Endoscopic partial epiglottectom using diathermy for chronic epiglottitis from khat chewing

Abstract

Objective The aim of this study was to determine the effect of endoscopic partial epiglottectomy on airway obstruction. Patients and Methods A prospective study was conducted in the ENT Department, Al-Thawra Teaching Hospital, Sana’a, Yemen. A total of 58 patients underwent partial epiglottectomy using standard laryngeal instruments and monopolar microdissection scissors and hook diathermy, during the period January 2005–July 2011. Results A total of 58 patients were included in this study, 47 male and 11 female. Their ages ranged from 21–60 years, with a mean age of 32.39 years. A total of 58 (100%) patients presented with change of voice, 58 (100%) patients presented with difficulty in breathing on exertion, 20 (34.5%) patients presented with foreign body sensation, 58 (100%) with stridor on exertion, 20 (34.5%) with stridor at rest, 20 (34.5%) with dysphagia, and four cases with tracheostomy in situ. Postsurgical results All (100%) patients showed improvement in voice, breathing, and disappearance of stridor. An overall 90% (18/20) of patients had disappearance of foreign body sensation. Recurrence occurred in 25.9% of patients. Postoperative aspiration occurred in 11 (19%) patients for short time. Conclusion Using diathermy to perform endoscopic partial epiglottectomy is simple, effective, and safe in the treatment of hypertrophic epiglottis using laryngeal instruments and diathermy. It did not need special preparation and could be performed in hospitals that have no laser facilities.