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IMPORTANT The information provided is of a general nature and should not be used as a substitute for professional advice. If you think you may suffer from an allergic or other disease that requires attention, you should discuss it with your family doctor. The content of the information articles and all illustrations on this website remains the intellectual property of Dr Raymond Mullins and cannot be reproduced without written permission.
Introduction
Laryngospasm results from sudden contraction of the muscles of the throat, often occurring in seconds. The vocal cords slam shut when trying to breathe in, the opposite of what normally happens during breathing. Symptoms are those of a sensation of tight throat, a sensation of swollen throat, a choking sensation, hard to get enough air into the lungs and noisy breathing in. Most episodes last less than a few minutes. Symptoms can be very frightening but are not normally dangerous when unrelated to anaesthesia.
Laryngospasm triggers
Symptoms usually follow throat irritation triggered by spicy food, acid reflux after a large or fatty meal or alcohol. Sometimes symptoms are triggered inhaling strong irritants such as strong smells or perfumes. Less commonly, acute anxiety and intubation (insertion of a breathing tube) before surgery and occasionally exercise can trigger similar episodes. Episodes occurring at night-time will make one suspect acid reflux or possible sleep apnoea as the cause. Oversensitive nerves of the upper airways may be the cause, for example after respiratory infection or upper airway surgery.
Mimicking conditions
Symptoms generally come on over seconds, which helps to distinguish this from angioedema, where swelling of the throat or upper airway gradually develops and worsens over many minutes. Food allergy does not normally cause isolated sensation of throat swelling without accompanying g itchy theory or other symptoms like itchy skin, rash or stomach upset.
Acute Management
Management of acute attacks involves:
• Trying to avoid coughing or talking;
• Trying to relax and slow breathing down (faster treating makes the situation worse by worsening collapse of the upper airways);
• Breathing through the nose if possible (this can trigger a reflex opening of the vocal cords) and out through the mouth slowly; and
• Pointing the chin up and extending the neck while breathing is though to anchor the voice box and make muscle spasm harder to sustain.
• So-called “:straw breathing” techniques as per the videos below
Long term management
If patient experience frequent episodes, a trial of acid reflux medication can be given. Otherwise, ENT surgical review looking for abnormalities of the upper airways, speech pathology review for regular such as Lyrica/gabapentin to reduce nerve irritation, can be helpful in some cases.
Weblink’s for more information
https://www.voicedoctor.net/therapy/laryngospasm
https://www.mayoclinic.org/diseases-conditions/gerd/expert-answers/laryngospasm/faq-20058269
YouTube videos
Last reviewed 9 June 2020
Laryngospasm: like a really bad frog in the throat!