Diseases

Glottal edema – causes, symptoms & treatment

Glottal edema

The medical term glottis edema refers to an acute swelling of the laryngeal mucosa. With advanced glottal edema, there is a risk of suffocation.

What is glottal edema?

Glottal edema is a life-threatening swelling of the mucous membrane (edema) in the laryngeal area. Glottal edema can also be called laryngeal edema. It can be caused by infectionsallergies or medications. Typical symptoms of glottal edema are hoarseness and increasing shortness of breath.

Therapy is carried out depending on the cause. A quick action is necessary, since with a complete displacement of the larynx death by suffocation threatens. If there is an acute risk of suffocation, intubation or tracheotomy is performed.

Causes

Possible causes of laryngeal edema include infections. These can be caused by bacteria or viruses. In young children, epiglottitis is particularly feared. It is an inflammation of the epithelium, which is usually caused by the bacterium Haemophilus influenzae type B. But also diphtheria, especially laryngeal diphtheria, can result in glottal edema.

Diphtheria is caused by the pathogen Corynebacterium diptheriae. More rarely, glottal edema develops with infection with Streptococcus pneumoniae, Staphylococcus aureus or with other beta-hemolytic streptococci. Another cause of glottal edema is an acute allergic reaction. With an allergy, the body reacts to non-infectious foreign substances with an inflammatory reaction.

While rashes are considered more of a mild allergic symptom, glottal edema is a severe anaphylactic allergic reaction. Such an allergic reaction can be caused, for example, by the consumption of nuts or other allergens. Various medications can also cause glottal edema. It occurs more frequently when taking ACE inhibitors.

Glottal edema is also a complication of radiation therapy. Radiotherapy is mostly used in patients with cancer. Laryngeal edema can also develop after trauma. For example, edema caused by choking would be conceivable.

Symptoms, complaints & signs

The cardinal symptom of glottal edema is hoarseness. Those affected have a rough voice and get increasingly bad air (dyspnea). They may also complain of difficulty swallowing. If glottal edema is infectious, it may be accompanied by fever. The more pronounced the swelling, the sooner a so-called inspiratory stridor becomes audible.

A stridor is a pathological breathing background noise caused by a narrowing of the airways. A stridor localized in the region of the larynx sounds like a whistling or a hiss. Due to the increasing narrowing of the airways, the shortness of breath worsens, so that acute suffocation attacks can occur in an emergency.

If glottal edema is based on epiglottitis, the swelling of the mucous membranes often announces itself beforehand. The disease begins quite suddenly and takes a fulminant course. The affected patients suffer from severe sore throat and high fever. Typical for epiglottitis with glottal edema is a clunky language. Since swallowing is extremely painful for those affected, saliva runs out of their mouths.

Large amounts of saliva are also produced (hypersalivation). The allergic glottal edema can announce itself by a scratching and itching in the throat. The affected patients often have to clear their throats. Also, a swollen tongue and redness in the mouth area after eating potential allergens can indicate an allergy as the cause of glottal edema.

Diagnosis

The diagnosis can be made quite quickly on the basis of the characteristic symptoms. If glottal edema is suspected, a transfer to a hospital should always be made. A diagnostic measure to confirm the suspected diagnosis is an inspection of the throat. Possibly this can be carried out by a fiber optic inserted into the nose. In the case of inflammation, a bright red and inflamed epithelium appears as a local finding.

In all forms of glottal edema, swelling of the mucous membrane is noticeable. Caution should be exercised when examining the mouth and throat. The objects of examination can irritate the tissue to such an extent that the mucous membrane quickly swells even further. There is a threat of death by suffocation.

Complications

In the worst case, glottal edema causes suffocation or ingestion. Children in particular are exposed to an increased risk of suffocation, which can lead to death relatively quickly. The affected person suffers primarily from a deep voice and hoarseness.

Speaking and swallowing is associated with pain in most cases. Not infrequently, the swallowing difficulties also lead to a reduced intake of fluids and food, which can lead to dehydration or malnutrition. The tongue swells, sore throat may make itself felt. With difficulty breathing, hyperventilation may also occur and the throat itches in the patient.

Treatment of glottal edema is usually causal and is carried out with the help of antibiotics. When taking medications, in most cases there are no further complications and the disease disappears again. In severe cases, the affected person may be dependent on artificial respiration in order not to suffocate. Furthermore, no special consequential damage occurs and life expectancy is not reduced by glottal edema.

When to go to the doctor?

Since glottal edema can lead to the death of the affected person in the worst case, treatment is definitely necessary. As a rule, a doctor should be consulted if the patient suffers from difficulty swallowing and has difficulty breathing. Even strenuous activities or sports may no longer be possible, so that the patient’s quality of life is significantly reduced. Furthermore, pathological breathing sounds often indicate the glottal edema and should be examined by a doctor.

In severe cases, the disease can lead to suffocation of the affected person. Many patients complain of permanent sore throat and scratching or itching in the throat. Also, a swollen tongue usually indicates glottal edema and must be examined by a doctor. First and foremost, the person concerned can turn to a or to a hospital. Treatment is always carried out in a hospital. In acute emergencies or in a serious condition, the emergency doctor can also be called.

Treatment & Therapy

The therapy of glottal edema depends on the cause. In order for the mucous membranes to decongest as quickly as possible, anti-inflammatory are used in high doses. In addition, an attempt is made to prevent further swelling by putting on a so-called ice tie. An ice tie is a closable hose that is filled with pieces of ice. The cold leads to a vasoconstriction and thus to a reduced blood circulation.

As a result, less fluid escapes into the tissue. If the edema was caused by a bacterial infection, are administered. In epiglottitis, third- and fourth-generation antibiotics have proven to be particularly effective. Allergic glottal edema is treated with antihistamines.

If there is a risk of suffocation, intubation can be performed. Here, an endotracheal tube is pushed between the vocal folds of the larynx into the trachea. This widens the airways and enables external ventilation. A tracheotomy may also be required. Here, access to the trachea is obtained surgically. The trachea is opened between the second to fourth tracheal cartilage.

This creates a connection between the trachea and the outer air space. This is also known as a tracheostomy. The patients can be artificially ventilated via this tracheostoma until the mucous membranes have gone down and they can breathe independently again.

Outlook & Forecast

The prognosis of glottal edema is linked to the course of the disease, as well as the use of timely medical care. In an acute form, there is a risk of premature death without an ambulance service and immediate treatment. The edema triggers a reduced air supply, so that the person concerned is threatened with suffocation. Normally, the edema develops slowly and continuously. The affected person should already consult a doctor in case of tightness in the throat or increasing swallowing difficulties. As a result, acute situations are usually avoided.

Without medical treatment, an increase in symptoms is to be expected. If glottic edema is treated with medication, the prognosis is good. There may be a need for temporary artificial ventilation, which leads to a severe impairment of well-being and quality of life. However, after the swelling has receded due to the medication and the causal triggers have been treated, a complete healing can be expected.

The experiences as well as the treatment can lead to complications such as anxiety or sore throat. Normally, the physical irregularities gradually recede until freedom from symptoms is achieved. In the case of emotional problems, follow-up treatment may be necessary to process what has been experienced so that the quality of life is completely restored and anxiety is reduced.

Prevention

Not all glottal edema can be prevented. Against the causative agent of epiglottitis there is a vaccination. This is also recommended by the Standing Committee on Vaccination (STIKO). Allergic glottal edema can only be avoided by strictly avoiding known allergens.

Aftercare

As a rule, no special options for aftercare are possible or necessary in the case of glottis edema. The patient must primarily identify and treat the reason for the glottic edema. Without treatment, in the worst case, the affected person can suffocate, so that treatment is necessary in any case.

The symptoms are usually treated with the help of medication, although surgical interventions may also be necessary. The medication should be taken according to medical instructions and, above all, regularly. Possible interactions with other medicines must also be taken into account. After surgery, the patient should always rest and protect their body.

In most cases, a stay in a hospital is necessary. Strenuous activities or other stressful activities should be avoided during this time. Often, those affected are also supported in their breathing. If the glottal edema is not treated in time, in the worst case it can also lead to the death of the patient. In emergencies, therefore, a doctor should always be called or the hospital should be visited directly to prevent further complications. Some variants of glottal edema can be prevented with the help of vaccinations.

What you can do yourself

People in whose environment this disease occurs can be vaccinated against the pathogen. A condition arising from allergy should be addressed by limiting exposure to the allergens. In general, it should be noted that there are only a few options for self-help with this disease.

Nevertheless, it is possible to bring relief by cooling the affected area. However, the ice must not touch the skin directly to avoid cold burns. In the case of allergies, taking Antihistamines can have a positive effect on the course. If the disease leads to swallowing difficulties, the patients are often dependent on the help of other people to take food and liquids.

Above all, the care provided by one’s own family or friends has a positive effect on the course of the disease. Possible psychological complaints or depression can also be prevented by talking to the family or other people affected.

Due to the breathing difficulties, the person concerned should refrain from strenuous activities or sporting activities and take care of the body. This should be considered especially if the disease occurs as a result of cancer.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.