Acute and chronic stenosis of the larynx and trachea: symptoms

Regardless of the cause that causes acute stenosis, the symptoms of laryngeal stenosis are the same. The pronounced negative pressure in the mediastinum with intense inspiration and hypoxia causes a characteristic symptom complex: a change in the rhythm of breathing, the occlusion of the supraclavicular pits and the entrainment of the intercostal spaces, the forced position of the patient with the head thrown back, the larynx of the larynx during inspiration and exhalation. The severity of clinical manifestations of acute and chronic stenosis depends on the nature of traumatic effects on the body, the degree of damage to the hollow organs of the neck, the extent of stenosis, the duration of its existence, individual sensitivity (resistance) to hypoxia, the general state of the body.

Violation of innervation of the larynx leads to severe functional disorders; change in the pattern of breathing; organ, tissue, cell hypoxia. Peripheral nerve injuries are more common in the central nervous system and differ from them by clinical manifestations and prognosis.

The main symptom of acute and chronic respiratory failure is shortness of breath. Depending on its severity, the following degrees of respiratory failure are distinguished:

• I degree - dyspnea occurs with physical exertion:
• II degree - dyspnea occurs with small physical exertion (slow walking, washing, dressing);
• III degree - dyspnea at rest.

According to the clinical course and the magnitude of the airway clearance, there are four stages of stenosis of the larynx and trachea.

• Compensation stage. Characterized by the decrease and deepening of the breath, shortening or loss of pauses between the inhalation and exhalation, the reduction in heart rate. The size of the glottis is 6-8 mm, or the lumen of the trachea is narrowed by 1/3 of the diameter. In rest there is no shortage of breath, shortness of breath appears when walking.
• Stage of subcompensation. Characteristic inspiratory dyspnea with the inclusion of auxiliary muscles in the act of breathing, note the retraction of intercostal spaces, soft tissues of the jar and supraclavicular pits, stridorous (noisy) breathing at rest, pallor of the skin. Blood pressure remains normal or elevated; the size of the glottis is 4-5 mm, the lumen of the trachea is narrowed by 1/2 of a diameter or more;
• The stage of decompensation. Characterized by frequent shallow breathing, pronounced proror, forced sitting position. The larynx makes maximum excursions. The face acquires a pale-cyanotic color, marked by excessive sweating, acrocyanosis, tachycardia, threadlike pulse, arterial hypotension. The voice gap is 2-3 mm, the lumen of the trachea is slit.
• Asphyxia. Characteristically intermittent breathing or its termination. The voice slit and / or tracheal lumen is 1 mm. Sharp oppression of cardiac activity. Pulse frequent, threadlike, often not probed. The skin is pale gray due to the spasm of small arteries. Possible loss of consciousness, exophthalmos, involuntary urination, defecation, cardiac arrest. Rapid development of stenosis aggravates the severity of the condition, since the compensatory mechanisms in such a situation do not have time to develop.

The nature of organ changes in stenosis of the larynx and trachea depends on the severity and duration of the disease.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]