Isolated laryngeal burns and scalds are extremely rare and are often associated with burns and scalds of the head and face.
Etiology
The causes include:
- Inhalation of high-temperature smoke and gas during fires, which is often accompanied by burns to the head and face.
- Accidental ingestion of strong acids or alkalis, which is often accompanied by chemical burns to the pharynx and esophagus.
- Inhalation of hot liquids or steam, which is often accompanied by injuries to the nose, mouth, pharynx, trachea, bronchi, and lungs.
- Inhalation of toxic or corrosive gases.
Clinical Manifestations
Based on the severity of concurrent lower respiratory tract injuries, laryngeal burns and scalds are categorized into mild, moderate, and severe types to facilitate assessment and treatment planning.
Mild Type
The injury is confined to areas above the glottis. Symptoms may include hoarseness and laryngeal pain, along with pharyngeal pain, difficulty swallowing, nasal hair singeing, and congestion of the nasal and oral mucosa.
Moderate Type
The injury extends above the level of the tracheal carina. In addition to the clinical manifestations of the mild type, there may also be symptoms such as irritating cough and rapid breathing.
Severe Type
The injury reaches the bronchi and alveoli. In addition to the clinical manifestations of the moderate type, severe coughing and purulent bloody sputum may be observed.
Diagnosis
Medical History
There is typically a history of burns or scalds to the head and face, accidental ingestion of strong acids, strong alkalis, or other chemical corrosives, or inhalation of hot liquids, steam, or toxic gases.
Examination
Burns or scalds to the skin and mucosa around the mouth and nose, singeing of nasal hair, and clinical manifestations corresponding to mild, moderate, or severe types may be present.
Bronchoscopy
Findings in the airway may include mucosal swelling, ulceration, exudation, and formation of fibrinous membranes, indicating mucosal damage.
Treatment
Mild Type
Treatment primarily focuses on preventing infection and reducing or eliminating mucosal swelling. Measures include cleaning the oral cavity, removing secretions from the oral cavity and pharynx, aerosolized inhalation of glucocorticoids, and systemic use of antibiotics.
Moderate Type
In addition to the treatment measures for the mild type, for patients with dyspnea or those anticipated to develop respiratory issues, early endotracheal intubation or tracheotomy may be performed.
Severe Type
In addition to the treatment measures for the moderate type, systemic administration of high-dose antibiotics is employed. In cases of toxic gas inhalation, antidotes are used. Care following tracheotomy should be intensified, with prompt management of pulmonary infections and pulmonary edema. Measures are taken to counteract shock, maintain water and electrolyte balance, and protect the function of major organs.