Glottic Edema

Glottic Edema Basics

Dictionary Medical

The medical term glottic edema describes an acute swelling of the larynx mucosa. With advanced glottic edema there is a risk of suffocation.

What is Glottic Edema?

According to DIGOPAUL, glottic edema is a life-threatening swelling of the mucous membrane (edema) in the larynx area. Glottic edema can also be referred to as laryngeal edema . It can be caused by infections, allergies, or medications. Typical symptoms of glottic edema are hoarseness and increasing shortness of breath.

The therapy depends on the cause. Rapid action is necessary, as there is a risk of death from suffocation if the larynx is completely obstructed. If there is an acute danger of suffocation, intubation or tracheostomy is performed.

Causes

Possible causes of laryngeal edema include infections. These can be caused by bacteria or viruses. Epiglottitis is particularly feared in small children. It is an inflammation of the epiglottis, usually caused by the bacterium Haemophilus influenzae type B. However, diphtheria, especially laryngeal diphtheria, can also result in glottic edema.

Diphtheria is caused by the pathogen Corynebacterium diptheriae. Less commonly, glottic edema occurs with infection with Streptococcus pneumoniae, Staphylococcus aureus, or other beta-hemolytic streptococci. Another cause of glottic edema is an acute allergic reaction. In the case of an allergy, the body reacts to non-infectious foreign substances with an inflammatory reaction.

While skin rashes tend to be considered a mild allergic symptom, glottic edema is a severe anaphylactic allergic reaction. Such an allergic reaction can be caused, for example, by eating nuts or other allergens. Various medications can also cause glottic edema. It occurs more frequently when taking ACE inhibitors.

Glottic 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 from choking would be conceivable.

Symptoms, Ailments & Signs

The cardinal symptom of glottic edema is hoarseness. Those affected have a hoarse voice and get increasingly bad breath ( dyspnea ). They may also complain of difficulty swallowing. If glottic 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 noise caused by a narrowing of the airways. A stridor located in the region of the larynx sounds like a whistle or like a hiss. Due to the increasing narrowing of the airways, the shortness of breath worsens, so that in an emergency it can lead to acute attacks of suffocation.

If the glottic edema is based on epiglottitis, the swelling of the mucous membrane is often announced beforehand. The disease begins quite suddenly and takes a fulminant course. The affected patients suffer from severe sore throat and high fever. A lumpy speech is typical of epiglottitis with glottic edema. Since swallowing is extremely painful for those affected, saliva runs out of their mouths.

Large amounts of saliva are also produced ( hypersalivation ). The allergic glottic edema can be announced by a scratchy and itchy throat. Affected patients often have to clear their throats. A swollen tongue and reddening of the mouth after consuming potential allergens can also indicate an allergy as the cause of glottic edema.

Diagnosis

The diagnosis can be made quite quickly based on the characteristic symptoms. If glottic edema is suspected, transfer to a hospital should always take place. A diagnostic measure to secure the suspected diagnosis is an inspection of the throat. This can possibly be carried out through a fiber optic inserted into the nose. In the case of inflammation, the local finding is a crimson and inflamed epiglottis.

In all forms of glottic edema, swelling of the mucous membrane can be seen. Care should be taken when examining the mouth and throat. The objects to be examined can irritate the tissue in such a way that the mucous membrane quickly swells even further. There is a risk of death by suffocation.

Complications

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

Speaking and swallowing is associated with pain in most cases. Difficulty swallowing often leads to reduced intake of fluids and food, which can lead to dehydration or malnutrition. The tongue swells, a sore throat can make itself felt. Hyperventilation may also occur with difficulty breathing, and the patient’s throat will be itchy.

The treatment of glottic edema is usually causal and is carried out with the help of antibiotics. When taking medication, in most cases there are no further complications and the disease disappears again. In severe cases, the person concerned may need artificial respiration in order not to suffocate. Furthermore, no particular consequential damage occurs and life expectancy is not reduced by glottic edema.

When should you go to the doctor?

Since glottic edema can lead to the death of the affected person in the worst case, treatment is necessary in any case. As a rule, a doctor should be consulted if the patient has difficulty swallowing and is unable to breathe properly. Strenuous activities or sports may no longer be possible, so that the patient’s quality of life is significantly reduced. Furthermore, pathological breathing noises often indicate glottic edema and should be examined by a doctor.

In severe cases, the condition can lead to suffocation. Many patients complain of persistent sore throats and scratchy or itchy throats. A swollen tongue also usually indicates glottic edema and must be examined by a doctor. First and foremost, the person concerned can turn to a general practitioner or to a hospital. Treatment is always carried out in a hospital. In acute emergencies or in the event of a serious condition, the emergency doctor can also be called.

Treatment & Therapy

The treatment of glottic edema depends on the cause. So that the mucous membranes go down as quickly as possible, anti-inflammatory glucocorticoids 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 tube that is filled with pieces of ice. The cold leads to vasoconstriction and thus reduced blood flow.

This means that less liquid escapes into the tissue. If the edema is caused by a bacterial infection, antibiotics are given. Third- and fourth-generation antibiotics have proven particularly effective for epiglottitis. Allergic glottic edema is treated with antihistamines.

If there is a risk of suffocation, intubation can be performed. Here, an endotracheal tube is pushed into the trachea between the vocal folds of the larynx. This widens the airways and enables external ventilation. A tracheostomy may also be necessary. This involves surgical access to the trachea. The trachea is opened between the second through fourth tracheal cartilages.

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 are swollen and independent breathing is possible again.

Outlook & Forecast

The prognosis of glottic edema is linked to the course of the disease and the use of timely medical care. In an acute form, without emergency medical services and prompt treatment, there is a risk of premature death. The edema triggers a reduced air supply, so that the affected person is at risk of suffocation. Normally, the edema develops slowly and continuously. The affected person should consult a doctor if they experience a tightness in their throat or if they have increasing difficulty swallowing. This usually avoids acute situations.

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 and the treatment can lead to complications such as anxiety or a sore throat. Normally, the physical irregularities gradually recede until you are free of symptoms. 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 fully restored and anxiety is reduced.

Prevention

Not all glottic edema can be prevented. There is a vaccination against the causative agent of epiglottitis. This is also recommended by the Standing Vaccination Commission (STIKO). Allergy-related glottic 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 medication, although surgical interventions may also be necessary. The medication should be taken according to doctor’s 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.

A stay in a hospital is usually necessary. Strenuous activities or other stressful activities should be avoided during this time. Those affected are often also helped with their breathing. If the glottis edema is not treated in time, the worst case scenario can be the death of the patient. In emergencies, a doctor should always be called or the hospital should be visited directly to prevent further complications. Some variants of glottic edema can be prevented with the help of vaccinations.

You can do that 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 affected people.

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.

Glottic Edema