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Rozpoznanie, leczenie i zapobieganie zapaleniu krtani

Transkrypcja filmu video (w języku angielskim)
- [Voiceover] Diagnosis of laryngitis, which is "itis," swelling, and "larynx," which refers to the soft tissue and vocal cords, known also as the voicebox, is mostly accomplished clinically and through good history-taking. A patient with recent exposure to a viral illness, such as the cold or the flu, may actually develop laryngitis, but, of course, exposure to pathogens and viral agents is not the only cause of laryngitis. A careful history of the patient needs to be taken. For example, they may be exposed to a lot of different chemicals or smoke, or they may be a singer and use their voice often, or potentially they may have a nodule on their vocal cords. Whatever the cause is of the laryngeal irritation, or the irritation of the larynx or the vocal cords, asking questions is the best way to diagnose the type of laryngitis. Of course, laryngitis can either be acute or chronic, where acute is more associated with viral illnesses and very rarely, bacteria, and chronic is associated with irritants such as smoking or repeated straining of the voice caused by talking or singing. Really, clinical is the best way to diagnose laryngitis because there are really no other lab tests that can be performed. However, if a physician or a health practitioner suspects something other than a viral illness, which is the most common cause of acute laryngitis, then it might be good to get a direct view of the larynx to see what's going on, In fact, there might be a nodule, or if the patient has signs of acid reflux, there might be damage seen to the soft tissue of the larynx. This can also help diagnose bacterial laryngitis. This could give direct visualization of any exudate or white pussy fluid created by bacteria, and this would give a sign that it could be a bacterial infection. Direct visualization of the larynx, known as laryngoscopy, so visualization-scopy of the larynx, can give confirmation of many different causes of laryngitis. To do laryngoscopy, a physician or health practitioner will insert a long tube-like structure that has a camera on the end of it. This camera will allow a direct view from above of the larynx and associated structures. However, laryngoscopy is usually only pursued in cases of chronic laryngitis. Now, in making the diagnosis of laryngitis, it's also important to note that there are other causes of a horse, raspy voice. One of the most dangerous causes, I'll go ahead and scroll down here, is epiglottitis. Epiglottitis is a very dangerous illness. Epiglottitis is swelling of the epiglottis, and the epiglottis is this flap of tissue that sits above the larynx. It helps protect the airway. However, when it gets swollen, it can potentially obstruct the airway, which can cause serious consequences such as difficulty breathing. Epiglottitis also causes a hoarseness of the voice just like laryngitis, but obstruction of the airway causing difficulty breathing is the major source of concern in epiglottitis. Patients may also have difficulty swallowing, which can lead to drooling, because a patient is unable to swallow the saliva that they're producing. This can actually help in differentiating between epiglottitis and laryngitis. Another difference between the two is in epiglottitis, there's no coughing. Patients tend not to cough, and that's because the vocal cords and the larynx have a lot of cough receptors, so when the larynx gets swollen, this can press on those cough receptors and cause a patient to cough. However, the epiglottis doesn't have any of these receptors, and so patients tend not to cough too much. Epiglottitis can also cause high fever. When dealing with a patient with a hoarse voice, it's important to look for these symptoms. If any of these symptoms come up, a patient should be treated for epiglottitis right away. Treatment for epiglottitis will be antibiotics. Now, the treatment for laryngitis is very supportive. It has to do with general home remedies. Patients are advised to rest their voice, drink lots of fluids, and pursue anything that can help soothe the pain in their throat. Patients can use such things as cough drops or lozenges. It's also recommended to gargle with saltwater because the saltwater can kill both pathogens and also decrease swelling. This is just accomplished through osmosis. Water can be pulled out of the swollen soft tissue in the presence of a saltier environment on the outside. Treatments for chronic laryngitis are more focused on reducing exposure to the chemical irritant or whatever is causing the chronic laryngitis. For example, quitting smoking can help resolve chronic laryngitis, or if the patient is a singer, they can decrease the use of their voice and go through proper speech counseling to decrease the trauma to their voicebox. Treatment, again, is home remedies and also decreasing exposure to irritants. Last of all, prevention of laryngitis focuses on good hygiene to avoid any viral illnesses and decreasing exposure to any noxious substances such as cigarette smoke.