Objective:To evaluate the clinical profiles,diagnosis,and treatment of patients with acute epiglottitis at a tertiary care teaching hospital of eastern India.Methods:This is a retrospective study in which 28 patients ...Objective:To evaluate the clinical profiles,diagnosis,and treatment of patients with acute epiglottitis at a tertiary care teaching hospital of eastern India.Methods:This is a retrospective study in which 28 patients of acute epiglottitis participated.This study was conducted between January 2016 and October 2019.The diagnosis of acute epiglottitis was based on the clinical presentations and fiberoptic laryngoscopic examinations of the larynx and hypopharynx.Details of age,gender,personal history,clinical symptoms,treatment,and hospital stay were evaluated.Results:Out of the 28 patients with acute epiglottitis,17(60.71%)were male and 11(39.29%)were female with age ranged from 4 years to 62 years and a mean age of 23.45 years.The median duration from the onset to resorting to physicians is 3 d.Among the 28 patients,4 patients(14.29%)were under the treatment for diabetes mellitus.Four cases(14.29%)required airway management with intubation and tracheostomy.Conclusions:Acute epiglottitis is an acute infectious condition of the supraglottis and may lead to airway obstruction.Clinical presentations alone are insufficient for the diagnosis of acute epiglottitis.Fiberoptic nasopharyngolaryngoscopic examination should be performed as soon as possible for confirmation of the disease.展开更多
Omicron,a severe acute respiratory syndrome coronavirus-2 variant,has spread around the globe,causing dramatic increases in infection rates.Viral mutant antigens were responsible for the strong infectivity,fast replic...Omicron,a severe acute respiratory syndrome coronavirus-2 variant,has spread around the globe,causing dramatic increases in infection rates.Viral mutant antigens were responsible for the strong infectivity,fast replication,and high reinfection rates reported from all ages.Omicron causes clinical symptoms mostly related to the upper respiratory tract with minimal symptoms from the lower respiratory tract besides an urgent presentation of cases that resembled a fatal illness,epiglottitis.Not to mention the long coronavirus disease 2019,which rises exponentially in the Omicrons era.Apparently,the disease has a less aggressive course than earlier variants with lower death rates;however,the infection is not trivial.Severe infection was raised among pediatrics,unvaccinated,and the elderly.Complete vaccine protection is urgently needed to protect the most vulnerable community members.Additionally,self-protective strategies such as wearing a mask and safe social distancing cannot be omitted.展开更多
Background: Epiglottic abscess in an otherwise healthy adult is seen as a rare sequelae of acute epiglottitis. It is a life threatening condition which requires emergency management, which if not done early, may resul...Background: Epiglottic abscess in an otherwise healthy adult is seen as a rare sequelae of acute epiglottitis. It is a life threatening condition which requires emergency management, which if not done early, may result in fatality. Respiratory infections, exposure to environmental chemical or trauma which may lead to inflammation and infection of the structures around the throat which may lead on to epiglottitis, and an epiglottis abscess very rarely. In our case, patient was immediately managed by doing an emergency tracheostomy followed by incision and drainage in the OPD (outpatient department). This emphasizes on need for emergency airway management by doing a tracheostomy there by facilitating incision and drainage in a case of epiglottic abscess as a daycare procedure. Aim: The primary aim of this clinical record is to emphasize the need for immediate airway management in epiglottic abscess there by facilitating incision and drainage as an OPD (out-patient department) Procedure. Case Presentation: A 45-year-old man presented to the OPD (outpatient department) with complaints of dysphagia, odynophagia, muffled voice, noisy breathing for the previous 7 hours. On clinical examination pt was in stridor & respiratory distress. Since the pt was in stridor, it was immediately shifted to the OT (operation theatre), and an emergency tracheostomy was done and the airway was secured, following which a video laryngoscopic examination was done in the OPD, which revealed oedematous enlarged epiglottis with pus pointing obscuring the laryngeal inlet. Abscess was incised and drained, and pus was sent for culture & sensitivity. Pt was treated with I. V (intravenous) antibiotics as per culture reports and subsequent video laryngoscopic examination revealed near normal epiglottis with an adequate laryngeal inlet. Conclusion: Patients with epiglottic abscess are at increased risk of airway compromise, hence in such patients airway should be immediately secured by doing an emergency tracheostomy. This case shows the benefits of an emergency tracheostomy for doing incision and drainage for epiglottic abscess as an OPD procedure.展开更多
Objective: To investigate the indications of supraglottic laryngectomy. Supraglottic laryngectomy with or without one arytenoid is a functional laryngectomy suitable for treatment of epiglottis squamous carcinoma. Thi...Objective: To investigate the indications of supraglottic laryngectomy. Supraglottic laryngectomy with or without one arytenoid is a functional laryngectomy suitable for treatment of epiglottis squamous carcinoma. This procedure consists of resection of the thyroid cartilage, epiglottis and the entire preepiglottic space. Methods: Between 1990 and 1996, we used supraglottic laryngectomy to treat 40 patients with supraglottic carcinoma. The data were collected by a review of patient records and follow-up. The cancers were stages T1 (17 cases), T2 (17 cases) and T4 (6 cases) according to the 1987 UICC on cancer staging criteria. Results: 12 ipsilateral and one bilateral functional neck dissection were operated simultaneously. Of which 7 patients had metastasis in lymph nodes. No patient died postoperatively. Only 8 (20%) had slight aspiration before the 20th day. All patients had decannulated. 29 cases received radiotherapy and chemotherapy. A follow-up analysis showed survived rate of 74% at 3 years. Conclusion: We propose supraglottic laryngectomy for the surgical treatment of early supraglottic carcinomas, which could acquire almost normal laryngeal function.展开更多
BACKGROUND Epiglottic cysts is a rare but potentially lethal supraglottic airway pathology in infants due to the high risk of cannot intubation or cannot ventilation.Awake fiberoptic intubation appeared to be the safe...BACKGROUND Epiglottic cysts is a rare but potentially lethal supraglottic airway pathology in infants due to the high risk of cannot intubation or cannot ventilation.Awake fiberoptic intubation appeared to be the safest technique,but it is very challenging in infants with large epiglottic cysts.Even it has the risk of airway loss.We report that cyst aspiration is an effective treatment as the first-choice procedure for airway management in an infant with large epiglottic cysts.CASE SUMMARY A 46-day-old male infant weighing 2.3 kg presented to the emergency room with difficulty feeding,worsening stridor,and progressive respiratory distress.Epiglottic cysts was diagnosed,but fibro bronchoscopy examination failed,as the fiberoptic bronchoscope was unable to cross the epiglottic cysts to the trachea.The infant was transferred to the operating room for emergency cystectomy under general anesthesia.Spontaneous respiration was maintained during anesthesia induction,and cyst aspiration was performed as the first procedure for airway management under video laryngoscopy considering that the preoperative fibro bronchoscopy examination failed.Then,the endotracheal tube was intubated successfully.Cystectomy was performed uneventfully,and the infant was safely transferred to the intensive care unit after surgery.The infant was extubated smoothly on the third postoperative day and discharged on the eighth day after surgery.On follow-up 1 year after the surgery,a normal airway was found by fibro bronchoscopy examination.CONCLUSION Epiglottic cyst aspiration can be considered the first procedure for airway management in infants with large epiglottic cysts.展开更多
Most common site of schwannoma in larynx is aryepiglottic fold and false cords. Epiglottis involvement is rare. The ultimate diagnosis is based on the histologic demonstration of characteristic spindle cells with typi...Most common site of schwannoma in larynx is aryepiglottic fold and false cords. Epiglottis involvement is rare. The ultimate diagnosis is based on the histologic demonstration of characteristic spindle cells with typical nuclear palisading and positive immunohistochemistry for S-100 protein, but negative for a-smooth muscle actin, CD34, and vimentin. Effective treatment is complete excision.展开更多
Large epiglottic cysts can block the glottis, leading to serious consequences. This condition presents a challenge in terms of airway management for anesthesiologists during induction of anesthesia. We report the use ...Large epiglottic cysts can block the glottis, leading to serious consequences. This condition presents a challenge in terms of airway management for anesthesiologists during induction of anesthesia. We report the use of a ShikaniTM Seeing Optical Stylet combined with a Macintosh laryngoscope to aid tracheal intubation in seven patients with large epiglottic cysts. Use of this technique can avoid cyst rupture and allow smooth, safe intubation.展开更多
文摘Objective:To evaluate the clinical profiles,diagnosis,and treatment of patients with acute epiglottitis at a tertiary care teaching hospital of eastern India.Methods:This is a retrospective study in which 28 patients of acute epiglottitis participated.This study was conducted between January 2016 and October 2019.The diagnosis of acute epiglottitis was based on the clinical presentations and fiberoptic laryngoscopic examinations of the larynx and hypopharynx.Details of age,gender,personal history,clinical symptoms,treatment,and hospital stay were evaluated.Results:Out of the 28 patients with acute epiglottitis,17(60.71%)were male and 11(39.29%)were female with age ranged from 4 years to 62 years and a mean age of 23.45 years.The median duration from the onset to resorting to physicians is 3 d.Among the 28 patients,4 patients(14.29%)were under the treatment for diabetes mellitus.Four cases(14.29%)required airway management with intubation and tracheostomy.Conclusions:Acute epiglottitis is an acute infectious condition of the supraglottis and may lead to airway obstruction.Clinical presentations alone are insufficient for the diagnosis of acute epiglottitis.Fiberoptic nasopharyngolaryngoscopic examination should be performed as soon as possible for confirmation of the disease.
文摘Omicron,a severe acute respiratory syndrome coronavirus-2 variant,has spread around the globe,causing dramatic increases in infection rates.Viral mutant antigens were responsible for the strong infectivity,fast replication,and high reinfection rates reported from all ages.Omicron causes clinical symptoms mostly related to the upper respiratory tract with minimal symptoms from the lower respiratory tract besides an urgent presentation of cases that resembled a fatal illness,epiglottitis.Not to mention the long coronavirus disease 2019,which rises exponentially in the Omicrons era.Apparently,the disease has a less aggressive course than earlier variants with lower death rates;however,the infection is not trivial.Severe infection was raised among pediatrics,unvaccinated,and the elderly.Complete vaccine protection is urgently needed to protect the most vulnerable community members.Additionally,self-protective strategies such as wearing a mask and safe social distancing cannot be omitted.
文摘Background: Epiglottic abscess in an otherwise healthy adult is seen as a rare sequelae of acute epiglottitis. It is a life threatening condition which requires emergency management, which if not done early, may result in fatality. Respiratory infections, exposure to environmental chemical or trauma which may lead to inflammation and infection of the structures around the throat which may lead on to epiglottitis, and an epiglottis abscess very rarely. In our case, patient was immediately managed by doing an emergency tracheostomy followed by incision and drainage in the OPD (outpatient department). This emphasizes on need for emergency airway management by doing a tracheostomy there by facilitating incision and drainage in a case of epiglottic abscess as a daycare procedure. Aim: The primary aim of this clinical record is to emphasize the need for immediate airway management in epiglottic abscess there by facilitating incision and drainage as an OPD (out-patient department) Procedure. Case Presentation: A 45-year-old man presented to the OPD (outpatient department) with complaints of dysphagia, odynophagia, muffled voice, noisy breathing for the previous 7 hours. On clinical examination pt was in stridor & respiratory distress. Since the pt was in stridor, it was immediately shifted to the OT (operation theatre), and an emergency tracheostomy was done and the airway was secured, following which a video laryngoscopic examination was done in the OPD, which revealed oedematous enlarged epiglottis with pus pointing obscuring the laryngeal inlet. Abscess was incised and drained, and pus was sent for culture & sensitivity. Pt was treated with I. V (intravenous) antibiotics as per culture reports and subsequent video laryngoscopic examination revealed near normal epiglottis with an adequate laryngeal inlet. Conclusion: Patients with epiglottic abscess are at increased risk of airway compromise, hence in such patients airway should be immediately secured by doing an emergency tracheostomy. This case shows the benefits of an emergency tracheostomy for doing incision and drainage for epiglottic abscess as an OPD procedure.
文摘Objective: To investigate the indications of supraglottic laryngectomy. Supraglottic laryngectomy with or without one arytenoid is a functional laryngectomy suitable for treatment of epiglottis squamous carcinoma. This procedure consists of resection of the thyroid cartilage, epiglottis and the entire preepiglottic space. Methods: Between 1990 and 1996, we used supraglottic laryngectomy to treat 40 patients with supraglottic carcinoma. The data were collected by a review of patient records and follow-up. The cancers were stages T1 (17 cases), T2 (17 cases) and T4 (6 cases) according to the 1987 UICC on cancer staging criteria. Results: 12 ipsilateral and one bilateral functional neck dissection were operated simultaneously. Of which 7 patients had metastasis in lymph nodes. No patient died postoperatively. Only 8 (20%) had slight aspiration before the 20th day. All patients had decannulated. 29 cases received radiotherapy and chemotherapy. A follow-up analysis showed survived rate of 74% at 3 years. Conclusion: We propose supraglottic laryngectomy for the surgical treatment of early supraglottic carcinomas, which could acquire almost normal laryngeal function.
文摘BACKGROUND Epiglottic cysts is a rare but potentially lethal supraglottic airway pathology in infants due to the high risk of cannot intubation or cannot ventilation.Awake fiberoptic intubation appeared to be the safest technique,but it is very challenging in infants with large epiglottic cysts.Even it has the risk of airway loss.We report that cyst aspiration is an effective treatment as the first-choice procedure for airway management in an infant with large epiglottic cysts.CASE SUMMARY A 46-day-old male infant weighing 2.3 kg presented to the emergency room with difficulty feeding,worsening stridor,and progressive respiratory distress.Epiglottic cysts was diagnosed,but fibro bronchoscopy examination failed,as the fiberoptic bronchoscope was unable to cross the epiglottic cysts to the trachea.The infant was transferred to the operating room for emergency cystectomy under general anesthesia.Spontaneous respiration was maintained during anesthesia induction,and cyst aspiration was performed as the first procedure for airway management under video laryngoscopy considering that the preoperative fibro bronchoscopy examination failed.Then,the endotracheal tube was intubated successfully.Cystectomy was performed uneventfully,and the infant was safely transferred to the intensive care unit after surgery.The infant was extubated smoothly on the third postoperative day and discharged on the eighth day after surgery.On follow-up 1 year after the surgery,a normal airway was found by fibro bronchoscopy examination.CONCLUSION Epiglottic cyst aspiration can be considered the first procedure for airway management in infants with large epiglottic cysts.
文摘Most common site of schwannoma in larynx is aryepiglottic fold and false cords. Epiglottis involvement is rare. The ultimate diagnosis is based on the histologic demonstration of characteristic spindle cells with typical nuclear palisading and positive immunohistochemistry for S-100 protein, but negative for a-smooth muscle actin, CD34, and vimentin. Effective treatment is complete excision.
文摘Large epiglottic cysts can block the glottis, leading to serious consequences. This condition presents a challenge in terms of airway management for anesthesiologists during induction of anesthesia. We report the use of a ShikaniTM Seeing Optical Stylet combined with a Macintosh laryngoscope to aid tracheal intubation in seven patients with large epiglottic cysts. Use of this technique can avoid cyst rupture and allow smooth, safe intubation.
