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Otolaryngology (ENT)3851 papers

Laryngeal spasm

Last edited: 4/13/2026

Overview

Laryngeal spasm refers to involuntary contractions of the laryngeal muscles, often leading to acute airway obstruction and voice disturbances. It can be triggered by various factors including trauma, irritation, or underlying neurological conditions. 19

Diagnosis

  • Clinical presentation includes sudden onset of stridor, hoarseness, and potential airway obstruction.
  • Diagnostic evaluation may include laryngoscopy to visualize laryngeal structures and identify spasms.
  • Electromyography (EMG) can assess neuromuscular function if neurological causes are suspected. 19
  • Management

  • First-line treatments:
  • - Rapid airway management, including administration of sedatives like flumazenil for midazolam-induced spasms. 60 - Bronchial dilation or intubation if airway obstruction is severe.
  • Adjunctive treatments:
  • - Avoidance of irritants and triggers. - Pharmacological interventions such as benzodiazepines for severe cases (e.g., midazolam). 60 - Neuromuscular blocking agents in critical situations to relax laryngeal muscles. 19

    Special Populations

  • Pediatrics: Laryngospasm is common in infants, often associated with upper respiratory infections or gastroesophageal reflux. Management focuses on supportive care and airway protection. 25
  • Elderly: Increased risk of complications due to comorbidities; careful monitoring and individualized treatment plans are essential. 19
  • Key Recommendations

  • Rapid identification and management of airway obstruction are critical in acute laryngeal spasm cases. (Evidence: Strong 19)
  • Use bronchoscopy or rigid laryngoscopy for definitive diagnosis when clinical suspicion is high. (Evidence: Moderate 19)
  • Administer benzodiazepines for severe cases to alleviate laryngeal muscle spasms, considering individual patient factors. (Evidence: Moderate 60)
  • Avoid unnecessary intubation unless airway compromise is imminent; prioritize non-invasive supportive measures. (Evidence: Expert opinion)
  • References

    1 Payen C, Carsuzaa F, Kucharczak F, Lallemant B, Garrel R, Gallet P et al.. Swine model for total laryngectomy training: assessment of the face, content, and construct validity. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2025. link 2 Wierzbicka M. 15th Congress of the European Laryngological Society, May 2025, Warsaw, Poland. Otolaryngologia polska = The Polish otolaryngology 2025. link 3 Bellahsen-Harrar Y, Lubrano M, Lépine C, Beaufrère A, Bocciarelli C, Brunet A et al.. Exploring the risks of over-reliance on AI in diagnostic pathology. What lessons can be learned to support the training of young pathologists?. PloS one 2025. link 4 Fantini M, Crosetti E, Firino A, Gallia M, Borrelli G, Stacchini M et al.. Phonosurgical Injection Approaches for Voice Restoration After Open Partial Horizontal Laryngectomies: A Pilot Study. Journal of voice : official journal of the Voice Foundation 2024. link 5 Santander MJ, Sepúlveda V, Iribarren J, Rosenbaum A, Albrich D, Varas J et al.. Development and Validation of a Laryngeal Microsurgery Simulation Training System for Otolaryngology Residents. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2023. link 6 Biau J, Pointreau Y, Blanchard P, Khampan C, Giraud P, Lapeyre M et al.. Radiotherapy for laryngeal cancers. Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique 2022. link 7 Molteni G, Bertolin A, Gazzini L, Sacchetto A, Marchioni D. Modular Approach to Open Partial Horizontal Laryngectomy: Step-by-Step Anatomic Dissection. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2022. link 8 Feit NZ, Wang Z, Demetres MR, Drenis S, Andreadis K, Rameau A. Healthcare Disparities in Laryngology: A Scoping Review. The Laryngoscope 2022. link 9 Lechien JR, Akst LM, Saussez S, Crevier-Buchman L, Hans S, Barillari MR et al.. Involvement of Laryngopharyngeal Reflux in Select Nonfunctional Laryngeal Diseases: A Systematic Review. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2021. link 10 Chen Z, Lv Y, Feng Y. Case Report of Acute Airway Obstruction Caused by Transglottic Squamous Carcinoma (Stage IV) During the Coronavirus Pandemic Cured by ECMO-Assisted Tracheostomy. Ear, nose, & throat journal 2021. link 11 Battoo AJ, Sheikh ZA, Thankappan K, Haji AG. Emergency Laryngectomy Feasibility and Indications Beyond Airway Obstruction in the Era of Concurrent Chemoradiotherapy. Ear, nose, & throat journal 2021. link 12 Fermi M, Mattioli F, Ghirelli M, Maccarrone F, Molteni G, Presutti L et al.. Open laryngeal surgery training on ex-vivo ovine model: Development and dissection experience. Auris, nasus, larynx 2021. link 13 Mengin AC, Kayser C, Tuzin N, Perruisseau-Carrier J, Charpiot A, Berna F et al.. Mindfulness Improves Otolaryngology Residents' Performance in a Simulated Bad-News Consultation: A Pilot Study. Journal of surgical education 2021. link 14 Fagan JJ. Semon Lecture: 'Laryngectomy Practice Based on Personal Research', Royal Society of Medicine, 5 November 2020, London, UK. The Journal of laryngology and otology 2021. link 15 Lechien JR, Burns JA, Akst LM. The Use of 532-Nanometer-Pulsed Potassium-Titanyl-Phosphate (KTP) Laser in Laryngology: A Systematic Review of Current Indications, Safety, and Voice Outcomes. Ear, nose, & throat journal 2021. link 16 Swegal WC, Herbert RJ, Eisele DW, Chang J, Bristow RE, Gourin CG. Observed-to-expected ratio for adherence to treatment guidelines as a quality of care indicator for laryngeal cancer. The Laryngoscope 2020. link 17 Mehlum CS, Døssing H, Davaris N, Giers A, Grøntved ÅM, Kjaergaard T et al.. Interrater variation of vascular classifications used in enhanced laryngeal contact endoscopy. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2020. link 18 Sullivan CB, Ostedgaard KL, Al-Qurayshi Z, Pagedar NA, Sperry SM. Primary Laryngectomy Versus Salvage Laryngectomy: A Comparison of Outcomes in the Chemoradiation Era. The Laryngoscope 2020. link 19 Collins S, Schedler P, Veasey B, Kristofy A, McDowell M. Prevention and Treatment of Laryngospasm in the Pediatric Patient: A Literature Review. AANA journal 2019. link 20 Helliwell T, Chernock R, Dahlstrom JE, Gale N, McHugh J, Perez-Ordoñez B et al.. Data Set for the Reporting of Carcinomas of the Hypopharynx, Larynx, and Trachea: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting. Archives of pathology & laboratory medicine 2019. link 21 Dawson C, Pracy P, Patterson J, Paleri V. Rehabilitation following open partial laryngeal surgery: key issues and recommendations from the UK evidence based meeting on laryngeal cancer. The Journal of laryngology and otology 2019. link 22 Robinson RA, Simms VA, Ward EC, Barnhart MK, Chandler SJ, Smee RI. Total laryngectomy with primary tracheoesophageal puncture: Intraoperative versus delayed voice prosthesis placement. Head & neck 2017. link 23 Rudert H, Werner JA. The laryngeal disease of the German Emperor Friedrich III: treatment failure or fateful course. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2016. link 24 Bunijevac M, Petrović-Lazić M, Jovanović-Simić N, Vuković M. Voice analysis before and after vocal rehabilitation in patients following open surgery on vocal cords. Vojnosanitetski pregled 2016. link 25 Babl FE, Grindlay J, Barrett MJ. Laryngospasm With Apparent Aspiration During Sedation With Nitrous Oxide. Annals of emergency medicine 2015. link 26 Senior A. Friedrich Berthold Reinke (1862-1919): brilliant yet troubled anatomist of the vocal fold. The Journal of laryngology and otology 2015. link 27 Villari CR, Courey MS. Management of Dysphonia After Radiation Therapy. Otolaryngologic clinics of North America 2015. link 28 Prasad VM, Remacle M. Voice Rehabilitation After Transoral Laser Microsurgery of the Larynx. Otolaryngologic clinics of North America 2015. link 29 Sadoughi B, Fried MP, Sulica L, Blitzer A. Hoarseness evaluation: a transatlantic survey of laryngeal experts. The Laryngoscope 2014. link 30 Esteban F, Menoyo A, Abrante A. Critical analysis of robotic surgery for laryngeal tumours. Acta otorrinolaringologica espanola 2014. link 31 Simo R, Bradley P, Chevalier D, Dikkers F, Eckel H, Matar N et al.. European Laryngological Society: ELS recommendations for the follow-up of patients treated for laryngeal cancer. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2014. link 32 Succo G, Peretti G, Piazza C, Remacle M, Eckel HE, Chevalier D et al.. Open partial horizontal laryngectomies: a proposal for classification by the working committee on nomenclature of the European Laryngological Society. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2014. link 33 Cohen SM, Dinan MA, Roy N, Kim J, Courey M. Diagnosis change in voice-disordered patients evaluated by primary care and/or otolaryngology: a longitudinal study. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2014. link 34 Moon S, Raffa F, Ojo R, Landera MA, Weed DT, Sargi Z et al.. Changing trends of speech outcomes after total laryngectomy in the 21st century: a single-center study. The Laryngoscope 2014. link 35 Karkos PD, George M, Van Der Veen J, Atkinson H, Dwivedi RC, Kim D et al.. Vocal process granulomas: a systematic review of treatment. The Annals of otology, rhinology, and laryngology 2014. link 36 Bradley PJ, Counter P, Hurren A, Cocks HC. Provision of surgical voice restoration in England: questionnaire survey of speech and language therapists. The Journal of laryngology and otology 2013. link 37 Cohen SM, Kim J, Roy N, Courey M. Prescribing patterns of primary care physicians and otolaryngologists in the management of laryngeal disorders. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2013. link 38 Fagan JJ, Lentin R, Quail G. International practice of laryngectomy rehabilitation interventions: a perspective from South Africa. Current opinion in otolaryngology & head and neck surgery 2013. link 39 Chaukar DA, Vaidya AD, D'Cruz AK. Practice of laryngectomy rehabilitation interventions: a perspective from India. Current opinion in otolaryngology & head and neck surgery 2013. link 40 Nakayama M, Laccourreye O, Holsinger FC, Okamoto M, Hayakawa K. Functional organ preservation for laryngeal cancer: past, present and future. Japanese journal of clinical oncology 2012. link 41 McCulloch TM, Van Daele D, Ciucci MR. Otolaryngology head and neck surgery: an integrative view of the larynx. Head & neck 2011. link 42 Folz BJ, Silver CE, Rinaldo A, Ferlito A. Themistocles Gluck: biographic remarks emphasising his contributions to laryngectomy. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2011. link 43 Sinclair CF, Rosenthal EL, McColloch NL, Magnuson JS, Desmond RA, Peters GE et al.. Primary versus delayed tracheoesophageal puncture for laryngopharyngectomy with free flap reconstruction. The Laryngoscope 2011. link 44 Moukarbel RV, Doyle PC, Yoo JH, Franklin JH, Day AM, Fung K. Voice-related quality of life (V-RQOL) outcomes in laryngectomees. Head & neck 2011. link 45 Gultekin E, Yelken K, Garca MF, Develioglu ON, Kulekci M. Effects of neck dissection and radiotherapy on short-term speech success in voice prosthesis restoration patients. Journal of voice : official journal of the Voice Foundation 2011. link 46 Galm T, Kulkarni A, Ahmad I. Laryngeal carcinoma metastasis to the orbit: case report. The Journal of laryngology and otology 2011. link 47 Bradley PJ, Mackenzie K, Wight R, Pracy P, Paleri V. Consensus statement on management in the UK: transoral laser assisted microsurgical resection of early glottic cancer. Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 2009. link 48 Chummun S, Winter SC, Draper MR. Prospective, randomized, single-blinded study comparing the use of a flexible nasendoscope and a rigid laryngoscope in outpatient laryngeal and pharyngeal examinations. 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