Is surgical airway necessary for airway management in deep neck infections and Ludwig angina?

Wolfe, Mary M.; Davis, James W.; Parks, Steven N.

doi:10.1016/j.jcrc.2010.02.016

Cited by 52 publications

(41 citation statements)

References 19 publications

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“…[1] As shown in our case, however, with early recognition and medical intervention, escalation to tracheostomy can often be avoided. [10,11] IV steroids, application of a cool humidified face tent, and epinephrine nebulizers may also assist in controlling edema that may progress to obstruct the airway. [8] IV ampicillin-sulbactam was started immediately on presentation, though IV clindamycin or penicillin with metronidazole are alternatives.…”

Section: Discussionmentioning

confidence: 99%

“Air” on the side of caution: The importance of early recognition and intervention in Ludwig’s angina

Long

Demirci

Kruse

2018

CRIM

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Ludwig's angina is a deep neck infection of the supramylohyoid and inframylohyoid spaces. Without prompt recognition and intervention, it can progress to airway compromise with significant morbidity and mortality. Although otolaryngologists and oral surgeons are well-versed in this condition, it is vital that physicians across all specialties are knowledgeable about the presentation and basic treatment of this potentially fatal condition. Here we report a case of Ludwig's angina in a 29-year-old male that was successfully managed with both medical and surgical intervention. We also aim to describe the presentation and treatment of Ludwig's angina in order to increase awareness in non-surgical fields.

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Section: Discussionmentioning

confidence: 99%

“Air” on the side of caution: The importance of early recognition and intervention in Ludwig’s angina

Long

Demirci

Kruse

2018

CRIM

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“…But recently, starting broad spectrum antibiotics soon and carefully observing the patient for signs of impending respiratory failure, in a safe environment like intensive care unit is the norm. [3] An artificial airway is required less frequently in children (only one third of cases) than in adults. Approximately 80% of adults with Ludwig's Angina require incision and drainage.…”

Section: Discussionmentioning

confidence: 99%

Ludwig’s Angina: A Challenge for Anaesthesiologist

Singh¹,

Sharma²,

Jain³

et al. 2017

AIMDR

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Ludwig's angina is an aggressive, rapidly spreading cellulitis of the floor of mouth and neck. It is less frequently seen in children as compared to adults. Successful management of Ludwig's angina requires proper understanding of the anatomy, appropriate antibiotic therapy and surgical drainage whenever needed. Airway management is of prime concern and should be done with prior planning and cooperation of surgeon and anaesthesiologist. We hereby describe the successful management of Ludwig's angina in a 3 year old child.

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“…In 1942 Taffel and Harvey advocated aggressive management of early LA with wide surgical decompression of the submandibular and sublingual spaces under local anaesthetic, resulting in a mortality rate of less than 2% [21]. An artificial airway in all patients with LA was standard practice 30 years ago [22] but there has been a recent shift towards observation in a safe environment with airway intervention by tracheal intubation only if signs of impending airway obstruction develop [23]. Paediatric patients with LA are reported to require active airway intervention less frequently than in adults and it has been suggested that the presence of dental caries, which is more common in adults, is related to a more severe progression and increased need for airway intervention [4].…”

Section: Discussionmentioning

confidence: 99%

Ludwig?s Angina: Paediatric Case Report and Literature Review

Brotherton¹,

Templeton²

2014

Intern Med

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Ludwig's Angina (LA) is an uncommon but potentially fatal cellulitis of the submandibular space, complicated by contiguous spread of infection within the respiratory tract and acute airway obstruction. A 13 month-old female developed LA following upper respiratory tract infection with Parainfluenza-3 virus. There was rapid deterioration due to acute airway obstruction and emergency endoctracheal intubation was necessary. A literature review identified thirty-five paediatric cases of LA with a 14% mortality rate. It occurs predominantly in immunocompetent children with an odontogenic source of infection in a third and unknown source of infection in a third of cases. This is the first reported case of a child with preceding respiratory viral infection who developed LA and it is proposed that respiratory viruses may play a previously unrecognized role in the aetiology of Ludwig's angina in children.

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Is surgical airway necessary for airway management in deep neck infections and Ludwig angina?

Cited by 52 publications

References 19 publications

“Air” on the side of caution: The importance of early recognition and intervention in Ludwig’s angina

“Air” on the side of caution: The importance of early recognition and intervention in Ludwig’s angina

Ludwig’s Angina: A Challenge for Anaesthesiologist

Ludwig?s Angina: Paediatric Case Report and Literature Review

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