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CC BY-NC-ND 4.0 · International Journal of Practical Otolaryngology 2018; 01(01): e1-e5
DOI: 10.1055/s-0038-1660522
Original Article
Georg Thieme Verlag KG Stuttgart · New York

A Clinical Study of Patients with Acute Epiglottitis

Michihisa Kono
1   Department of Otolaryngology–Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
,
Takashi Goto
1   Department of Otolaryngology–Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
,
Nobuyuki Bandoh
1   Department of Otolaryngology–Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
,
Yasuaki Harabuchi
2   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
› Author Affiliations
Further Information

Publication History

09 January 2018

28 February 2018

Publication Date:
13 June 2018 (online)

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Abstract

Acute epiglottitis is an acute inflammation of the upper respiratory airway that rarely causes airway obstruction. A retrospective study was conducted on 115 patients with acute epiglottitis from April 2007 to December 2017 (65 males and 50 females; aged 12–85 years old, median age of 45 years). When counting the number of patients according to the month, from April to September more than 10 patients were treated. Median duration from symptom onset to first visit was 3 days (1–14 days). Eight (7%) of 115 patients had diabetes, and 16 (13.9%) had epiglottic cyst. We divided all the patients into six groups by laryngeal findings according to the classification of Katori and Tsukuda. Number of patients classified as IA, IB, IIA, IIB, IIIA, and IIIB was 41 (35.7%), 21 (18.3%), 22 (19.1%), 15 (13%), 8 (7%), and 8 (7%), respectively. Median duration of hospitalization was 5 days (2–26 days). In the blood test on the first day of hospitalization, the number of white blood cells (WBC) ranged from 3,400 to 25,350/μL (median 10,350/μL) and the C-reactive protein (CRP) ranged from 0.01 to 23.3 mg/dL (median, 2.5 mg/dL). The number of WBC and CRP at the fourth day after the hospitalization was significantly lower than those at the first day. Eight (7%) patients required the airway management such as tracheotomy or cricothyroidotomy. Age, laryngeal finding (severe epiglottis swelling and arytenoid edema; Katori and Tsukuda's classification IIIB), and high inflammatory reaction in blood test (WBC ≥ 20,000/μL and CRP ≥ 20 mg/dL) were the factors that significantly correlated with the airway management.

Keywords

acute epiglottitis - airway management - laryngeal finding - inflammatory reaction in blood test - tracheotomy

Patient Consent

Informed consent for publication of clinical details was obtained from all patients.


 

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