急性喉頭蓋炎症例の検討

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  • Clinical Study of 29 Cases of Acute Epiglottitis
  • リンショウ キュウセイ コウトウガイ エンショウレイ ノ ケントウ

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Acute epiglottitis results in inflammation of supraglottic structures and finally causes airway obstruction. In the present study, we examined the clinical findings of acute epiglottitis with special reference to flexible fiberscopic findings and indication of tracheostomy. Twenty-nine patients with acute epiglottis hospitalized and treated at the Department of Otolaryngology, Hyogo College of Medicine, between January 1998 and January 2003 were examined in this study. According to the flexible fiberscopic findings, we deviled patients into four groups. Group I was comprised of patients with swelling limited to the epiglottis, Group II included those with swelling in the epiglottis, arytenoids and aryepiglotic fold, and Group III was comprised of patients with unilateral vocal cord obstructed due to the swelling of the false vocal cord and Group IV was those with fully obstructed vocal cords. Tracheostomy was performed in 2 cases (50%) in Group III, 3 cases (100%) in Group IV and no cases in Groups I and II. In spite of the intensive treatment, four cases deteriorated rapidly within 48 hours. We speculated that observation is mandatory during the first 48 hours of treatment. Physicians have to consider that the patients with obstruction of unilateral vocal cord due to the swelling of the false vocal cord (Group III), or bilateral obstruction of vocal cords (Group IV) have a high risk of airway obstruction and tracheostomy is indicated.

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