Vol.100 No.10 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 10 October 2007
The Investigation of Epiglottic Abscess
Yumiko Maruyama and Shigeru Hoshida
(Kurobe City Hospital)
Toshiaki Tsukatani and Mitsuru Furukawa
(Kanazawa University Graduate School of Medicine)
Severe airway stenosis due to acute upper airway infection is an emergent situation. Without prompt and appropriate treatment, the outcome may be fatal.
During the period from November 2005 to October 2006, we treated five epiglottic abscess patients. We examined the occurrence factors and their clinical courses. We divided these patients into two groups regarding their postoperative clinical courses in order to examine the retrospective necessity of tracheostomy.
One case had diabetes and chronic renal failure, but the other four had no past illness which might reduce immune function. We experienced two cases who showed advanced epiglottic abscess in spite of conservative therapy against epiglottitis.
We performed surgical drainage and tracheostomy in all five patients. Although upper airway stenosis improved satisfactorily after operations in two of the five (group I), epiglottic swelling was exacerbated again on the day following the operation compared with the epiglottic thickness immediately after the operation in the other three (group II). We investigated clinical differences between the two groups, and found that both the value of CRP and number of WBC in group II on the day when abscess diagnosis was made had a tendency to be higher compared with those in group I. And the number of hospitalization days of group II also had a tendency to be longer than that of group I.
Epiglottic abscess runs a risk of suffocation. In contrast, patients generally convalesce satisfactorily with appropriate airway management. Accurate diagnosis and prompt treatment are thought to be essential.
Key words : epiglottic abscess, airway stenosis, tracheostomy, immune function, suffocation