=Definition.=—An acute, catarrhal inflammation of the mucous membrane
of the larynx. This may be ushered in as an independent disease or it
may be associated with inflammation of the upper respiratory passages.
=Osteopathic Etiology= and =Pathology.=—One of the principal causes
of acute catarrhal laryngitis is exposure to cold and dampness, which
contracts the muscles of the neck region, especially about the larynx.
Lesions in the upper and middle cervical vertebræ are important
predisposing causes. Occasionally the first rib becomes luxated,
causing a greater or less congestion of the laryngeal mucous membrane
by contracting the lower antero-lateral muscles of the neck, and
affecting lymphatic drainage. Improper placing of tone, as well as too
constant use of the voice in speaking and singing, are common causes.
Inhalation of irritating gases or dust, and mechanical injuries to
the larynx are occasional causes. The disease may be associated with
certain infectious diseases, as measles, diphtheria, influenza and
whooping cough.
=Pathologically=, the mucous membrane is intensely reddened and
inflamed; this inflammation involves both the true and false vocal
cords and may extend into the trachea and about the epiglottis. The
membrane is covered slightly with mucous secretion. In rare instances
edema of the glottis may occur. The muscular contraction about
the larynx impedes blood and lymphatic drainage and thus induces
congestion. The contraction may be so severe as to slightly prolapse
the organ. The vertebral lesions impinge upon or affect vasomotor
fibers and thus bring about congestion.
=Symptoms=.—There is hoarseness and cough with a sensation of tickling
in the larynx; these are the most constant symptoms. The cough is
dry and the voice altered. At first the voice is husky, but some
attempts at speaking are attended with more or less pain and finally
the voice may be entirely lost. Deglutition is painful. At first the
expectoration is scanty, but later it becomes mucopurulent. There
is rarely much fever. When there is considerable edema, dyspnea and
asphyxia are prominent features.
=Prognosis.=—Simple catarrhal laryngitis never terminates fatally.
When there is dyspnea or asphyxia indicating edema of the larynx, the
prognosis is grave. The attack usually lasts from one week to ten days,
but this can be materially shortened by careful osteopathic treatment.
In severe infections it may be two or three weeks before the larynx
returns to its former condition.
=Treatment.=—In a few cases confinement of the patient to his room, and
possibly the bed, will be necessary; especially should the larynx have
rest from phonation, and the taking of food of an irritating character
should be avoided. Smoking is to be prohibited. The room should be
at an even temperature, from 70 to 75 degrees F., and the atmosphere
saturated with moisture by the generation of steam.
The tissues in the cervical region about the cervical sympathetic and
vagi nerves should be carefully adjusted. The deep posterior muscles
of the cervical spine are to be relaxed and direct treatment given
over and about the larynx. Relaxing tissues and raising the larynx
will be very effectual in relieving the =huskiness= of the voice
and in controlling the congestion and inflammation of the laryngeal
mucosa. Besides the treatment of the vagi nerves at the atlas and their
course down the lateral and anterior portion of the neck, the superior
laryngeal may be treated at the upper portion of the great cornu of
the hyoid bone and the inferior laryngeal at the inner side of the
cleido muscle near its sternal attachment. Adjust the tissues along
the course of the external carotid and subclavian arteries, chiefly
the first rib for the latter. Give careful treatment to the internal
jugular and innominate veins. Correct any tissues that may impinge upon
the lymphatics of the mucous and submucous coats of the larynx where
they are drained into the deep cervical glands. Release any immobility
of the upper chest, relax the pectoral, auxiliary and upper dorsal
muscles, and adjust the first four or five dorsal vertebræ.
Prompt action of the skin, freedom of the bowels, placing the feet
in a hot bath and continued local hot packs, or even an ice-bag in
severe cases, will be of special value at the onset; but due attention
should be given these throughout the entire course. The fever is easily
aborted by the cervical treatment and proper attention to the bowels
and sweat glands.