Laryngeal Oedema Or Oedema Glottidis: Causes, Features, Treatment

Often termed "oedema glottidis" in the past, it involves
the supraglottic and subglottic region where laryngeal
mucosa is loose. Oedema of the vocal cords occurs rarely
because of the sparse suhepithelial connective tissue.
Aetiology:
1. Infections
(i) Acute epiglottitis, laryngo-tracheo-bronchitis,
tuberculosis or syphilis of larynx.
(ii) Infection in neighbourhood, e.g. peritonsillar
abscess, retropharyngeal abscess and Ludwig's
angina.
2. Trauma. Surgery of tongue, floor of mouth, laryngeal
trauma, foreign body, endoscopy especially in
children, intubation, thermal or caustic burns or
inhalation or irritant gases or fumes.
3. Neoplasms. Cancer of larynx or laryngopharynx
often assoc iated with deep ulceration.
4. Allergy. Angioneurotic oedema, anaphylaxis.
5. Radiation. For cancer of larynx or pharynx.
6. Systemic diseases. Nephritis, heart failure, or
myxoedema.
Symptoms and Signs
1. Airway obstruction. Degree of respiratory distress
varies. Tracheostomy may become essential.
2. Inspiratory stridor.
3. Indirect laryngoscopy shows oedema of supraglottic
or subglottic region. Children may require direct
laryngoscopy.
Treatment
If there is airway obstruction, intubation of larynx or tracheostomy
will be immediately required. Less severe cases
are treated conservatively and treatment will depend on
the cause. An injection of adrenaline (1:1 000) 0.3-0.5 ml
i.m., repeated in 15 minutes if necessary, is useful in allergic
or angioneurotic oedema. Steroids are useful in
epiglottitis, laryngo- tracheo-bronchitis or oedema due to
traumatic allergic or post-radiation causes.