The inflammatory process in the larynx can spread to the perichondrium and cartilage, as a result, the laryngeal chondro-perichondritis is developing. Chondro-perichondritis can be primary (it causes hematogenous infection) and secondary (first the mucous membrane of the larynx is affected, and then the perichondrium and cartilage).
Distinguish chondro-perichondritis and diffuse, acute and chronic. Basically, both sheets of perichondria are affected, therefore the division of chondroperi chondrite into external and internal is to some extent conditional.
Etiology of larynx chondro-perichondritis
Often the cause of the disease is injuries, gunshot wounds, blunt injuries, foreign bodies, intubation, high performance of tracheostomy with damage to the cricoid cartilage and subsequent pressure on it tracheocoenals, which leads to pressure sores cartilage. chondro-perichondritis can develop as a result of radiotherapy for a malignant tumor of the larynx.
Clinical picture of larynx chondro-perichondritis
Chondro-perichondritis most often is purulent. Pus exfoliates the perichondrium, disrupts cartilage nutrition, as a result of which it dissolves or is necrotic with the formation of sequestrants released through fistulas. The leaves of the perichondrium can form a sequelial capsule around the dead cartilage.
Another form of the disease is sclerosing. Infiltration is not suppressed, granulation develops with subsequent scarring.
The disease is characterized by pain in the larynx, during swallowing, fever, hoarseness, difficulty breathing. Define the smoothness of the larynx contours, a slight increase in the size of the neck, a thickening of the cartilage. During the palpation the patient feels a sharp pain. Sometimes there is a fluctuation, cervical lymphadenitis.
The laryngoscopic pattern is characterized by edema and infiltration of the mucous membrane. The mobility of one or both halves of the larynx is impaired. Due to damage to the cricoid cartilage, stenosis of the larynx develops. Purulent chondro-perichondritis can be complicated by aspiration pneumonia, sepsis. The symptomatology of chronic chondro-perichondritis is not so bright. Late complications of hopperperichondritis include cicatricial stenoses of the larynx.
The diagnosis of the disease is facilitated by radiologic examination of the larynx, which helps to determine the thickening of the shadows of soft tissues and the change in the pattern of normal ossification of cartilage. Chronic chondro-perichondritis is characterized by a so-called disordered calcification.
Treatment of larynx chondro-perichondritis
In the treatment of chondroperiochondritis of the larynx, the main place is occupied by antibiotics, as well as decongestants. A timely treatment prevents the development of suppuration. With the development of decompensated stenosis of the larynx, tracheostomy is performed. In the case of abscesses, they should be disclosed.
If this is not enough, a laryngofissure is carried out, with the mucosa lining the skin, thereby removing pus and sequestration of the cartilage. Self-disclosure of the abscess can lead to aspiration of pus and development of severe pulmonary complications.
Irrational treatment leads to a rough deformation of the larynx and its persistent stenosis.