A comparison of endotracheal intubation and tracheostomy in the management of acute epiglottitis in children in the tropics

Abstract

In children, acute epiglottitis is rapidly fatal due to airway obstruction by swollen supraglottic structures, but the oedema is short-lived. Therefore, in many centres short-term endotracheal intubation has replaced tracheostomy as the method of choice for relieving the obstruction. We have tried both methods in 15 children over a period of three years under conditions of limited material and human resources. Tracheostomy was found to be safer. It was concluded that it is better to have a live healthy child with a small scar in the neck than a dead child without a scar.

Acute epiglottitis in the adult

“…The initial treatment is basically determined by the degree and evolution of the dyspnoea (Ossof et al, 1980;Odetoyinbo, 1986;Warshawski et al, 1986;Hodge and Ganzel, 1987). Some of the series, have different criteria for intervention in the airway: thus in a number of them, a tracheostomy was carried out, where there was initial stridor and no response to the medical treatment (Odetoyinbo, 1986). In our series surgical treatment was applied either in the presence of initial and intense stridor or in those patients whose dyspnoea worsened in spite of receiving the correct medical treatment.…”

“…There were 58 patients, among them 46 males and only 12 females. The diagnosis of acute epiglottitis was made according to clinical criteria and 19781979198019811982198319841986198819891990 FIG. 1 Epiglottitis: yearly incidence (58 cases).…”