Laryngospasme mpe Dysfonctionnement ya corde vocale (Obstruction inducible ya laryngé): Stridor inspirateur, Manœuvre ya Larson ya kopumbwa na mbanga, mpe Réinitialisation ya sniff ya panting¶

Sudden, terrifying inability to pull air in past the throat can result from two closely related functional crises of the vocal cords: acute reflex laryngospasm (a violent, involuntary, complete or near-complete closure of the true and false vocal cords mediated by the superior laryngeal nerve) and vocal cord dysfunction (VCD), now officially classified by international respiratory societies as inducible laryngeal obstruction (ILO) (paradoxical adduction of the vocal cords toward the midline during inhalation rather than opening widely as they normally should). While complete laryngospasm is a life-threatening anesthetic, post-extubation, drowning, or acid-reflux airway emergency that can produce severe hypoxia, bradycardia, or negative-pressure pulmonary edema within 60 to 120 seconds if not physically broken, awake inducible laryngeal obstruction (VCD/ILO) is a benign, self-limiting functional spasm triggered by high-intensity exercise, acid reflux, cold air, strong chemical odors, post-nasal drip, or acute stress that is frequently misdiagnosed as life-threatening status asthmaticus or anaphylaxis. Because both conditions narrow the glottic chink at the level of the larynx in the neck, they produce a loud, high-pitched, musical or crowing sound when breathing IN (inspiratory stridor) with the patient pointing directly to their throat, in contrast to bronchial asthma, which narrows the lower airways inside the chest and causes whistling wheezing primarily when breathing OUT (expiratory wheezing). If someone develops sudden stridor, cannot speak or breathe, shows bluish lips (cyanosis), has neck or tongue swelling, or loses consciousness, call your local banimero ya mbalakaka mbala moko (911 na États-Unis mpe na Canada, 112 na Union européenne mobimba, 999 na Royaume-Uni). Tala mpe ba guides na biso ya moninga na asthma attacks, . epiglottitis, croup, and stridor, mpe ba réactions allergie mpe anaphylaxie.

Your immediate priority is to check for red-flag signs of true mechanical or anaphylactic airway obstruction (foreign body choking, lip or tongue angioedema, drooling, or declining consciousness), apply Larson's maneuver (firm bilateral inward and upward pressure at the laryngospasm notch right behind the earlobe combined with a forward jaw thrust) if acute complete laryngospasm strikes an unresponsive or post-sedation patient, and coach an awake patient through the Double Nasal Sniff and Pursed-Lip Exhale (or Panting Reset) to reflexively abduct (open) the vocal cords within seconds.

Sala boye sikoyo¶

1. Check immediately for life-threatening red flags and call your local emergency number if present. Dial 911 in the United States and Canada, 112 across the European Union, 999 in the United Kingdom, 000 in Australia, or check our global directory of banimero ya mbalakaka if this is the person's first episode of stridor, if they were eating right before onset (choking), if they have hives or swollen lips or tongue (allergic reactions), if they have fever and drooling (epiglottitis), or if their lips turn blue or they become confused or unresponsive.
2. If an Awake Person Has Sudden Vocal Cord Spasm (VCD / ILO) or Post-Cough Paroxysmal Laryngospasm: Sit them upright with shoulders dropped forward and stop them from gasping through an open mouth. Gasping hard through an wide-open mouth creates high-velocity turbulent airflow across the larynx, which sucks the vocal cords tightly together via the Bernoulli vacuum effect and dries out the laryngeal mucosa.
3. Coach the "Double Nasal Sniff + Long Pursed-Lip Exhale" (EILOBI / Respiratory Retraining Reset):
4. Step A (Exhale First): Tell the person to blow their remaining air gently out through tightly pursed lips (as if blowing through a narrow coffee stirrer or flickering a candle flame without blowing it out) for 3 to 4 seconds. Breathing out against pursed lips creates 5 to 10 cmH2O of back-pressure (intrinsic PEEP) that pneumatically pushes the vocal cords apart.
5. Etape B (The Nasal Sniff): Tika bango bakanga monoko, ba relaxer mbanga na zolo, pe bazua ba sniffs mibale ya mbangu, ya malembe NA zolo (lokola soki bazali koyoka nsolo ya fololo). Kosokola na zolo esalaka ete réflexe ya makasi ya moboko ya bɔɔngɔ esalaka na nzela ya muscle cricoaryténoïde postérieur (muscle seul abducteur ya larynx) oyo esalaka ete bansinga ya mongongo efungwama na makasi.
6. Step C (The Panting / Straw Breath Alternative): If their nose is congested, have them pant rapidly like a dog with their tongue relaxed on the floor of the mouth, or inhale slowly through a narrow opening between pursed lips while expanding their belly (diaphragmatic breathing).
7. Soki Laryngospasme Silent Complète Esali (Flux d'air Zéro Malgré Heaving ya ntolo, to Post-Anesthésie / Post-Reflux / Spasme ya kozinda): Salá mbala moko MANÉUVRE YA LARSON.
8. Locate the Larson's point ( the "laryngospasm notch") on both sides of the head: the small bony depression bounded anteriorly by the ascending ramus (back edge) of the lower jawbone, posteriorly by the mastoid process behind the ear, and superiorly by the base of the skull, right behind the earlobe.
9. Place the tips of your middle or index fingers deep into both notches and press forcefully inward toward the center of the skull and forward/upward toward the nose simultaneously lifting the lower jaw into a strong forward jaw thrust.
10. Larson's maneuver mechanically stretches the geniohyoid and thyrohyoid ligaments to pull the epiglottis and false vocal cords apart while triggering intense cranial nerve stimulation that breaks the vagal laryngospasm reflex arc within 5 to 15 seconds.
11. If the Person Has Known Asthma as Well as Vocal Cord Dysfunction: Use their rescue salbutamol (albuterol) inhaler with a spacer if unsure, as up to 30 to 50 percent of VCD patients have coexisting asthma. However, understand that beta-2 agonist inhalers and epinephrine do not relax striated laryngeal muscle in pure vocal cord dysfunction, so breathing retraining must be performed alongside any inhaler use.
12. Take a small sip of room-temperature water (only once the person can draw a gentle breath and is not choking on food) or hum a low note ("Mmmmmm"). Both the pharyngeal swallowing reflex and low-pitch humming (phonation) reset disordered brainstem laryngeal motor signaling and relax hypertonic thyroarytenoid and lateral cricoarytenoid muscles.

Clinical decision tree: inspiratory stridor, VCD/ILO, and complete laryngospasm¶

flowchart TD
    A["Sudden onset of throat tightness, difficulty breathing IN, or high-pitched inspiratory stridor"] --> B{"Check Consciousness, Airflow, and Anaphylaxis / Foreign Body Signs"}
    B -->|Unconscious, cyanotic, silent chest with tracheal tug, or post-sedation/drowning| C["COMPLETE LARYNGOSPASM OR CHOKING: Call EMS (911/112/999); verify no foreign body; immediately perform LARSON'S MANEUVER + Jaw Thrust + 100% O2 positive pressure (CPAP 10 to 20 cmH2O)"]
    B -->|Swollen lips/tongue, generalized hives, hypotension, or exposure to allergen| D["ANAPHYLAXIS OR ANGIOEDEMA: Inject Intramuscular Epinephrine (0.3 to 0.5 mg) into outer mid-thigh immediately and call EMS"]
    B -->|Fever, drooling, tripod posture, muffled hot-potato voice, or barking cough| E["EPIGLOTTITIS OR CROUP: Keep patient calm and upright; do NOT inspect throat with spoon; call EMS immediately"]
    B -->|Awake, alert, no hives/swelling, pointing to throat; loud inspiratory stridor triggered by exercise, cough, reflux, scent, or stress| F["Inducible Laryngeal Obstruction (VCD / ILO) or Awake Paroxysmal Laryngospasm"]
    F --> G["Step 1: Sit upright leaning slightly forward; drop shoulders; relax jaw and neck muscles"]
    G --> H["Step 2: Exhale slowly through tightly PURSED LIPS for 4 seconds (creates positive back-pressure to push cords open)"]
    H --> I["Step 3: Take 2 gentle NASAL SNIFFS in through nose (or pant like a dog / breathe through a imaginary straw) using belly breathing"]
    I --> J{"Did stridor and throat tightness resolve within 1 to 3 minutes?"}
    J -->|Yes (Typical VCD / Awake Laryngospasm resolution)| K["Sip water slowly; avoid triggers (reflux, cold air, irritants); arrange outpatient laryngoscopy and Speech-Language Pathology (EILOBI) therapy"]
    J -->|No: Stridor persists > 3 to 5 minutes, SpO2 drops below 92%, or severe distress| L["Call EMS (911/112/999) for Emergency Department evaluation, flexible nasolaryngoscopy, CPAP, or Heliox (80:20 helium-oxygen)"]
    C --> M["Hospital / Anesthesia Escalation if Larson Maneuver + CPAP fail: IV Propofol (0.25 to 0.8 mg/kg) or IV Succinylcholine (0.1 to 1.0 mg/kg) + tracheal intubation"]

Pathophysiology: How the Larynx Works and Why the Vocal Cords Slam Shut¶

The human larynx (voice box) serves three critical biological functions: maintaining an open airway for breathing, producing voice (phonation), and acting as a protective sphincter valve to prevent food, liquid, and stomach acid from entering the lungs during swallowing.

Normal Vocal Cord Movement vs Paradoxical Adduction (ILO) vs Complete Laryngospasm¶

1. Kopema ya normal:
2. During Inhalation (Breathing In): The respiratory center in the medulla oblongata fires signals down the recurrent laryngeal nerve to contract the posterior cricoarytenoid (PCA) muscle, the only muscle in the entire human body that opens (abducts) the vocal cords. The vocal cords swing wide apart into a broad V-shape, allowing silent, laminar airflow into the trachea.
3. Na tango ya Exhalation (Breathing Out): Ba cordes vocales e relaxer mua moke vers la ligne milieu (ekitisaka na 10 à 30 pour cent) pona ko maintenir pression physiologique positif légère fin-expiratoire.
4. Inducible Laryngeal Obstruction (Vocal Cord Dysfunction / VCD):
5. In patients with VCD / ILO (including Exercise-Induced Laryngeal Obstruction [EILO] in competitive athletes), chronic irritation of the laryngeal mucosa (from silent laryngopharyngeal acid reflux, post-nasal drip, or inhaled irritants) or autonomic hyper-reactivity causes the adductor muscles (lateral cricoarytenoid, thyroarytenoid, and interarytenoid muscles) to contract paradoxically during inhalation (or causes the aryepiglottic folds above the cords to prolapse inward during peak exercise).
6. Instead of opening into a wide V when the person breathes in, the anterior two-thirds of the vocal cords slam together toward the midline, leaving only a tiny posterior diamond-shaped chink at the back of the glottis through which air whistles with a high-pitched inspiratory stridor.
7. Acute Complete Reflex Laryngospasm:
8. Mediated via the internal branch of the superior laryngeal nerve (a branch of the Vagus Nerve, CN X), complete laryngospasm is an exaggerated, primitive brain-stem protective reflex designed to keep water or vomit out of the lungs.
9. When a droplet of microscopic stomach acid (laryngopharyngeal reflux / LPR), thick post-nasal mucus, blood, water (during swimming or drowning), or a violent coughing fit (such as Bordetella pertussis whooping cough or post-viral vagal neuropathy) hits the hypersensitive laryngeal vestibule, the true vocal cords, false vocal cords (vestibular folds), and aryepiglottic folds all contract into a sustained tetanic spasm simultaneously.
10. Unlike normal swallowing closure (which lasts 0.5 seconds), reflex laryngospasm locks the glottis shut for 15 to 90 seconds even after the irritant is gone.

Side-by-side comparison: Vocal Cord Dysfunction (ILO) vs Asthma Attack vs Anaphylaxis vs Foreign Body Choking¶

Because up to 40 percent of patients with Vocal Cord Dysfunction are misdiagnosed for years as having "refractory brittle asthma", sometimes receiving unnecessary high-dose oral corticosteroids, intramuscular epinephrine injections, or even emergency endotracheal intubation, every emergency responder and patient should know these classic distinguishing features:

Detailed step-by-step guide to Larson's Maneuver (The Laryngospasm Notch Technique)¶

Described by anesthesiologist Dr. C. Philip Larson Jr. and honed over four decades of clinical practice, Larson's maneuver is the single most effective non-pharmacological physical maneuver to break acute complete or severe partial laryngospasm (whether occurring after general anesthesia extubation, during procedural sedation with ketamine, during a drowning rescue, or during a severe awake paroxysmal laryngospasm attack where the patient cannot inhale at all).

Anatomical Landmarks of the Laryngospasm Notch (Larson's Point)¶

On both sides of the head, immediately behind the earlobes, sits a deep pyramidal depression called the laryngospasm notch: - Anterior Boundary (Front Wall): The posterior border of the ascending ramus and condyle of the mandible (lower jawbone). - Posterior Boundary (Back Wall): The anterior border of the bony mastoid process of the temporal bone behind the ear. - Superior Boundary (Roof): The base of the skull right below the external auditory canal (ear canal) and styloid process. - What Lies Deep Inside the Notch: The stylohyoid ligament, the trunk of the facial nerve (CN VII), branches of the glossopharyngeal (CN IX) and vagus (CN X) nerves, and the parotid fascia.

How to Execute Larson's Maneuver in 4 Steps¶

1. Position Yourself Behind or Facing the Patient: Stand at the head of the bed (if the patient is lying down) or directly behind/beside the seated patient.
2. Tia misapi na yo ya katikati to ya index na mozindo na kati ya ba notches nionso mibale ya laryngospasme: Glissé ba pads ya misapi mibale ya katikati (to misapi ya index) mbala moko sima ya ba lobes ya matoyi na kati ya libulu triangulaire doux entre bord ya sima ya mokuwa ya mbanga mpe mokuwa ya mastoïde, kaka na likolo mpenza ya mbanga pene na canal ya matoyi.
3. Fina na makasi na kati (na médial) epai ya katikati ya mokuwa ya motó: Salá pression makasi mpe ya mozindo na kati epai ya litoi oyo ezali na ngámbo mosusu. Yango ebimisaka stimulus périostéal ya makasi mpe ya makasi likolo ya processus styloïde mpe bitape ya misisa ya motó.
4. Benda na mbala moko liboso mpe na likolo (Anterior-Cephalad Jaw Thrust) epai ya Zolo: Tango ozali kofina na kati na kati ya notch, kanga misapi na yo sima ya angle/ramus ya mandibule mpe tombola mbanga mobimba ya nse na makasi liboso (tombolaka mino ya nse liboso ya mino ya likolo).

Mpo na nini Manœuvre ya Larson esalaka (Mécanisme double mécanique et neurologique)¶

• Dépliage mécanique Supraglottique: Kobenda mandibule na makasi liboso etandaka misisa géniohyoïde, mylohyoïde, mpe thyrohyoïde mpe ligament hyoépiglottique, kobenda mokuwa ya hyoïde mpe base ya monoko liboso. Yango efungolaka na nzoto ba pli aryepiglottes oyo ekangami mpe ebendaka bansinga ya mongongo ya lokuta mosika na bansinga ya mongongo ya solosolo.
• Interruption autonomique centrale / réflex vagal: Pression profonde makasi na kati ya notch ya laryngospasme e stimulaka ba fibres afferentes somatiques ya ba nerfs trigéminales (CN V), faciale (CN VII), na glossopharyngé (CN IX), kotinda impulsion centrale surprise na tractus noyau solitarius mpe ambis noyaux na kati ya cerveau oyo epekisaka arc moteur ya nerf laryngé supérieur hyperactif, esalaka que ba cordes vocales e relaxer pe ebalukaka na kati ya 5 à 15 secondes (mbala mingi ezo accompagner na souffrance to komela oyo eyokamaka).

Buku ya sikisiki ya litambe na litambe mpo na Lamuka Kopema na kozongisama na nsinga ya mongongo (Kopema, kopema, mpe EILOBI)¶

Ntango elenge, mosani to mokóló azali kolamuka mingi mpe azali kokutana na épisode aigu ya Dysfonctionnement ya Cordon Vocale (OIT) to laryngospasme paroxysme après kosekwa / sima ya reflux (emonisaka lokola kokangama ya zolo ya somo mpe stridor inspiratoire ya mongongo makasi), kosala pression ya mpasi te longola se soki obstruction silencieuse mobimba esalemaka. Na esika na yango, tambwisa bango na nzela ya mayele oyo ya kobikisa laryngé Pathologie de langue-parole (SLP) oyo esalemi na bilembeteli:

Technique 1: Kopema na zolo + Kopema na mbɛbu oyo ekangami na libumu ("Sniff-Sniff-Blow")¶

1. Posture Reset: Fandisa mutu semba na bord ya kiti, sala que apema maboko na ye ya liboso na ba cuisse (tripode to relaxed forward lean), bwaka mapeka na ye mosika na matoyi, pe afungola mino na ye.
2. Exhaler First Through Pursed Lips: Instruct them: "Koluka te ko sukola mopepe na kati sikoyo. Pucker lips na yo lokola ozali ko whistler pe souffler mopepe oyo ozali na yango libanda malembe malembe pendant 4 secondes: Sssssss to Fffffff." Pression expiratoire positive oyo epusaka ba cordes vocales adductées na se.
3. Double Nasal Sniff In: Instruire bango: "Bomba monoko na yo ekangama mpe zua ba sniffs mibale ya mbangu, ya pete na kati na zolo na yo, lokola ko sniff rose: Sniff, sniff." Ko sniff nasal maximalement recrute le muscle cricoaryténoïde postérieur, ko forcer ba cordes vocales na abduction ya large.
4. Zongela na boumeli ya ba Cycles 5 to 10: Na kati ya pema 3 to 5, stridor ya mongongo makasi elɛmbisamaka mpe elimwaka.

Technique 2: The Panting Reset (When the Nose Is Blocked)¶

Soki moto yango azali na congestion nasale to akoki ko sentir na zolo na ye te: 1. Tika bango bafungola monoko mwa moke mpe pemisa monoko na bango plat mpe ya monene na nse ya monoko nsima ya mino ya nse ya liboso. 2. Have them pant rapidly and shallowly like a hot dog (2 to 3 shallow pants per second) for 5 to 10 seconds, followed by a slow pursed-lip exhale. 3. Panting continuously stimulates the brainstem respiratory rhythm generator to keep the posterior cricoarytenoid muscle contracted, preventing the vocal cords from slamming shut mid-breath.

Technique 3: EILOBI Breathing (Exercise-Induced Laryngeal Obstruction Biphasic Inspiration) for Athletes¶

Developed specifically by Scandinavian and international sports medicine laryngologists for competitive runners, swimmers, cyclists, and rowers who develop supraglottic or glottic closure at maximum exertion (EILO): 1. While continuing or slowing their stride, the athlete inhales initially through lightly adducted teeth or pursed lips (creating slight oral resistance) for the first half of inhalation, then smoothly opens the mouth while expanding the lower ribcage and abdomen (diaphragmatic excursion) without lifting the clavicles or tensing the anterior neck strap muscles. 2. Why it works: Creating slight oral resistance at the lips shifts the pressure drop forward to the mouth instead of at the larynx, eliminating the negative Bernoulli suction across the aryepiglottic folds and vocal cords.

Sleep-Related and Reflux-Induced Paroxysmal Laryngospasm (Waking Up Gasping at Night)¶

One of the most frightening human experiences is sleep-related laryngospasm: a person wakes up bolted upright from deep sleep in the middle of the night completely unable to inhale a single drop of air, making a desperate high-pitched crowing sound (or total silence) for 15 to 45 seconds and feeling certain they are about to die, before the throat finally pops open with a loud gasp.

• Primary Cause (Silent Laryngopharyngeal Reflux / LPR): When lying flat at night, a tiny micro-droplet of gastric acid and pepsin travels up the esophagus past the upper esophageal sphincter and drips onto the posterior larynx (the interarytenoid notch). Unlike the esophagus (which can tolerate brief acid exposure), the laryngeal mucosa has almost zero carbonic anhydrase defense; a single drop of acid triggers an immediate, violent chemoreflex laryngospasm to protect the lungs.
• How to Break a Nighttime Reflux Laryngospasm Attack:
• Stand up or sit bolt upright immediately (stops further acid reflux).
• Suppress the urge to gasp violently through an open mouth; immediately blow out through pursed lips and take tiny nasal sniffs.
• As soon as a tiny trickle of air passes, take one small sip of water kept on the nightstand and swallow. The mechanical act of swallowing triggers a brainstem reset that immediately unlocks the laryngeal sphincter.
• How to Prevent Nighttime Attacks: Stop all food and liquids at least 3 hours before bedtime, elevate the head of the bed by 15 to 20 centimeters (6 to 8 inches) or sleep on an inclined wedge pillow (sleeping on the left side keeps the gastroesophageal junction above the pool of stomach acid), and consult an ENT or gastroenterologist for proton pump inhibitor (PPI) and alginate raft therapy.

Hospital and Anesthesia Management of Refractory Laryngospasm¶

In the hospital emergency department, intensive care unit, or operating room (such as after pediatric tonsillectomy, upper endoscopy, or ketamine procedural sedation), if complete laryngospasm does not break within 15 to 30 seconds of Larson's maneuver + chin lift, clinicians execute a rapid escalation protocol before hypoxia or negative-pressure pulmonary edema (NPPE) develops:

1. Remove the Irritant Stimulus: Gently suction blood, saliva, or secretions from the hypopharynx above the vocal cords and remove any supraglottic airway device or oral airway that is tickling the glottis.
2. 100% Oxygen Continuous Positive Airway Pressure (CPAP 10 to 20 cmH2O) with Tight Two-Handed Mask Seal: Combine Larson's maneuver with a two-handed C-E mask grip delivering 100% oxygen with 10 to 20 cmH2O of continuous positive airway pressure (CPAP) via a Mapleson circuit or anesthesia bag. Avoid violent high-pressure squeezing of the bag if the cords are completely locked, as pressures above 25 cmH2O force air down the esophagus into the stomach (gastric insufflation), pushing up on the diaphragm.
3. Sub-Hypnotic Intravenous Propofol (First-Line Pharmacological Breaker): Administer a small intravenous bolus of Propofol (0.25 to 0.8 mg/kg IV). Deepening sedation with low-dose propofol breaks 75 to 85 percent of refractory post-extubation or sedation laryngospasms within 15 seconds without requiring paralysis or re-intubation.
4. Intravenous or Intramuscular Succinylcholine (Gold-Standard Neuromuscular Blockade): If hypoxia worsens (SpO2 dropping below 85%) or bradycardia develops despite propofol and Larson's maneuver:
5. Low-Dose IV Succinylcholine: 0.1 to 0.25 mg/kg IV immediately relaxes the striated vocal cord muscles within 20 to 30 seconds while often preserving spontaneous diaphragm breathing.
6. Succinylcholine ya dose mobimba IV (1,0 kino 2,0 mg/kg IV) to IM Succinylcholine (4,0 mg/kg IM na kati ya deltoïde to quadriceps soki ligne IV ezali te): Ezali ko paralyser mobimba ba cordes vocales mpo na ventilation ya urgence mpe intubation endotrachée, couplé na IV Atropine (0,02 mg/kg) na bana mike mpo na kopekisa bradycardie makasi oyo euti na hypoxique/succinylcholine.
7. Héliox (80% Hélium / 20% Oxygène) mpo na Stridor réfractaire ya Lamuka makasi: Na Département ya Urgence, ba maladi oyo bazali na stridor ya voie respiratoire ya likolo ya kolamuka makasi oyo eumelaka eyanoli noki na Héliox (80:20 to 70:30 mélange hélium-oxygène) mpo hélium ezali na densité moko ya sambo ya azote, na se Reynolds azali ko nommer, pe abongoli flux ya mopepe ya glottique turbulent ezongi na écoulement laminaire ya lisse tango azali kobuka cycle ya aspiration ya Bernoulli.

Mituya ya mbalakaka ya etuka mpe malako ya kliniki¶

• Etats-Unis mpe Canada: Benga 911 mpo na mbala ya liboso stridor, cyanose, anaphylaxie, to laryngospasme oyo ezo répondre te. Landa Société thoracique américaine (ATS), Collège américain ya minganga ya ntolo (CHEST), mpe Académie américaine ya otolaryngologie-Chirurgie ya mutu mpe nkingo (AAO-HNS) malako mpo na bondimi ya laryngoscopie flexible ya Obstruction laryngée inducible (OIT) mpe traitement ya réformation respiratoire.
• Royaume-Uni: Benga 999 pona stridor aigu na détresse respiratoire to cyanose. Mabongisi ya boyokani ya ** Société européenne respiratoire (ERS) / Société européenne laryngologique (ELS) / Hospital Royal Brompton** elimboli Obstruction laryngée inducible (OIT) mpe Obstruction laryngée induite par exercice (EILO) mpe epesi toli ya kosala laryngoscopie continue na tango ya test ya exercice (CLE) mpe traitement spécialiste ya koloba mpe ya monoko.
• Union européenne: Benga 112 na ba Etats membres nionso ya UE. Landa liloba ya boyokani ya ERS / ELS / ACCP Task Force Consensus ya kosangisa na ntina ya Nomenclature mpe Diagnostic ya ba Obstructions Laryngées Inducibles.
• Australie na Nouvelle-Zélande: Benga 000 na Australie to 111 na Nouvelle-Zélande. Bolanda ba algorithmes ya gestion ya crise ya laryngospasme Société thoracique ya Australie na Nouvelle-Zélande (TSANZ) mpe Collège ya ba anesthésistes australiens et nouvelle-Zélande (ANZCA).

Mituna oyo batunaka mingi¶

Ndenge nini nakoki koyeba bokeseni kati na Dysfonctionnement ya Cordon Vocale (VCD / OIT) mpe attaque ya asthme?¶

Bokeseni ya polele ezali soki ezali mpasi mpo na kopema IN to OUT, mpe esika wapi makelele ewuti: na Dysfonctionnement ya Cordon Vocale (obstruction laryngée inducible), bansinga ya mongongo na nkingo na yo ekangamaka na ndenge ya paradoxale ntango ozali kopema, kosala ete ezala lokola mopepe ebɛti efelo na zolo na yo na mongongo ya koganga ya likolo (stridor) ntango ozali kopema, mpe ba épisodes ebandi mpe etelemaka na boumeli ya miniti moke niveaux etikalaka normal. Na attaque ya asthme, ba tubes bronchiques ya mike na mozindo na kati ya ntolo na yo ekómaka moke, mpe yango esalaka ete ezala mpasi mingi mpo na kopema mopɛpɛ OUT na kopumbwapumbwa ya kopema na ntolo oyo esɛngaka inhalateur bronchodilateur (salbutamol/albuterol) mpe esɛngaka bangonga mingi mpo na kosilisa.

Manœuvre ya Larson ezali nini mpe notch ya laryngospasme ezali wapi?¶

Manœuvre ya Larson ezali technique ya physique ya urgence oyo esalelamaka pona kobuka laryngospasme makasi to ya mobimba. Notch ya laryngospasme (point ya Larson) ezali mwa esika ya triangle oyo ekɔti mbala moko nsima ya matoi nyonso mibale, oyo ezali na katikati ya nsɔngɛ ya nsima ya mokuwa ya nse ya mbanga (ramus mandibulaire) na liboso, mokuwa ya mastoïde nsima ya litoi na nsima, mpe moboko ya mokuwa ya motó na likoló. Kofina makasi na kati epai ya katikati ya motó na misapi na yo ya katikati na mozindo na ba notches nyonso mibale wana ozali kobenda na mbala moko mokuwa ya nse ya mbanga liboso mpe likoló (kopusama na mbanga) efungolaka misisa ya laryngé mpe ebimisaka réflexe ya misisa ya motó oyo elɛmbisaka spasme ya nsinga ya mongongo na boumeli ya mwa basegɔnde.

Mpo na nini koswa na zolo na yo mpe kopema na nzela ya mbɛbu oyo ekangami epekisaka kolɛmba ya nsinga ya mongongo?¶

Ntango bansinga na yo ya mongongo ekangami na ndambo, kopema makasi na monɔkɔ oyo efungwami esalaka ete vide ya mbangu mingi (effet Bernoulli) oyo emɛlaka bansinga ya mongongo lisusu makasi. Kobimisa mopɛpɛ malɛmbɛmalɛmbɛ na nzela ya mbɛbu oyo ekangami makasi esalaka ete mokɔngɔ ezala na mpasi ya malamu longwa na nse oyo ezali kotinda bansinga ya mongongo ekabwana, nzokande kokɔtisa nsolo mibale ya malɛmbɛ na nzela ya zolo esalaka ete réflexe ya motindo ya bɔɔngɔ oyo etongami na kati oyo epelisaka misisa ya cricoaryténoïde ya nsima, misisa bobele moko na nzoto oyo ebendaka bansinga ya mongongo polele.

Mpo na nini ntango mosusu nalamukaka na katikati ya butu nazali kopema mopɛpɛ mpe zolo ekangami?¶

Kolamuka na mbalakaka uta na mpɔngi kozanga kokoka kobenda mopɛpɛ na kati na boumeli ya segɔnde 15 to 45 na mongongo ya stridor ya makasi ezali laryngospasme ya reflux classique oyo euti na mpɔngi. Ntango olali patatalu, gouttelette microscopique ya acide ya libumu mpe enzyme digestive (reflux laryngopharyngé) ekoki komata na esophage na yo mpe kosimba bansinga ya mongongo na yo, mpe yango ebimisaka réflexe ya kobatela mbala moko oyo ekangamaka na boîte ya mongongo mpo acide ekɔta na mimpululu na yo. Kofanda bolt semba, kopumbwa libanda na nzela ya mbɛbu oyo ekangami, kofinafina na malɛmbɛ na zolo na yo, mpe komɛla mwa mai moke kozongisa réflexe na boumeli ya mwa basegɔnde.

Maziba mpe bokambi ya Leta¶

• Société européenne respiratoire (ERS), Société européenne laryngologique (ELS), mpe Collège américain ya minganga ya ntolo (ACCP): Liloba ya boyokani ya mokili mobimba na ntina ya nomenclature, diagnostic, mpe gestion ya ba obsstructions laryngées inducibles (OIT mpe EILO).
• Larson CP Jr. (Anesthésiologie / Gestion clinique ya voie respiratoire): Laryngospasme: Traitement ya malamu koleka (Description fondamentale ya Notch ya Laryngospasme na Manœuvre ya Larson ya Jaw-Thrust).
• Société thoracique américaine (ATS) mpe Académie américaine ya allergie, asthme mpe immunologie (AAAAI): Différenciation clinique mpe co-gestion ya dysfonctionnement ya cordon vocale (Mouvement paradoxique ya pli vocal) mpe Asthme.
• Association ya ba anesthésistes (Royaume-Uni) mpe Collège ya ba anesthésistes ya Australie mpe ya Nouvelle-Zélande (ANZCA): Algoritme ya gestion ya crise ya laryngospasme périopératoire (CPAP, Manœuvre ya Larson, Propofol, mpe Succinylcholine).
• Royal College of Speech and Language Therapists (RCSLT) mpe Association américaine de parole-langue-écoudition (ASHA): Reformation respiratoire mpe Thérapie EILOBI mpo na Obstruction laryngée inducible.

Ba guides oyo etali yango¶

• Traitement ya urgence ya attaque ya asthme na technique ya espaceur ya inhalateur
• Epiglottite, croup, stridor, mpe obstruction aiguë ya nzela ya mopepe ya likolo
• Édème pulmonaire à pression négative (NPPE) sima ya kosilisa étouffement to laryngospasme
• Ba réactions allergie na anaphylaxie ba secours ya liboso
• Mituya ya mbalakaka na kotalela mboka