Laryngospasms

Laryngospasm
Diagram of the larynx showing the vocal cords, which are involved in laryngospasm.
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Sudden inability to breathe or speak, stridor, anxiety
Complications	Hypoxia, cardiac arrest
Onset	Sudden
Duration	Usually brief, but can be prolonged
Types	N/A
Causes	Gastroesophageal reflux disease, anesthesia, irritants
Risks	N/A
Diagnosis	N/A
Differential diagnosis	N/A
Prevention	N/A
Treatment	Removal of irritant, positive pressure ventilation, muscle relaxants
Medication	N/A
Prognosis	Generally good with prompt treatment
Frequency	N/A
Deaths	N/A

Laryngospasm is a sudden and involuntary contraction of the vocal cords that temporarily makes it difficult to speak or breathe. This condition is often brief but can be frightening and, in rare cases, life-threatening if it leads to significant hypoxia.

Pathophysiology

Laryngospasm occurs when the muscles of the larynx (voice box) contract involuntarily. This can be triggered by various stimuli, including irritation from gastroesophageal reflux disease (GERD), exposure to certain chemicals or allergens, or as a complication during anesthesia. The spasm results in the closure of the vocal cords, which obstructs airflow into the lungs.

Causes

Laryngospasm can be caused by:

• Gastroesophageal reflux disease (GERD), where stomach acid irritates the larynx.
• Irritation from inhaled substances such as smoke, dust, or allergens.
• Complications during anesthesia, particularly during the induction or emergence phases.
• Neurological conditions that affect the control of the laryngeal muscles.

Symptoms

The primary symptom of laryngospasm is a sudden inability to breathe or speak. This may be accompanied by:

• Stridor, a high-pitched wheezing sound caused by disrupted airflow.
• Anxiety or panic due to the sensation of choking.
• Cyanosis, a bluish discoloration of the skin due to lack of oxygen, in severe cases.

Diagnosis

Diagnosis of laryngospasm is primarily clinical, based on the sudden onset of symptoms and the characteristic stridor. A thorough history and physical examination are essential to rule out other causes of airway obstruction.

Treatment

Immediate management of laryngospasm involves:

• Ensuring the patient is in a safe position and providing reassurance.
• Removal of any potential irritants or triggers.
• Application of positive pressure ventilation if necessary.
• Administration of muscle relaxants in severe cases, especially if the spasm occurs during anesthesia.

Prognosis

The prognosis for laryngospasm is generally good, especially with prompt recognition and treatment. Most episodes resolve spontaneously within a few minutes.

Prevention

Preventive measures include:

• Managing underlying conditions such as GERD.
• Avoiding known triggers, such as certain foods or environmental irritants.
• Careful monitoring and management during anesthesia to prevent complications.

Also see

• Vocal cord dysfunction
• Anaphylaxis
• Asthma
• Tracheal stenosis