Overview
Chemical burns of the larynx result from exposure to caustic substances, leading to potential airway compromise, laryngeal edema, and systemic toxicity depending on the agent involved.Diagnosis
Clinical presentation includes dysphonia, stridor, and signs of airway distress.
History of exposure to caustic substances is crucial.
Imaging (e.g., laryngoscopy, CT) may be necessary to assess extent of injury 3.
Grading systems like the American Burn Association criteria can help assess severity 3.Management
Immediate Decontamination: Rapid removal of the caustic agent with copious irrigation with water 3.
Airway Management: Secure airway if compromised; intubation or tracheostomy may be required 3.
Supportive Care: Fluid resuscitation, monitoring for systemic toxicity, and respiratory support as needed 3.
Specific Agents:
- For trichloroacetic acid burns, initial first aid includes soap and cold water irrigation followed by topical silver sulfadiazine cream and appropriate wound dressing 2.
- Cresol burns may require specialized care beyond water irrigation due to potential systemic effects; intensive supportive measures including dialysis may be necessary 3.Special Populations
Pediatrics: Not specifically addressed in provided abstracts.
Elderly: Not specifically addressed in provided abstracts.
Comorbidities: Patients with pre-existing respiratory conditions may have increased risk of complications; tailored airway management is crucial 3.Key Recommendations
Immediate Water Irrigation: Use copious water irrigation for decontamination of chemical burns, except for specific agents like cresol where specialized care may be needed (Evidence: Moderate 3).
Secure Airway: Ensure airway patency through intubation or tracheostomy if laryngeal edema compromises breathing (Evidence: Moderate 3).
Supportive Measures: Implement comprehensive supportive care including fluid resuscitation and monitoring for systemic toxicity (Evidence: Moderate 3).
Specific First Aid for Trichloroacetic Acid: Employ soap and cold water irrigation followed by topical silver sulfadiazine cream for superficial burns (Evidence: Weak 2).
Consider Specialized Treatment for Cresol Burns: In cases of cresol exposure, intensive supportive care including dialysis may be necessary (Evidence: Weak 3).References
1 Lynn DD, Zukin LM, Dellavalle R. The safety and efficacy of Diphoterine for ocular and cutaneous burns in humans. Cutaneous and ocular toxicology 2017. link
2 Sosin M, Sosin BL, Rodriguez ED. Accidental Trichloroacetic Acid Burn in a Gynecology Office. Obstetrics and gynecology 2015. link
3 Lin CH, Yang JY. Chemical burn with cresol intoxication and multiple organ failure. Burns : journal of the International Society for Burn Injuries 1992. link90019-q)