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SURGICAL MANAGEMENT OF LUDWIG’S ANGINA
Author(s) -
Greenberg Simon L. L.,
Huang Johnson,
Chang Robert S. K.,
Ananda Subramaniam N.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04146.x
Subject(s) - medicine , airway management , conservative management , angina , airway , intubation , endotracheal intubation , presentation (obstetrics) , surgery , conservative treatment , intensive care medicine , psychiatry , myocardial infarction
Background: Ludwig’s angina (LA) is a dangerous surgical condition that can cause severe airway compromise and death. There is controversy regarding the best way to manage the airway of patients with LA. Options range from conservative management involving close observation and i.v. antibiotics to airway intervention, including tracheostomy and endotracheal intubation using fibre‐optic nasendoscopy. We present evidence supporting a role for conservative airway management in a select subset of patients. Methods: This paper reviews 9 years’ experience of treating patients with LA at Liverpool Hospital. Results: Twenty‐one out of 29 (72%) of our patients were treated conservatively following initial clinical assessment. One of these patients subsequently deteriorated requiring emergency intubation. Of those treated non‐conservatively at initial presentation, seven patients were able to be intubated using fibre‐optic nasoendoscopy and one patient required tracheostomy under local anaesthesia. Conclusion: A general discussion of issues related to the management of LA is presented. Based on our experience we conclude that there is a subset of patients with LA who can be managed safely with conservative management.