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Abscess and phlegmon of the larynx
Last reviewed: 23.04.2024
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[Causes of abscess of larynx
Abscess of the larynx and phlegmon of the larynx often arise as a complication of the paratonsillar abscess or abscess of the lingual tonsil, as well as in case of damage to the larynx by an alien body with subsequent infection of the arising brine. Sometimes these diseases occur as complications of severe laryngitis. As pathogenic microbiota are streptococcus, pneumococcus, staphylococcus, and with gangrenous forms this microbiota is associated with anaerobes.
How does the phlegmon of the larynx manifest?
Symptoms of phlegmon of the larynx are usually the same as with inflammatory edema of it, however, in qualitative terms, they are much more pronounced, develop rapidly, especially with gangrenous laryngitis, and after a few hours, the inflammatory infiltrate and laryngeal edema can lead to rapid suffocation. The general condition quickly deteriorates, body temperature reaches 39-41 ° C with strong chills, indicating the progression of the septic process.
Particularly painful sensations include unbearable pain in the larynx, giving in the ear, temporal and occipital areas, and coughing, unbearable pain in which sometimes brings the patient to a pain shock characterized by a violation of cardiac activity, a general vasoconstrictive reaction and hypoxia, a fog of consciousness.
At the beginning of the disease, the endoscopic picture is very similar to that of edematous laryngitis, after 1-2 days, when general phenomena develop on the mucous membrane of the larynx, yellowish infiltrates appear against the background of pronounced hyperemia of the surrounding mucous membrane. At the same time, edema and infiltration of surrounding tissues increase with the formation of a purulent fistula.
Most often, the abscess develops in the region of the epiglottis cavities, the lingual surface of the epiglottis, and rarely on the scaly folds on the threshold of the larynx. At the same time, regional lymph nodes significantly increase, which become dense, painful and not soldered to surrounding tissues. With especially large-scale intra-oral abscesses and phlegmon, the purulent masses that break through can enter the trachea and lower respiratory tract, causing their acute purulent inflammation, right up to the lung abscess. Untimely treatment can aggravate the purulent-inflammatory process and cause chondroperichondritis, damage to its joints, generalized phlegmon with melting cartilage and the threat of asphyxia and rapidly advancing death. Of the other complications, abscess and phlegmon of the larynx should also not exclude cervical purulent cellulite, mediastinitis, general sepsis.
Diagnosis of laryngeal phlegmon
Diagnosed phlegmon of the larynx usually does not cause any difficulties and is based on the general severe condition, laryngoscopic pattern, severe pain syndrome. The most common error in the diagnosis of the phlegmon of the larynx, as well as the abscess of the larynx is the acceptance of them in the initial phase for vulgar edematous laryngitis.
What do need to examine?
Treatment of larynx abscess
Treatment of the larynx abscess should be early, at the stage of inflammatory edema of the larynx, the evolution of which toward the phlegmon is always unpredictable. Apply massive doses of antibiotics in combination with sulfonamides, decongestant and desensitizing therapy, microlaringosurgical interventions to dissect and suction content from formed abscesses. In this case, the incisions must be superficial, penetrating only into the cavity, without damage to the perichondrium, since the risk of chondroperichondritis is very high. Opening of the larynx abscess is performed when the patient is lying down with a slightly lowered head end (prevention of pus flow into the trachea), simultaneously with the opening of the abscess cavity or phlegmon, suction of pus is produced. The cough reflex thus helps to eject it outward.
An abscess of the larynx has a cautious outlook due to the possibility of severe complications.