Foreign bodies of the larynx
Foreign bodies of the larynx are much less common than foreign bodies of the nose, ears, trachea or bronchi. In the larynx, foreign bodies are most often stuck due to their large volume or uneven edges (egg and nut shells, meat and fish bones, metal objects, dentures, etc.) and in most cases are wedged between the ligaments. There are cases when larynx fixes leeches falling into it when drinking water directly from natural water bodies. The most common occurrence in the larynx of foreign bodies is observed in children aged from five to seven years; However, mentally ill people and old people with weakened closing and swallowing reflexes are also affected by this
Causes and course
Foreign bodies of the larynx come from the nasopharynx and the nasal cavity (during children's games), while eating - from the oral cavity, from the esophagus and stomach - during vomiting, from the bronchi and trachea - when coughing. During the tonsillotomy or adenotomy, iatrogenous foreign bodies of the larynx (aspiration of a fragment of a surgical instrument or a distant lymphadenoid tissue) may occur.
Most often the foreign body of the larynx stuck at the level of vocal and vestibular folds, and only then can it go down into the Morganiev pockets. Much less often the delay of foreign bodies occurs in the arytenoid area or the front commissure.
The most frequent mechanism for foreign bodies to enter the larynx is a sudden aspiration by a foreign body that occurs during laughter, talking, sneezing, eating, in the event of an unexpected blow to the back of the head. Also, aspiration by foreign bodies often occurs during drowsiness or sleep, with fright, distracted attention or in a state of intoxication.
Irritating and traumatizing the mucous membrane, the foreign bodies of the larynx cause inflammation and swelling, the severity of which depends on their length of stay in the larynx, on the nature of the foreign body and on the attachment of a secondary infection. In case of penetration into the larynx of acute foreign bodies, perforation is possible, so that foreign bodies can penetrate into neighboring areas and become so-called "entrance gates" for the development of secondary infection (mediastinitis, perichondritis, external jugular vein thrombosis, and perilaryngeal abscesses). If foreign bodies stay in the larynx for a sufficiently long period of time, contact ulcers, bedsores, contact granulomas and secondary infection may occur
Symptoms depend on the location and size of foreign bodies. With a small foreign body comes a sudden strong reflex cough. Also there is a reflex vomiting, promoting the expulsion of foreign bodies. In the event of a significant foreign body entering the larynx, which fully or almost entirely covers the guttural cleft, asphyxia occurs, which, if untimely tracheotomy leads initially to a coma, and then to a clinical death
Even small foreign bodies of the larynx represent a significant threat to human life, therefore their immediate removal by a qualified specialist in out-patient conditions is shown. Only in case of arisen asphyxiation, an attempt is made to remove the foreign body on its own (before the arrival of the health worker) with the help of a finger
The prognosis of life is serious enough, especially for young children, who are more likely to have severe asphyxia and a rapid onset of death. With timely rendered quality medical care - the forecast is quite favorable.
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