Ludwig's Angina—A Controversial Surgical Emergency: How We Do It

Objectives . To review the current protocols used for management of Ludwig's angina and to assess the efficacy of conservative measures in these cases. Methods . A retrospective review of patients who were admitted to our institution for management of Ludwig's angina between 2003 and 2010. Results . Two patients were identified. Both were managed successfully with conservative measures and close airway observation. None needed an emergency intubation or surgical tracheostomy. There were no mortalities, and both had a short hospital stay. Conclusion . Recently, management of Ludwig's angina has evolved from aggressive airway management into a more conservative one. This is based on close airway observation on a specialised airway unit and a serial clinical airway assessment. Improved imaging modalities, antibiotic therapy, surgical skills, and clinical experience are the key factors behind this change in practice.