Adult acute supraglottitis: analysis of factors associated with airway intervention
DOI:
https://doi.org/10.34631/sporl.846Keywords:
Acute supraglottitis, epiglottitis, adult, airwayAbstract
Aim: Characterize the clinical presentation and treatment management of adults with acute supraglottitis (AS) and to recognize factors associated with the need for airway intervention and longer hospital stay.
Study Design: Retrospective.
Material and Methods: Analysis of AS cases, observed in an ENT Emergency Service, between 2011 and 2017.
Results: We included 85 cases, with 83 patients undergoing exclusive medical treatment and two cases requiring airway intervention. Smoking/alcoholic habits, evidence of muffled voice and respiratory distress signs, such as tachypnea or stridor, were associated with the need for airway intervention. Hospitalization was prolonged in patients with sialorrhea, dyspnea and need for airway intervention.
Conclusions: In adult patients, AS has specific characteristics that must be recognized to allow its timely identification. In this series, we recognize the success of the conservative treatment of this infection and the reduced number of patients submitted to airway intervention.
References
Shah RK, Roberson DW, Jones DT. Epiglottitis in the Hemophilus influenzae type B vaccine era: changing trends. Laryngoscope. 2004 Mar;114(3):557-60. doi: 10.1097/00005537-200403000-00031.
Bajanca-Lavado MP, Simoes AS, Betencourt CR, Sá-Leão R. Characteristics of Haemophilus influenzae invasive isolates from Portugal following routine childhood vaccination against H. influenzae serotype b (2002-2010). Eur J Clin Microbiol Infect Dis. 2014 Apr;33(4):603-10. doi: 10.1007/s10096-013-1994-6.
Haemophilus influenzae type b (Hib) Vaccination WHO position paper: July 2013-Recommendations. Vaccine. 2013 Dec 16;31(52):6168-9. doi: 10.1016/j.vaccine.2013.10.045
Wurtele P. Acute epiglottitis in children and adults: a large-scale incidence study. Otolaryngol Head Neck Surg. 1990 Dec;103(6):902-8. doi: 10.1177/019459989010300603.
Mayo-Smith MF, Spinale JW, Donskey CJ, Yukawa M. et al. Acute epiglottitis. An 18-year experience in Rhode Island. Chest. 1995 Dec;108(6):1640-7. doi: 10.1378/chest.108.6.1640.
Briem B, Thorvardsson O, Petersen H. Acute epiglottitis in Iceland 1983-2005. Auris Nasus Larynx. 2009 Feb;36(1):46-52. doi: 10.1016/j.anl.2008.03.012.
Wolf M, Strauss B, Kronenberg J, Leventon G. Conservative management of adult epiglottitis. Laryngoscope. 1990 Feb;100(2 Pt 1):183-5. doi: 10.1288/00005537-199002000-00014.
Ng HL, Sin LM, Li MF, Que TL. et al. Acute epiglottitis in adults: a retrospective review of 106 patients in Hong Kong. Emerg Med J. 2008 May;25(5):253-5. doi: 10.1136/emj.2007.050153.
Park HH, Lee JC, Lee TH, Kwon JK. et al. Acute supraglottitis in adults: what's the optimal airway intervention? Auris Nasus Larynx. 2012 Apr;39(2):204-7. doi: 10.1016/j.anl.2011.08.005
Chang YL, Lo SH, Wang PC, Shu YH. Adult acute epiglottitis: experiences in a Taiwanese setting. Otolaryngol Head Neck Surg. 2005 May;132(5):689-93. doi: 10.1016/j.otohns.2005.01.011.
Bizaki AJ, Numminen J, Vasama JP, Laranne J. et al. Acute supraglottitis in adults in Finland: review and analysis of 308 cases. Laryngoscope. 2011 Oct;121(10):2107-13. doi: 10.1002/lary.22147.
Cheung CS, Man SY, Graham CA, Mak PS. et al. Adult epiglottitis: 6 years experience in a university teaching hospital in Hong Kong. Eur J Emerg Med. 2009 Aug;16(4):221-6. doi: 10.1097/MEJ.0b013e328320ad2f.
Ovnat Tamir S, Marom T, Barbalat I, Spevak S. et al. Adult supraglottitis: changing trends. Eur Arch Otorhinolaryngol. 2015 Apr;272(4):929-935. doi: 10.1007/s00405-014-3464-x.
Wen S, Feng D, Chen D, Yang L. et al. Molecular epidemiology and evolution of Haemophilus influenzae. Infect Genet Evol. 2020 Jun;80:104205. doi: 10.1016/j.meegid.2020.104205.
Frantz TD, Rasgon BM, Quesenberry CP, Jr. Acute epiglottitis in adults. Analysis of 129 cases. JAMA. 1994 Nov 2;272(17):1358-60.
Shih L, Hawkins DB, Stanley RB Jr. Acute epiglottitis in adults. A review of 48 cases. Ann Otol Rhinol Laryngol. Sep-Oct 1988;97(5 Pt 1):527-9. doi: 10.1177/000348948809700517.
Katori H, Tsukuda M. Acute epiglottitis: analysis of factors associated with airway intervention. J Laryngol Otol. 2005 Dec;119(12):967-72. doi: 10.1258/002221505775010823.
Shapira Galitz Y, Shoffel-Havakuk H, Cohen O, Halperin D. et al. Adult acute supraglottitis: Analysis of 358 patients for predictors of airway intervention. Laryngoscope. 2017 Sep;127(9):2106-2112. doi: 10.1002/lary.26609.
Riffat F, Jefferson N, Bari N, McGuinness J. Acute supraglottitis in adults. Ann Otol Rhinol Laryngol. 2011 May;120(5):296-9. doi: 10.1177/000348941112000503.
Smith MM, Mukherji SK, Thompson JE, Castillo M. CT in adult supraglottitis. AJNR Am J Neuroradiol. 1996 Aug;17(7):1355-8.
Fujiwara T, Miyata T, Tokumasu H, Gemba H. et al. Diagnostic accuracy of radiographs for detecting supraglottitis: a systematic review and meta-analysis. Acute Med Surg. 2016 Nov 10;4(2):190-197. doi: 10.1002/ams2.256.
Guardiani E, Bliss M, Harley E. Supraglottitis in the era following widespread immunization against Haemophilus influenzae type B: evolving principles in diagnosis and management. Laryngoscope. 2010 Nov;120(11):2183-8. doi: 10.1002/lary.21083.
Berger G, Landau T, Berger S, Finkelstein Y. et al. The rising incidence of adult acute epiglottitis and epiglottic abscess. Am J Otolaryngol. Nov-Dec 2003;24(6):374-83. doi: 10.1016/s0196-0709(03)00083-8.
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