Laryngeal Edema

Abstract: The dose-volume outcome data for RT-associated laryngeal edema, laryngeal dysfunction, and dysphagia, have only recently been addressed, and are summarized. For late dysphagia, a major issue is accurate definition and uncertainty of the relevant anatomical structures. These and other issues are discussed.

Abstract: Background Hereditary angioedema (HAE) is an autosomal dominant disease ( Mendelian Inheritance in Man 106100) caused by an inherited deficiency of C1 inhibitor (C1-INH) function The clinical symptoms include skin swelling, abdominal pain, and life-threatening episodes of upper airway obstruction We evaluated the efficacy of C1-INH concentrate for treating sudden airway compromise Methods A series of 95 patients with HAE and a functional deficiency of C1-INH belonging to 59 families underwent screening for laryngeal edema Double-blind treatment of randomized patients was not justifiable because of the life-threatening nature of this condition Efficacy was evaluated by determining the interval from injection of C1-INH concentrate to the beginning of resolution of symptoms The mean duration of episodes of laryngeal edema was compared in treated and untreated patients Clinical information was obtained from emergency department physicians, the hospitals involved, reports of the general practitioners, and patients and their relatives Results Forty-two patients had 517 episodes of laryngeal edema Eighteen patients received 500- or 1000-U injections of C1-INH concentrate in 193 episodes The C1-INH concentrate was effective in all laryngeal edemas The interval from injection to interruption in progress of symptoms ranged from 10 minutes to 4 hours (mean ± SD, 422 ± 199 minutes) The mean ± SD duration of laryngeal edema was 153 ± 93 hours in patients who received C1-INH concentrate and 1008 ± 262 hours in those who did not Conclusions Injected C1-INH concentrate is highly and rapidly effective in the treatment of laryngeal edema of HAE Relief and resolution of symptoms begins 30 to 60 minutes after injection, and duration of the upper airway obstruction is substantially reduced

Abstract: Incidence of and contributory factors in postintubation laryngeal edema were determined in 7875 children under 17 years of age. Data were assembled in the manner of a prospective study. With an overall incidence of 1 percent, children between ages 1 and 4 were most susceptible. Excessive size of the endotracheal tube was suspect in half of the cases. Other factors that increase trauma to the larynx while an endotracheal tube is in place showed significant correlation to the total incidence of postintubation laryngeal edema. No tracheostomies were required.