. Also, the baby has an increased heart rate and irregular breathing. If a patient in this condition is not provided with medical care, asphyxia occurs.
4. The fourth (terminal) degree is characterized by severe unconsciousness. In this case, the child is listening for shallow, rapid breathing. In some cases, it may even seem that the baby is better, as he does not have noisy breathing, barking paroxysmal cough and shortness of breath.

Diagnosis of stenosis

If one of the parents suspects that stenosis of the larynx is developing in children, photos of the visible manifestations of the disease on the stands of an otolaryngologist or district police officer will help dispel doubts. But only a professional doctor can confirm or refute this diagnosis.

The conclusion of a specialist in the acute form of the disease is based on the clinical picture, anamnesis data and examination of the child's larynx. The pediatrician clarifies in detail with the patient and parents the sequence of symptoms, as well as the circumstances and time when it appeared. Then the doctor, according to the data obtained, evaluates the dynamics and nature of the development of the disease. The last stage of diagnosis is listening to breathing and assessing visible external manifestations illness.

Features of the disease

The acute form of stenosis, especially in children under 7 years old, is characterized by rapid development, as a result of which signs of hypoxia appear after a couple of hours or even minutes. This feature of the course of the disease is explained by the anatomical features of the structure of the larynx in babies.

The upper part of this unpaired respiratory organ is covered from above by a soft epiglottis, but in its subglottis there is connective tissue with many blood vessels. It is she who, due to inflammatory processes, allergies and mechanical injuries may swell a lot.

As for the lumen of the larynx in children, it has the shape of a narrow funnel. In adults, this organ is cylindrical and wider. It is this anatomical feature of the structure of the respiratory tract that explains the fact that stenosis of the larynx in children under 7 years of age occurs much more often than in representatives of other age categories.

What should parents know?

If a child, on the background of an illness or after an injury, has the first symptoms of an illness, for example, shortness of breath, pallor of the skin or blue lips and fingertips, you should not hesitate.

The first thing household members should do is overcome their own panic and call an ambulance. It is advisable not to leave the child alone during the call and start giving him first aid. For this, the baby should be calmed, while his need for oxygen will decrease slightly and he will feel a little better. The child can be picked up or allowed to take a comfortable position for him, for example, on the couch. The main thing at this moment is that adults themselves do not succumb to panic, this can be felt by the baby and scared.

It is also worth noting that the treatment of laryngeal stenosis in children is best done in a hospital. After all, the condition of the crumbs can quickly worsen, and even if it was possible to stop the attack completely, it can happen again. Therefore, it is better not to refuse the recommendations of ambulance doctors to hospitalize the patient.

First aid for stenosis

If at the first degree of stenosis of the child, before the ambulance arrives, it is enough to calm him down, then at degrees 2-4, you need to act in accordance with a clear algorithm. In other words, if the crumbs show signs of hypoxia and he is suffocating, it is urgent to moisten the airways. This can be done by inhalation or humidification of the air in the room. In this case, the baby should not be nervous and cry.

It is strictly forbidden to give the patient various antitussive syrups and tablets during an attack, as this can serve as an additional impetus for the development of puffiness. You should also not rub it with ointments or gels, it will be more effective foot bath with warm water and plenty of drink.

Inhalations for stenosis

The ideal option can be considered a situation where there is a compressor inhaler and a pharmaceutical saline solution at home. After 2-5 minutes of the procedure, the baby's condition will improve significantly. But to boast of having home first aid kit such an expensive device, unfortunately, not everyone can. Therefore, you should not panic and think that this is the only way to stop stenosis of the larynx in children. Inhalations with sodium chloride are only one of the options to alleviate the condition of the baby.

If there is no inhaler in the house, the child should be taken to the bathroom and hot water should be turned on. The increased humidity in a small room will allow the baby to breathe a little more freely until the ambulance arrives.

Treatment of the disease

Before considering the groups of drugs that a child may need to recover, it is worth noting that the treatment of laryngeal stenosis in children should be carried out only in a hospital. It can be both a surgical and an otolaryngological department of a children's hospital, where there is everything necessary equipment to stop an attack and complete cure illness.

As regards the necessary medications, then their list depends on the disease against which the stenosis manifested itself. It can be both antibacterial, decongestant and anti-inflammatory drugs, as well as anti-allergic and hormonal. Directly to relieve swelling of the larynx, the drugs "Dexamethasone", "Prednisolone" or "Aminazin" can be used.

In cases where drug therapy does not give results, and the condition of a small patient is rapidly deteriorating, doctors may resort to surgical method treatment - tracheotomy.

How to prevent stenosis?

To prevent stenosis of the larynx in children, prevention should be aimed at preventing diseases that provoke swelling of the airways. To do this, parents should pay due attention to the hardening of children, prevent hypothermia of the crumbs during walks in the fresh air, and also strengthen immune system their children with vitamin complexes.

If the disease still turned out to be stronger, you should not take risks and wait until stenosis of the larynx appears in children. Help should be provided immediately. To do this, it is enough to include antiallergic drugs in the course of treatment, but first you should consult with a pediatrician.

My son had a stenosis of the larynx at night, they managed to stop the attack on the spot, they did not go to the hospital. write about this diagnosis.

Stenosis of the larynx in children - symptoms and treatment

Stenosis of the larynx is a dangerous disease for everyone, especially if it develops in children. The degree of its danger can be judged already because when an ambulance is called to a child with a suspicion of such a disease, the team leaves faster than to a person who has a heart attack. This is due to the fact that mortality among young children with advanced stenosis is too high, and at the first symptoms, the countdown is already going on for hours and minutes of the child's life.

Stenosis of the larynx in children always begins in the same way: with signs of a common cold. At first, the child becomes very anxious and restless, the first cough appears, the temperature rises. Full visibility may be maintained for several days viral infection and no more. But the clinical picture changes quite quickly, sometimes it takes several hours for the baby to begin to develop suffocation. This is very dangerous because stenosis begins its development late at night, when parents, exhausted by the baby's illness, usually sleep. Because of this, there is a high risk that the child will die from suffocation.

It is important to know that once the stenosis begins to progress, the child may lose the ability to speak and make sounds. Therefore, it is necessary to carefully monitor breathing: as soon as it becomes too frequent and difficult when inhaling, it is necessary to be near it inseparably. It is necessary to constantly monitor the color of the child's skin, especially if the baby does not yet know how to speak. As soon as an acute lack of oxygen begins in the body, the skin tone immediately changes and becomes cyanotic. The voice begins to noticeably sit down, becomes hoarse, a very specific cough is born: it looks more like the barking of a young dog. This is feature development of stenosis.

Stenosis of the larynx in children - treatment is effective if the child is shown to the pediatrician at the first sign of a cold. Adequate treatment and constant monitoring of the baby in most cases can avoid stenosis. It is very important to bring down the heat: rub the child with vodka, only warm - it is harmless and effective. In addition, prolonged high temperatures have a negative effect not only on breathing, but also on the work of a small heart.

The most important thing in such a situation is to suppress the panic at all costs. It is important to remember: a large mortality rate is due to the fact that parents go into shock, seeing that their child simply suffocates and turns blue in front of their eyes. It is urgent to grab the child and start rubbing it, which will allow him to maintain breathing. In the meantime, start hot water in the bathroom and make it look like air in steam rooms. Bring the child there, he can hold out there until the ambulance arrives.

Stenosis of the larynx in children - treatment

It is good if for such cases the drug "Prednisolone" will be in the first-aid kit. Even if no one knows how to give injections, there is no choice: you need to inject, look for a nurse or someone else, there is simply no time. Stenosis of the larynx in children develops too quickly, and only the courage of the parents depends on the gain of time before the arrival of qualified help. With obvious suffocation, an injection can be given to make it easier for the child to breathe. You just need to know for sure that there is no other choice and judge, if possible, sensibly: if the doctors are already on the way, and hot steam and rubbing the legs help, the child breathes, then you should not inject the drug.

In this case, the principle of the worst of evils applies, since such a drug does not bring anything good for the health of a small child. But if this cannot be avoided and the danger to life is high, the dosage must be observed: for small children up to six months, no more than half an ampoule should be administered, for children older than a whole.

But you need to be aware that such a disease can appear more than once. There are children who have attacks of stenosis with every viral or colds. That is why it is very important to learn how to deal with a dangerous opponent by suppressing panic. Otherwise, the child is simply doomed to a painful death.

You can’t go to the other extreme: the baby felt better after steaming or injection, so you shouldn’t go to the doctor anymore. Calling an ambulance followed by a visit to the local pediatrician is vital for recovery. Firstly, the attack may recur, and it is impossible to inject the drug every time. The child is in dire need of good and complex treatment, undergoing a course of physiotherapy, antibiotic treatment and elimination of swelling of the larynx.

It is necessary to monitor what exactly the child eats. Often, stenosis of the larynx in children begins with an allergy to a product or to some kind of smell. We must try to convey to grandmothers who love to “forget” about the prohibitions of their parents that a child can die if he is given chocolate, to which he is allergic. True, this method rarely works, so you need to carefully monitor the child, giving great attention detailed inquiries. With an exacerbation of the disease, this will help to quickly understand the root cause of the attack.

At the time of the attack, it often happens critical situation, then the specialists have to perform the operation on the spot. A section is made in the trachea to allow air to enter, a special tube is inserted. Urgent hospitalization should never be refused, even if the child seems to be almost healthy and has regained his former breath. During a crisis, constant monitoring is necessary and it is possible to ensure it only in stationary conditions.

In pediatric medical practice, there are a number of pathological conditions that require emergency medical care. One of these pathologies is stenosis of the larynx.

What it is?

Severe narrowing of the larynx is called stenosis. This is pathological condition may occur at any age. Usually the development of the disease occurs rapidly. A variety of reasons can lead to the development of stenosis. This pathology is most dangerous in newborn babies and infants.

The larynx is the organ responsible for the production of the voice. The vocal cords, which are located inside this anatomical element, take an active part in this. Narrowing or stenosis of the glottis, which is normally found in the larynx, and leads to the child dangerous symptoms respiratory disorders.

Some doctors also use other terms for this pathological condition in babies. They also call this narrowing stenosing laryngotracheitis or acute stenosis of the larynx. These terms largely explain the essence and mechanism of development of adverse symptoms in a baby.

Toddlers have several functional and anatomical features development of their body. This explains the mechanism of development of pathological narrowing of the glottis.

Mucous membranes lining respiratory organs, are well supplied with blood and are closely associated with lymphoid formations. This leads to the fact that any infection that has entered the body can lead to the development of a strong narrowing of the glottis.

The abundance of lymphoid tissue in the submucosal space of the vocal apparatus contributes to the development of severe edema and swelling of damaged tissues in a sick baby.

Such manifestations are especially dangerous in children. at the age of 2-6 months of life. In this case, the course of the disease can be extremely unfavorable. Without timely medical care, the baby may even die.

The larynx in children is quite small size and is shaped like a "funnel". The location of the vocal cords in babies is not at all the same as in adults. They are slightly higher.

During its development, the disease can consistently spread to several adjacent anatomical elements. The process begins with the glottis. Then it moves to the subvocal space and the anterior wall of the larynx. In this case, doctors talk about an extended pathological narrowing. Involvement in the pathological process of the posterior wall of the organ leads to the development of posterior stenosis.

If the tissues of the larynx are damaged in a circle, then such a clinical variant of the disease is called a circular narrowing. In this case, the course of the disease is already noticeably worsening.

Huge process causes development total stenosis. This condition is extremely dangerous, as it leads to the development of instant acute respiratory failure. Without medical attention, such a pathology can even lead to death.

Causes

The severity of adverse symptoms largely depends on the underlying cause that led to the development of this pathological condition in the child. The most common causes of stenosis in a baby are infectious pathologies. A variety of bacteria and viruses can lead to their development.

Stenosis is getting pretty frequent complication acute laryngitis. This pathological condition is usually caused in children by staphylococcal or streptococcal flora. Much less often, viral infections lead to the appearance of adverse symptoms of laryngitis.

The development of pathological narrowing of the glottis in babies is often parainfluenza, scarlet fever, diphtheria, influenza, typhus and others infectious pathologies. These diseases are also dangerous by the development of a pronounced intoxication syndrome, which is manifested by an increase in body temperature in a child and the development of severe general weakness.

traumatic injury larynx can also lead to the development of dangerous symptoms of acute respiratory failure in the crumbs. Such a pathological condition in newborn babies is facilitated by improperly performed childbirth.

Operations on thyroid gland can cause dangerous complications in the baby, manifested by the development of a strong pathological narrowing of the glottis.

In the youngest patients, the cause of laryngeal stenosis is also quite often hit foreign objects into the respiratory tract. Even a small piece of a toy that the baby turns in his hands can close the lumen of the bronchus in a child.

This feature is due to the rather narrow lumen of the bronchi in babies. An object caught in the respiratory tract can lead to asphyxia - a pronounced narrowing of the larynx and a complete cessation of breathing. In this case, emergency medical care is required in order to save the life of the child.

Congenital diseases of the trachea can also lead to the development of a severe narrowing of the glottis in the child. In this case, adverse Clinical signs stenosis appear already in newborn babies already in the first hours after birth.

As a rule, the treatment of pronounced anatomical defects in the structure of the larynx is carried out only with the help of surgical operations. The decision on the need for surgery is made by the operating pediatric otolaryngologist.

allergies can also manifest in a child by the development of severe stenosis of the larynx. In most cases, airborne allergens lead to this condition.

Food and chemical substances become common cause development of a pronounced narrowing of the glottis in a child. To improve breathing in this case, it is necessary to completely exclude the ingress of allergens into the children's body and prescribe antihistamines or hormonal drugs. Allergic pathologies, according to statistics, most often develop in children aged 5-12 years.

purulent formations, which appear in the neck, can also pass to the internal parts of the larynx, thereby causing severe inflammation there. This leads to the fact that the child narrows the lumen of the glottis and significantly disturbed breathing. Flow purulent diseases, as a rule, is quite severe and proceeds with the development of the most unfavorable symptoms.

In some cases, surgical treatment is required to eliminate ulcers on the neck.

Kinds

In their practice, physicians use the most various classifications which include a huge variety of different clinical variants of the disease.

According to the time of occurrence of adverse symptoms, all stenoses can be acute and chronic. For the first time, the narrowing of the glottis in a baby as a result of exposure to various reasons called acute. Usually its course is the most dangerous and quite often complicated by the development of acute respiratory failure.

A subacute process is said to occur if adverse symptoms persist for 1-3 months. Forecast of the current clinical appearance disease is generally more favorable. When appointed proper treatment all symptoms usually disappear completely. In some cases, chronic inflammation may occur.

If the pathological narrowing of the glottis in the baby persists for more than three months, then in this case, doctors are already talking about a chronic process. Usually this clinical variant of the disease appears in babies who have some congenital anomalies structures of the respiratory tract.

Secondary pathology, which contributes to the preservation of the narrowed lumen of the glottis, can also lead to the development of a chronic variant of laryngeal stenosis in a child.

Pediatric otolaryngologists also distinguish several clinical forms diseases. Each of them has its own characteristics in the development and degree of manifestation of adverse symptoms.

In their practice, doctors use a wide variety of tables that contain the main features of the development of each form of this pathological condition.

Given the reason that led to the appearance of a narrowing of the glottis, all stenoses can be divided into the following groups:

• Paralytic. They occur more frequently in children than in adults. As a rule, they develop in children who have undergone surgery on the thyroid gland or in the area of ​​other formations on the neck. Pathological narrowing in this case occurs due to damage to the vocal nerve during surgical treatment.

Some babies may develop post-intubation stenosis, which occurs after an improperly performed tracheal intubation.

• Cicatricial. They can occur both after traumatic effects and after operations performed on the neck. Traumatic damage to the mucous membranes during surgical incisions leads to the formation of a lot of scar tissue. Such scars tighten the glottis, which contributes to a change in its diameter. Long-term infectious diseases can also lead to the development of cicatricial changes in the child.

• Tumor. They are an extremely unfavorable option for the development of the disease. The narrowing of the glottis in this case develops due to the growth of tumor tissue. Severe papillomatosis of the larynx is also a provocative cause of the development of large neoplasms, which during their growth cause a change in the lumen of the glottis.

• allergic. They appear in babies with individual sensitivity to the development of allergies. A wide variety of allergens can provoke stenosis of the larynx. The most common in children include: bites of various insects, inhalation of plant pollen, certain chemicals and food.

Symptoms

The intensity of the symptoms increases as the glottic lumen narrows. So, doctors give several stages of development of this pathological condition:

• 1 degree. With a narrowing of 1 degree, the baby's breathing is disturbed. This clinical variant of the disease is also called compensated, as it has a very good prognosis. At this stage of the disease, the baby's voice formation is disturbed. The child's voice becomes more hoarse.

• 2 degree. Narrowing of the 2nd degree is accompanied by more pronounced adverse symptoms. This variant of the disease is called subcompensated. The baby becomes overly excited, breathes more often, his skin becomes bright red. Breathing movements in this case, they become clearly visible from the side.

The baby "sunk" some parts of the chest, which are located between the ribs.

• 3 degree. The most unfavorable option for the development of this pathological condition is a narrowing of the 3rd degree. This form of the disease is also called decompensated. In this state, the child can be both extremely agitated and completely inhibited. Skin begin to turn very pale, and the area of ​​\u200b\u200bthe nasolabial triangle and lips acquire a blue tint. In the most severe cases, the child may even lose consciousness completely.

Asphyxia

The most extreme stage of the development of the disease is called asphyxia. This is the most dangerous condition, especially for babies. Characterized given pathology complete cessation of breathing. In the absence of oxygen, brain cells begin to die.

If you do not provide emergency care, the baby may die from acute respiratory and heart failure.

Urgent care

Parents should remember that the appearance of signs of respiratory failure in a child is an emergency indication for to call an emergency ambulance. This must be done before making any attempts and actions in order to quickly remove the attack that has arisen.

After calling an ambulance, parents should first of all try to calm down and in no case panic! A "cold" mind is a necessary condition for helping your baby in such a difficult situation.

While waiting for the doctor, try to calm the baby. To do this, you can take the child in your arms. Constantly monitor the condition of your baby. Open all windows and doors in the children's room to ensure the flow of fresh air and oxygen into the room. In the cold season, put on a warm blouse and pants for your child so that he does not catch a cold.

First aid on the part of parents consists only in carrying out non-specific actions that will be aimed at some improvement in the well-being of the child.

Babies who have developed laryngeal stenosis due to severe infectious diseases flowing from high temperature, you can give antipyretic and anti-inflammatory drugs. Such first aid It is used only with persistent febrile condition.

Used to reduce airway edema and improve breathing antihistamines . These funds include: "Claritin", "Suprastin", "Loratadin", "Zirtek" and many others. They are usually used for 5-7 days. Longer use of drugs must be discussed with your doctor.

Treatment

Therapy for stenosis of the larynx is carried out only by the attending physician. In most cases, this pathological condition is treated in stationary conditions. For this, a whole range of different medicines is used.

With more severe course baby is hospitalized to the department intensive care and intensive care. If the cause of the pathological narrowing of the glottis was bacterial infection, then the treatment regimen must include antibacterial agents that have a wide range actions.

The frequency of use, daily dosage, method of administration and duration of the course of antibiotic therapy is chosen by the attending physician.

For some chronic forms stenosis to improve breathing sick babies are special inhalations. For this, as a rule, alkaline preparations or isotonic sodium chloride solution are used. The number of procedures required may vary. Usually, 12-15 inhalations are performed to achieve a positive effect.

In severe laryngeal stenosis, glucocorticosteroids have a positive effect. The dosage of dexamethasone is selected individually, taking into account the age and weight of the sick baby.

With a milder course, they can be prescribed hormonal agents in the form of inhalations and aerosols. "Pulmicort" allows you to improve performance external respiration and contributes to the improvement of the general well-being of the child.

During the acute period of the disease, all sick babies are recommended follow a special diet. The basis of such therapeutic nutrition is fermented milk products, as well as vegetables and fruits. All dishes are steamed, baked or boiled. Fatty and hard-to-digest foods from the children's menu are completely excluded.

After an acute period of the disease, a complex rehabilitation measures. It is necessary to eliminate residual symptoms and improve the overall well-being of the baby.

Hiking in salt cave, various physiotherapy procedures and hardening are excellent methods to restore breathing and strengthen the baby's immunity.

Additional information regarding this issue, you can find out in the next video.