Laryngeal obstruction

BSC NURSING III YEAR

1. Laryngeal obstruction Mr. Manikandan.T , RN., RM., M.Sc (N)., D.C.A .,( Ph.D ) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry .

2. INTRODUCTION The larynx is a stiff box that will not stretch. It contains a narrow space between the vocal cords (glottis), through which air must pass

3. DEFINITION Obstruction of the larynx because of edema is a serious, often fatal, condition. Swelling of the laryngeal mucous membranes may close off the opening tightly, leading to life-threatening hypoxia or suffocation.

4. MEANING Acute Laryngeal Edema: edema formation on larynx with inflammation, injury characterized by Hoarseness, dyspnea . Its managed by tracheostomy , epinephrine 1: 1000 Laryngospasm : spasm of laryngeal muscle occurs after administration general anesthesia, traumatic attempt at endotracheal intubation. Managed by establish airway, oxygen, nerotransmitters blocking agent – succinyl choline

5. MEANING Laryngeal paralysis :loss of sensation results of neck surgery, tumour Laryngeal injury: it often result from trauma during motor vehicle accident

6. CAUSES Hereditary Valve disorder Thracic surgery

7. CLINICAL FEATURES Hoarsenesss Dypnea Aspiration of food/ saliva Neck swelling Inabity to speak Cough

8. Management A thorough history can be very useful in diagnosing and treating the patient with a laryngeal obstruction. Maintain airway Avoid heavy alcohol or tobacco consumption, current medications, history of airway problems, recent infections, pain or fever, dental pain or poor dentition, and any previous surgeries, radiation therapy, or trauma. Rarely, patients with nasogastric tubes in place develop a postcricoid ulceration (referred to as “ nasogastric tube syndrome”). This ulceration affects the posterior cricoarytenoid muscles, causing vocal cord abduction paralysis and ultimately upper airway obstruction .

9. MANAGEMENT Corticosteroid Subdiaphragmatic abdominal thrust maneuver Establish airway Oxygen Ventilation Emergency tracheostomy arytenoidectomy