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Adult supraglottitis

H N Barrow1, A P Vastola, R C Wang

  • 1Department of Otolaryngology, Manhattan Eye, Ear, and Throat Hospital, Lubbock, TX.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 1, 1993
PubMed
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Adult supraglottitis management remains debated. This study found that elevated white blood cell counts, higher heart rates, and symptom duration under 24 hours indicate a higher risk of airway obstruction, guiding treatment decisions.

Area of Science:

  • Otolaryngology
  • Emergency Medicine
  • Critical Care

Background:

  • Airway management for adult supraglottitis presents a clinical dilemma regarding observation versus acute intervention.
  • Identifying predictors of airway compromise is crucial for timely and appropriate patient care.

Purpose of the Study:

  • To identify factors associated with a higher risk of airway obstruction in adult supraglottitis.
  • To review the outcomes of conservative treatment for adult supraglottitis.

Main Methods:

  • Retrospective analysis of 46 adult supraglottitis cases over an 8-year period.
  • Comparison of clinical and laboratory findings between patients managed conservatively and those requiring tracheostomy.
  • Statistical analysis (chi-squared) to assess the association between symptom duration and airway compromise.

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Main Results:

  • Seven patients (15%) required tracheostomy; 39 (85%) were managed conservatively.
  • All patients presented with odynophagia and fever.
  • Significantly elevated white blood cell counts and heart rates were observed in patients who underwent tracheostomy.
  • Symptom duration of less than 24 hours was significantly associated with airway compromise (p < 0.05).
  • No associated morbidity or mortality was reported.

Conclusions:

  • Adult supraglottitis can be managed conservatively in most cases.
  • Elevated white blood cell count, increased heart rate, and short symptom duration (<24 hours) are indicators of increased risk for airway compromise.
  • These factors can aid in clinical decision-making for airway management in supraglottitis.