Subglottic laryngitis is observed mainly in young children, before 3 years. It is of viral origin and is declared by the inflammation of the tissues under the vocal cords, the subglottic tissues.
Subglottic laryngitis occurs mainly in young children. It is of viral origin and is declared by the inflammation of the tissues under the vocal cords, the subglottic tissues. To better understand this pathology, Dr Jérôme Bois from the ENT and cervico-facial surgery department of Caen University Hospital answers our questions.
Definition: what is subglottic laryngitis?
The larynx is made up of 3 floors: the supraglottic floor, the glottic floor which corresponds to the vocal cords and the subglottic level which is the part below the vocal cords. “In children, this is the narrowest area of the laryngeal anatomy and explains why subglottic laryngitis can be severe” emphasizes Dr. Jérôme Bois. Subglottic laryngitis is therefore a inflammation of the tissues of the larynx below the vocal cords.
What are the symptoms of subglottic laryngitis?
As the affected tissues are below the vocal cords, there is little or no voice change. Symptoms of subglottic laryngitis are mainly breathing difficulties, moderate to severe, related to the shrinking of the sector with, in most cases, a stridor, “a rather high-pitched inspiratory noise” or, in some children, a horn, “a hoarse inspiratory noise accompanied by a rather particular cough called a barking cough”.
What are the causes in children?
Typically, subglottic laryngitis is seen between 6 months and 3 years of age. It’s about a peculiarity of the small child and which usually follows a viral infection.
What are the causes in adults?
Subglottic laryngitis is quite rare after 3 years and the situations are less severe. In adults, more glottic laryngitis is observed in the vocal cords.
Who to consult?
Subglottic laryngitis usually starts at night. In this case, it is advisable to call 15 to better understand the situation. On the other hand, there is every interest in consulting an ENT or a specialist in children who have laryngitis before the age of 6 months and who regularly have several episodes a year.
If the child has no breathing difficulties and only his voice is modified, i.e. he has moderate symptoms, conventional care can be offered at home, in particular using the water vapour : “Run hot water in the bathroom and go with your child inside, this helps to moisten the air and relieve minor laryngitis.” Often laryngitis is accompanied by nasopharyngitis symptoms, we will also associate with the treatment, paracetamol and nose washes. And if the symptoms are not very marked but persist, it is recommended to consult the attending physician the next day. If the situation is different and the child has breathing difficulties (15% of cases), the child and his parents will be transferred to the emergency room for treatment at the hospital. Subglottic laryngitis is to be differentiated from epiglottic, an infection of the epiglottis, the supra-glottis, which is of bacterial origin. Its symptoms can be misleading but in general are more serious: “Children often have more fever, are more altered, refuse to lie down, and have trouble swallowing or swallowing.” The epiglottis requires hospital care.
What is the treatment for subglottic laryngitis?
In the context of subglottic laryngitis without signs of respiratory struggle, a corticosteroid prescription by mouth and possibly by aerosol is indicated. The situation quickly settles down: “The breathing difficulties go away first, while the barking cough and altered voice may linger a bit longer.” In case of respiratory distress and hospital caretreatment with oral or inhaled corticosteroids will also be prescribed, as well as respiratory aid (oxygen) and even sometimes aerosols with adrenaline “so as to quickly reduce the place taken by the mucous membrane under the vocal cords and improve the respiratory passage”. In a few days, things are back to normal.
Thanks to Dr Jérôme Bois, ENT and cervico-facial surgery department at Caen University Hospital.