The glottis spasm is a spasm that prevents the aspiration of fluids with sustained contractions of the muscles located there. A glottis spasm is usually caused by inhaled water droplets and is particularly dangerous for water sports enthusiasts. Muscle relaxants stop the spasm.
What is glottal spasm?
The glottis is also known in medicine as the glottis. These are the vocal folds, the glottis, and the associated arytenoid structures. With glottal spasm, the glottis and larynx spasm. For what is kartagener syndrome used for, please visit fun-wiki.com.
Also known as laryngospasm or glottic spasm, this phenomenon is a protective mechanism that in and of itself has no pathological value. Rather than being associated with morbidity, glottal spasm prevents fluids from entering the nearby windpipe. Even with unconsciousness, the spasm does not resolve automatically.
As long as the muscles in the area of the glottis contract, the trachea is closed, so to speak, and thus safe from the entry of any substances. In anesthesia, however, the automatic and involuntary protective mechanism is one of the most devastating complications. The negative pressure that a glottis spasm can trigger is also clinically relevant. This negative pressure can promote the formation of edema.
Causes
In most cases, a glottal spasm is caused by inhaled water droplets. This is why the phenomenon often occurs, especially in water sports or diving. Since breathing stops during glottis spasm, those affected often panic and even faint in the process. This is a dreaded complication in diving.
Because the spasm does not resolve in all cases, even after fainting, divers with glottal spasm often suffocate as a result of the spasm. This type of drowning caused by a persistent airway obstruction is also called dry drowning. However, the cause of drowning is not the spasm of the glottis itself.
The triggering cause of the spasm cannot be eliminated under water by the cough reflex that is actually intended. This connection triggers the spasm of the glottis muscles. Irrespective of water sports, the glottis spasm sometimes occurs during anesthesia induction or drainage, since manipulation and excitation of the airways is registered during intubation or extubation.
Symptoms, Ailments & Signs
The glottis spasm is a spasm. Those affected experience an involuntarily induced, long-lasting and pronounced contraction of the glottis muscles. A spasm is often associated with more or less severe pain caused by the unusually violent contractions in the muscles.
The glottis spasm is not a clonic but a tonic spasm. So the contraction is relatively static and constant. It usually lasts at a constant level for a long time. During the prolonged spasm, patients stop breathing and panic. The more they panic, the faster they lose consciousness. In the case of spasms, a negative pressure relationship develops, which can promote accompanying symptomatic edema.
This water retention can cause swelling in a very short time. If edema develops, the glottal spasm can develop into a life-threatening condition. This is especially true when the upper airway is involved, where any edema compromises breathing and therefore requires immediate intervention.
Diagnosis & course of disease
The diagnosis of a glottis spasm, if at all, is made by the emergency doctor. In most cases, the context of the triggering situation and the visual diagnosis provide him with enough information for a diagnosis. After the diagnosis and initial treatment of the patient by the emergency doctor, the patient must be taken to the hospital.
This is important to rule out the formation of edema in the upper airways. In itself, glottal spasms have a favorable prognosis. An exception are those that take place under or in water and make those affected drown in a faint.
Complications
The violent contractions that occur with a glottal spasm can bring various symptoms with them as the disease progresses. Pain is usually severe, causing problems with swallowing and breathing. If edema develops, glottal spasm can cause life-threatening complications.
Shortness of breath, shortness of breath, or aspiration then occurs due to impaired breathing. Those affected also tend to panic and hyperventilate, eventually leading to loss of consciousness. If the spasm is not treated by then at the latest, the affected person threatens to suffocate. Emergency medical care also carries risks. For example, positive pressure ventilation can cause pressure points or cause the airways to dry out.
The use of unsuitable hoses can lead to eye irritation. The concomitant drug succinylcholine can cause cardiovascular problems, muscle pain and intraocular pressure disorders. In addition, allergic reactions can occur or the patient suffers interactions such as cardiac arrhythmia or gastrointestinal complaints due to another illness.
Further complications can arise if the patient regularly takes other medications or is physically very weak. The administration of drugs must then be monitored by a doctor in any case.
When should you go to the doctor?
If drops of water are swallowed unintentionally during water sports activities or swimming in a swimming pool or leisure pool, this normally does not pose any further problems. There is a brief shortness of breath, which usually regulates itself within a few seconds. In these cases, a doctor’s visit is not necessary. The natural cough reflex directs misdirected parts of the liquid to the right places or removes them from the mouth again.
However, if the liquid ingested causes a cramp or a disturbance of consciousness, there is a need for action. If you experience pain or unusual contractions in your throat, see a doctor. Anxiety or panic states should also be discussed with a therapist or doctor. If there is swelling, voice changes or persistent nausea, it is advisable to have further examinations carried out. Clarification of the cause is necessary in order to be able to bring about long-term changes. Edema formation and other airway swellings can trigger a life-threatening condition. Therefore, if you have shortness of breath or shortness of breath, you should consult a doctor.
A tight throat is a sign of a health problem and needs further investigation. In the event of a loss of consciousness, an emergency service must be alerted immediately. Persons present are requested to take first aid measures.
Treatment & Therapy
One of the first steps of emergency medical treatment for a glottis spasm is positive pressure ventilation through a mask. In mild cases, this measure not only relieves the spasm, but also prevents the development of edema. In many cases, this measure does not require any further treatment of the spasm, since the spasm has resolved itself and the triggering cause has long since been eliminated.
Depending on the strength of the spasm and the intensity of the triggering cause, at the latest the onset of fainting will release the contractions and breathing will resume. However, since unconsciousness does not necessarily lead to the resolution of the cramp symptoms, further treatment may well be necessary in individual cases. Treatment is usually by the administration of muscle relaxants.
The administration of succinylcholine, for example, relieves the spasm in seconds. However, since these drugs also affect the respiratory muscles, the patient must be intubated when administered. In this case, artificial respiration takes place until the muscle relaxants lose their effect. If, despite all measures, edema develops, this edema must be resolved in the hospital. This resolution is usually medical, but requires medical supervision if the upper airways are involved.
Prevention
The glottis spasm can be prevented. Water sports enthusiasts in particular should take measures to avoid aspirating water droplets. Anesthesiologists must prevent glottis spasms during anesthesia by not irritating the airways severely during extubation and intubation. As a complication in anesthesia, glottal cramps have become rather rare due to the meanwhile tightened preventive measures.
Aftercare
Follow-up care for a glottal spasm depends on the cause and progression. Usually the glottis spasm goes away on its own. Depending on the trigger, the patient often needs medical assistance. In most cases, the glottis spasm occurs once. After the cause has been determined and the patient discharged, no further follow-up examinations are usually necessary.
If the pain persists, medication is prescribed as part of the treatment. These must be removed carefully. This is usually monitored by the doctor in charge to avoid complications. If an edema has formed, an operation is necessary. The patient then has to spend a few days in the hospital for follow-up care.
If pressure points occur during emergency medical care, the affected area must be carefully monitored as part of the aftercare. Otherwise, the airways can dry out and cause further problems. Cardiovascular problems or intraocular pressure disorders, which can occur as a result of incorrect emergency medical treatment, require further monitoring in a clinic.
Aftercare for a glottis spasm is carried out by the emergency doctor and the general practitioner. Depending on the cause, other specialists such as an ENT doctor or an internist can be consulted. If the glottis spasm is based on motor disorders, physiotherapeutic treatment may also be useful.
You can do that yourself
When practicing water sports, the person concerned should practice handling water well in advance. The interaction of water and physical sporting activities must be practiced so that no situation of health impairments arises. For this purpose, it is particularly important to reflect on one’s own competencies. Overestimating oneself can lead to disorders or illnesses.
Instead, the use of aids or adequate protection of the respiratory tract is advisable. There are various items on the market that block the penetration of water into the respiratory tract during sporting activities in contact with water. They were specially developed for this purpose and are widely used by athletes of all stripes. The person concerned should try out whether he is better positioned with such utensils and ignore visual inconveniences.
If health problems occur, it is important to remain calm. Help must be called and hectic movements are to be avoided. These can lead to an increase in symptoms and trigger a life-threatening condition. It is therefore helpful in everyday life to make prior arrangements with people from the social environment who are in the immediate vicinity of the sporting activities. Hand signals can be agreed upon so that immediate action can be taken if necessary. Especially when dealing with children, sufficient clarification of warning signals should take place beforehand.
