Synonyms.—Edema of the Larynx; Submucous Laryngitis.
Definition.—An infiltration of the mucous membrane of the larynx with serum, usually due to inflammation.
Etiology.—Edema of the larynx may arise from injuries to the mucous membrane by swallowing a hard, rough, or sharp body, as a spicula of bone, or by the application of a caustic to the larynx. It may be due to an extension of inflammation of the neck and pharynx, or, in rare cases, to acute catarrhal laryngitis. Some drugs will give rise to it, notably potassium iodide.
It may arise as a complication in certain infectious diseases,—diphtheria, erysipelas, typhoid fever, hydrophobia, scarlet fever, influenza, etc. Tubercular, syphilitic, and malignant diseases of the larynx may be accompanied by edema.
It generally accompanies dropsy, due to kidney or cardiac lesions.
Pathology.—The mucous membrane of the upper portion of the larynx, the rim of the glottis, and the covering of the epiglottis are infiltrated with serum. The effusion into the sub-mucous tissues of the aryteno-epiglottis folds may be so extended as to include the respiratory passage.
Symptoms.—"The disease commences with a continually increasing impediment to respiration, and a feeling of fullness and constriction and continuous desire to clear the throat, as if caused by some foreign body; the voice becomes hoarse, croupal, then sharp, stridulous, whispering, and is then lost completely; there is a hoarse, convulsive cough, with fits of suffocation, causing great agony. While inspiration is prolonged, stridulous, and exceedingly difficult, expiration is comparatively easy. This feature is so marked as to be pathognomonic of the disease.
"There is no fever, but as the disease progresses the pulse becomes frequent, small, and irregular. The difficulty of breathing increases; the fits of coughing and suffocation are more frequent; symptoms of asphyxia are very apparent; the cerebral functions are disturbed; and at last death ensues from inability to inflate the lungs."
Diagnosis.—The difficult, labored respiration and easy expiration will suggest the character of the disease, while a laryngoscopic examination removes all doubt.
Prognosis.—The prognosis is unfavorable unless relief be obtained by prompt surgical interference.
Treatment.—If due to inflammation,—
|Water||4 ounces. M.|
|Sig. Teaspoonful every hour.|
Cloths wrung out of ice-water and applied to the throat, with small bits of ice held in the mouth, affords some relief. If no fever be present, cactus, convallaria, or strophanthus may be combined with the apocynum. Jaborandi and pilocarpin have been used with benefit by producing profuse diaphoresis. Where no relief is experienced by medication or scarification, intubation should be tried, and, this failing, as a last resort tracheotomy should be performed.
The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.