Otolaryngologic critical care

Bansal, Arvind K.; Miskoff, Jeffrey A; Lis, Ronald

doi:10.1016/s0749-0704(02)00062-3

Cited by 68 publications

(33 citation statements)

References 61 publications

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“…Management of a patient with Ludwig's angina requires early aggressive therapy with antibiotics, incision and drainage of any abscess and protection of the airway. [23] In addition, the offending tooth or teeth is usually extracted.…”

Section: Discussionmentioning

confidence: 99%

Management of Ludwig′s angina in pregnancy: A review of 10 cases

Osunde¹,

Bassey²,

Ver-or³

2014

Ann Med Health Sci Res

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Background:Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death.Aim:The present paper reviews the management of Ludwig's angina in the third trimester of pregnancy. The inherent dangers to the mother and her unborn child are highlighted.Materials and Methods:The case files of pregnant patients who had emergent incision and drainage for life-threatening facial cellulitis at the maxillofacial unit of the Murtala Mohammed Specialist Hospital in Kano, Nigeria, over a 2 year period were retrieved and demographic and clinical characteristics were retrospectively obtained and analyzed descriptively using the statistical package for social sciences (SPSS version 13.0, for Windows, September 2004, Chicago, Illinois). Comparative statistics were determined using Pearson's Chi-square, Fisher's exact tests and independent t tests as appropriate. A P value of less than 0.05 was considered significant.Results:A total of 10 patients were seen within the study period, age ranges from 23 to 40 years, mean 29.5 (5.3) years. Majority of the women were in their third decade [60% (6/10)] while the remaining 40% (4/10) were in their fourth decade of life. Two of the patients presented within the period of less than 1 week of onset of symptoms while those who presented within the periods of 1-2 weeks and periods of over 2 weeks accounted for 50% (5/10) and 30% (3/10) respectively. All the patients presented during the third trimester of their pregnancy and odontogenic infections were responsible for 80% (8/10) of the Ludwig's angina. There were 20% mortality among the patients and this was significant for those with underlying systemic conditions (P = 0.02). The time of presentation was not significant for the survival rate of the gravid patient (P = 0.36) but was significant for survival of the fetus (P = 0.01).Conclusion:During a life-threatening infectious situation such as Ludwig's angina, risks of maternal and fetal morbidity include both septicemia and asphyxia. Attending clinicians must consider the risks that the condition and the possible treatments may cause the mother and her unborn child.

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Section: Discussionmentioning

confidence: 99%

Management of Ludwig′s angina in pregnancy: A review of 10 cases

Osunde¹,

Bassey²,

Ver-or³

2014

Ann Med Health Sci Res

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“…It is a potentially life-threatening cellulitis, or connective tissue infection, of the neck and floor of the mouth which is characterised by progressive submandibular swelling with elevation and posterior displacement of the tongue [2, 3]. …”

Section: Discussionmentioning

confidence: 99%

Ludwig's Angina—A Controversial Surgical Emergency: How We Do It

Hasan

Leonard²,

Russell³

2011

International Journal of Otolaryngology

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Objectives. To review the current protocols used for management of Ludwig's angina and to assess the efficacy of conservative measures in these cases. Methods. A retrospective review of patients who were admitted to our institution for management of Ludwig's angina between 2003 and 2010. Results. Two patients were identified. Both were managed successfully with conservative measures and close airway observation. None needed an emergency intubation or surgical tracheostomy. There were no mortalities, and both had a short hospital stay. Conclusion. Recently, management of Ludwig's angina has evolved from aggressive airway management into a more conservative one. This is based on close airway observation on a specialised airway unit and a serial clinical airway assessment. Improved imaging modalities, antibiotic therapy, surgical skills, and clinical experience are the key factors behind this change in practice.

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“…Patients with immunodeficiency, malignancy, and organ transplant have an increased risk of contracting the disease (5,6). The most common symptoms before presenting to the hospital include tooth pain (79%), neck swelling (71%), dysphagia (52%), and neck pain (33%) (7). The classic physical findings include a brawny board-like swelling in the submandibular spaces but no pitting of the edema.…”

Section: Ludwig's Anginamentioning

confidence: 99%

“…Treatment centers on high doses of antibiotics, careful airway management, and surgical drainage for decompression. Appropriate antibiotics include high dose penicillin (Ϯ metronidazole), clindamycin, cefoxitin, or more broad spectrum antibiotics such as ticarcillin-clavulanate piperacillintazobactam, or ampicillin-sulbactam (7)(8)(9). Surgical incision and drainage is reserved for those patients who do not respond to medical therapy (8,9).…”

Section: Ludwig's Anginamentioning

confidence: 99%

Bedside ultrasound of the soft tissue of the face: A case of early Ludwig’s angina

Gaspari

2006

The Journal of Emergency Medicine

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Otolaryngologic critical care

Cited by 68 publications

References 61 publications

Management of Ludwig′s angina in pregnancy: A review of 10 cases

Management of Ludwig′s angina in pregnancy: A review of 10 cases

Ludwig's Angina—A Controversial Surgical Emergency: How We Do It

Bedside ultrasound of the soft tissue of the face: A case of early Ludwig’s angina

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