Rowe, David Phillip

Ollapallil, Jacob

2011-03

Ludwig's angina (LA) is an uncommon and potentially life-threatening condition of the upper aero-digestive tract that often requires the coordinated efforts of the surgical, anesthetic and intensive care teams to optimize management. The purpose of the present study was to investigate the documented clinical features and the surgical and airway management of LA at Alice Springs Hospital for the purpose of assessing surgical outcomes with particular reference to length of stay (LOS). Retrospective chart review from January 1998 to January 2008 examined patients admitted with LA at Alice Springs Hospital. Documented clinical features, interventions, and operative findings including floor of mouth swelling, Mallampati score, and airway compromise were collected. Outcomes, with particular respect to LOS, for those who received intravenous (IV) or inhalational induction and those that received awake fibre-optic intubations were compared. Of 30 patients with LA, 28 (93%) were managed with operative drainage with a LOS in the intensive care unit (ICU) of 2 days and a hospital LOS of 5 days. Seven received awake fibre-optic intubation and 21 had IV or inhalational anesthesia with none requiring tracheotomy. There was no statistical difference in LOS between those patients whose microbiological culture results showed no growth and those whose cultures had positive growth. Management was generally operative decompression with IV antibiotics. LOS is not affected by the presence or absence of culture positive infection. It is proposed that operative intervention is safe, effective, and is associated with shorter patient stays in the intensive care unit and the hospital overall.

Alice Springs Hospital, Gap Road, Alice Springs, Northern Territory, Australia. drdavidrowe@mac.com.

ANZ journal of surgery 2011-03; 81(3): 168-71

https://pubmed.ncbi.nlm.nih.gov/21342390/?otool=iaurydwlib

https://hdl.handle.net/10137/5703

Adolescent

Adult

Aged

Airway Management

Child

Child, Preschool

Female

Humans

Infant

Length of Stay

Ludwig's Angina

Male

Middle Aged

Retrospective Studies

Treatment Outcome

Young Adult

Decompression, Surgical

Does surgical decompression in Ludwig's angina decrease hospital length of stay?

Journal Article

Publication