{"id":766,"date":"2024-04-28T22:12:06","date_gmt":"2024-04-28T19:12:06","guid":{"rendered":"https:\/\/odyova.com\/haberler\/?p=766"},"modified":"2024-04-28T22:12:06","modified_gmt":"2024-04-28T19:12:06","slug":"larenjitler","status":"publish","type":"post","link":"https:\/\/odyova.com\/haberler\/larenjitler\/","title":{"rendered":"Larenjitler"},"content":{"rendered":"

Larenjitler, Akut ve Kronik olarak iki \u015fekilde kar\u015f\u0131m\u0131za \u00e7\u0131kmaktad\u0131r.<\/span><\/p>\n

a- Akut Larenjitleri, Eri\u015fkin ve \u00e7ocuklarda olmak \u00fczere g\u00f6zden ge\u00e7irece\u011fiz.<\/span><\/p>\n

Eri\u015fkinlerde:<\/span><\/p>\n

1.Akut kataral larenjit (larenjitis simplex): <\/span><\/p>\n

Ses k\u0131s\u0131kl\u0131\u011f\u0131 ile bulgu veren, basit, selim bir hastal\u0131kt\u0131r.<\/span><\/p>\n

Hemofilus \u0130nfluenza > pn\u00f6mokok > streptokok > stafikokok ve <\/span>
di\u011fer ajan patojenle etkendir. Viruslar daha s\u0131k olarak etken olabilir. <\/span><\/p>\n

-Larinksde bir g\u0131c\u0131k hissiyle beraber ses k\u0131s\u0131kl\u0131\u011f\u0131, <\/span>
-38-38,5\u00b0C ate\u015f, \u00fcst <\/span>
-solunum yollar\u0131nda da bir infeksiyon mevcuttur. <\/span>
-Bunlar\u0131n d\u0131\u015f\u0131nda \u00e7al\u0131\u015f\u0131lan ve oturulan ortam\u0131n hijyenik \u015fartlarda olmamas\u0131, <\/span>
-sesin k\u00f6t\u00fc kullan\u0131lmas\u0131, <\/span>
-avitaminozlar ve <\/span>
-baz\u0131 metabolik hastal\u0131klar kolayla\u015ft\u0131r\u0131c\u0131 etkenler aras\u0131ndad\u0131r.<\/span><\/p>\n

Muayenede <\/span>
-larinkste kord vokaller nisbeten daha a\u00e7\u0131k pembe renkde g\u00f6r\u00fcl\u00fcr. <\/span>
Sekresyon \u00e7ok artm\u0131\u015ft\u0131r.<\/span>
-Kendi halinde 7-10 g\u00fcnde spontan iyile\u015fir. <\/span>
-Ses istirahati (mutlak konu\u015fmamak!) tavsiye edilir. <\/span>
-Yatak istirahati, nemli ve optimal \u0131s\u0131da (22\u00b0C ve % 50 higroskopik nem) bir <\/span>
oda iyidir. <\/span>
-Antibiotikler, <\/span>
-efedrinli burun damlalar\u0131, <\/span>
-mentoll\u00fc inhalasyonlar tavsiye edilir. <\/span>
-Sigara yasaklan\u0131r. <\/span><\/p>\n

2.Gribal infeksiyon sonucu g\u00f6r\u00fclen larenjit: <\/span>
-Salg\u0131n halindeki gripler s\u0131ras\u0131nda hadisenin larinksde yerle\u015fmesi <\/span>
daha s\u0131kt\u0131r. <\/span>
-Klinik tablo biraz daha a\u011f\u0131rd\u0131r. <\/span>
-Larinkste hemorajik, \u00fclseratif, flegmon\u00f6z hatta nekrotizan karakterde <\/span>
lezyonlarda g\u00f6r\u00fclebilir. <\/span>
-\u00d6demat\u00f6 reaksiyonlara da \u00e7ok s\u0131kl\u0131kla rastlan\u0131r. <\/span>
-Ses k\u0131s\u0131kl\u0131\u011f\u0131 yan\u0131nda dispne mevcuttur. <\/span>
-Asfiksiye kadar varabilir. <\/span><\/p>\n

Tedavi semptomatikdir. Asfiksi i\u00e7in yakin takip, gerekirse <\/span>
kortikosteroidler hatta trakeotomiye ba\u015fvurulur. <\/span><\/p>\n

\u00c7ocukluklarda ortaya \u00e7\u0131kan larenjitler: <\/span><\/p>\n

1.Peudokrup: <\/span>
Difteriye \u00e7ok benzeyen bir tablo vard\u0131r. Adenoid vejetasyonla burnu t\u0131kal\u0131 bir <\/span>
\u00e7ocukta, gece ani dispne asfiksi <\/span>
meydana gelebilir. Birka\u00e7 (15-20) dakika i\u00e7inde tamamen ge\u00e7er. Ertesi <\/span>
ak\u015famlar daha hafif olarak tekrarlayabilir. Sedasyon (fenobarbital), <\/span>
efedrinli damlalar, boynun etraf\u0131na \u0131slak kompresler tavsiye edilir.<\/span><\/p>\n

2.Akut larengotrakeobron\u015fit (Krup): <\/span>
Larenks ile trakeobron\u015fiyal a\u011fac\u0131 ilgilendiren akut enfeksiy\u00f6z bir patolojidir. <\/span>
Solunum s\u0131k\u0131nt\u0131s\u0131na neden olan hastal\u0131klar\u0131n % 90'\u0131ndan sorumludur. T\u00fcm <\/span>
\u00e7ocuklar\u0131n % 3-5'i en az bir kez krup ata\u011f\u0131 ge\u00e7irir. Krup \u00f6zellikle sonbahar ve <\/span>
k\u0131\u015f aylar\u0131nda ve 18-24 ayl\u0131k bebeklerde g\u00f6r\u00fcl\u00fcr. Krup \u00f6ncelikle viral bir <\/span>
enfeksiyondur. <\/span><\/p>\n

Tedavi: <\/span>
-Krupta destekleyici tedavi esast\u0131r. <\/span>
-Nemlendirme, <\/span>
-epinefrin, <\/span>
-kortikosteroid ve <\/span>
-ent\u00fcbasyon s\u0131rayla uygulan\u0131r .<\/span><\/p>\n

3.Akut supraglottit: <\/span>
– Supraglottit s\u0131kl\u0131\u011f\u0131 ba\u015fvuru ya\u015f\u0131 y\u00fckseldik\u00e7e azal\u0131r. <\/span>
-Ba\u015fvuruda ortalama ya\u015f 3 ila 8'dir. <\/span>
-\u00c7ocuklardaki s\u0131kl\u0131\u011f\u0131 eri\u015fkinlere g\u00f6re 3 kat fazlad\u0131r. <\/span>
-Semptomlar\u0131n nedeni bakteriyel enfeksiyona ba\u011fl\u0131 supraglottik b\u00f6lgedeki <\/span>
-\u00f6demdir. <\/span>
-Supraglottitte ilk etken Haemophilus influenza tip b'dir. <\/span>
-Odinofaji, <\/span>
-dispne ve <\/span>
-a\u011f\u0131zda s\u0131cak patates varm\u0131\u015f gibi konu\u015fma g\u00f6r\u00fcl\u00fcr.<\/span><\/p>\n

Tedavi: <\/span>
-Antibiyoterapidir, baz\u0131 durumlarda <\/span>
-ent\u00fcbasyon gerekebilir. <\/span><\/p>\n

4.Gribal larenjit: <\/span>
-B\u00fcy\u00fcklerdekinden fark\u0131, asfiksinin s\u0131k olarak ortaya <\/span>
\u00e7\u0131kabilmesidir. <\/span>
-Uzun s\u00fcrelidir. <\/span>
-\u00c7ocuklar\u0131n larinksinin \u00e7ap\u0131 eri\u015fkinlerden \u00e7ok daha dar olmas\u0131 olay\u0131n \u015fidetini <\/span>
artt\u0131r.<\/span><\/p>\n

Tedavi: <\/span>
-Semptomatik tedavi yan\u0131nda, <\/span>
-hafif ve ba\u015flang\u0131\u00e7 vakalar\u0131nda odan\u0131n hafif nemlendirilmesi, <\/span>
-efedrinli burun damlalar\u0131, <\/span>
-sekresyonun kurutulmas\u0131 i\u00e7in adrenalin, <\/span>
-antihistaminikler, <\/span>
-\u00f6dem daha a\u011f\u0131rsa kortikosteroidler, <\/span>
-asfiksi olu\u015fursa trakeotomi gerekir. <\/span><\/p>\n

5.Difteri: <\/span>
-\u00c7o\u011funlukla burun, farinks difterisine sekonderdir. <\/span>
-1\/5 vakada primer olarak larinksde ba\u015flar. <\/span>
-Farinkste ve larinks i\u00e7erisinde de kirli sar\u0131 membranlar bulunur.<\/span>
– Ba\u015flang\u0131\u00e7ta bir disfoni mevcuttur. <\/span>
-Bazen daha sonra dispne ortaya \u00e7\u0131kabilir. Bir dil basaca\u011f\u0131 ile dile bas\u0131l\u0131nca <\/span>
epiglot \u00e7ocuklarda bir \u00e7\u0131k\u0131nt\u0131 halinde olup, bunun \u00fczerinde membranlar <\/span>
mevcutdur (Variot'un \u0093karl\u0131 da\u011f\u0094 belirtisi). <\/span>
-Hastalarda son a\u015famada asfiksi ortaya \u00e7\u0131kar. Stridor, tiraj g\u00f6r\u00fcl\u00fcr. <\/span><\/p>\n

Tedavi: <\/span>
-Antidifterik serum,verilmelidir. <\/span>
-Penisilin (veya yerine eritromisin ve tetrasiklin) verilir. <\/span>
-Kalp analeptikleri ve kardiyotonikleride eklenir. <\/span>
-VAC ve s\u00fcrrenal hormonlar\u0131 da gerekebilir. <\/span><\/p>\n

\u0130lerlemi\u015f vakalarda ise <\/span>
– ent\u00fcbasyon veya <\/span>
– trakeotomi yap\u0131lmal\u0131d\u0131r. <\/span><\/p>\n

Kronik larenjitler:<\/span><\/p>\n

a- Basit (kataral) kronik larenjit:<\/span><\/p>\n

Kola\u015fla\u015ft\u0131r\u0131c\u0131 etyolojik fakt\u00f6rler: <\/span><\/p>\n

– Hijyenik olmayan \u00e7evre \u015fartlar\u0131, <\/span>
– sesin k\u00f6t\u00fc kullan\u0131lmas\u0131, <\/span>
– \u00fcst solunum yollar\u0131nda infeksiyon, <\/span>
– metabolizma hastal\u0131klar\u0131, <\/span>
– avitaminozlard\u0131r. Ses k\u0131s\u0131kl\u0131\u011f\u0131 en belirgin semptomudur.<\/span><\/p>\n

b- Pakidermi: <\/span>
K\u0131rm\u0131z\u0131 ve beyaz (l\u00f6koplazi) cinsleri vard\u0131r. <\/span>
Hipertrofi ve mukoza proliferasyonunun ileri derece artmas\u0131na ba\u011fl\u0131d\u0131r. <\/span>
Daha ileri derecede \u00fcst tabakalar\u0131n kornifikasyonu ile beyaz pakidermi= l\u00f6koplazi te\u015fekk\u00fcl eder. <\/span>
Bu hiperkeratoz, h\u00fccre anar\u015fisi ile diskeratoza d\u00f6nerse <\/span>
prekanser\u00f6z olabilir.<\/span><\/p>\n

Tedavi: <\/span>
Kronik larenjit tedavisi \u00e7ok g\u00fc\u00e7t\u00fcr. <\/span>
-Kolayla\u015ft\u0131r\u0131c\u0131 fakt\u00f6rlerin ortadan kald\u0131r\u0131lmas\u0131, <\/span>
-sesin uygun \u015fartlarda kullan\u0131lmas\u0131, <\/span>
-t\u00fct\u00fcn\u00fcn yasaklanmas\u0131; <\/span>
-varsa b\u00fcy\u00fck pakidermik plaklar\u0131n \u00e7\u0131kar\u0131lmas\u0131; <\/span>
-beyaz l\u00f6koplazik plaklar\u0131n t\u00fcm olarak \u00e7\u0131kar\u0131lmas\u0131 veya hi\u00e7 dokunulmay\u0131p <\/span>
m\u00fc\u015fadahe alt\u0131nda tutulmas\u0131.<\/span>
www.drselcukonart.com<\/span><\/p>\n

Prof.Dr.Sel\u00e7uk ONART<\/span><\/p>\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Larenjitler Konu hakk\u0131nda detayl\u0131 ve g\u00fcncel bilgiler i\u00e7in bu makaleyi okuyun<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[24,70,42],"class_list":["post-766","post","type-post","status-publish","format-standard","hentry","category-kulak-burun-bogaz","tag-ses","tag-sik","tag-tedavi"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/766","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/comments?post=766"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/766\/revisions"}],"predecessor-version":[{"id":767,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/766\/revisions\/767"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=766"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=766"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=766"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}