Surgical Management of Ludwig’s Angina

Greenberg, Simon; Huang, Johnson; Chang, Robert S.; Ananda, S

doi:10.1111/j.1445-2197.2007.04146.x

Cited by 22 publications

(25 citation statements)

References 8 publications

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“…Of those treated nonconservatively at initial presentation, 7 (24%) patients were able to be intubated using fiberoptic nasoendoscopy and 1(3%) patient required tracheostomy under local anaesthesia [10]. …”

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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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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“…Despite a significant reduction in frequency and mortality in the post‐antibiotic era, odontogenic infections can still be life threatening. They may require urgent surgical intervention and ICU management because of the potential for spread of infection into intracranial and peri‐tracheal neck spaces and risk of airway compromise if appropriate management is not instituted . Antibiotics are at best only an adjunct to definitive dental treatment …”

Section: Introductionmentioning

confidence: 99%

Review article: Maxillofacial emergencies: Oral pain and odontogenic infections

DeAngelis

Barrowman

Harrod

et al. 2014

Emerg Medicine Australasia

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Oral pain and odontogenic infections are common reasons for patients to present to EDs and general medical practice in Australia. Although most odontogenic infections can be managed on an outpatient basis, because of their proximity to the airway, infections in this region can be life threatening, requiring urgent surgical intervention and ICU management. This article focuses on the emergency assessment, triage and nonspecialist management of oral pain and odontogenic infections.

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“…Ludwig's angina is described as a potentially lethal, rapidly spreading cellulitis, involving the sublingual and submandibular spaces, manifested by a brawny suprahyoid induration, tender swelling in the floor of the mouth, and elevation and posterior displacement of the tongue [1]. Certain peculiarities of cellulitis involving the submandibular and sublingual spaces are their closeness to the pharyngeal and laryngeal airways, the rate of spread of infection from sublingual space to the epiglottis causing laryngeal airway obstruction, limitation of infection, and edema by deep cervical fascia, mandible and the hyoid causing the tongue and floor of the mouth to elevate This is an Open Access article licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense), applicable to the online version of the article only.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Outcomes in Conservative versus Surgical Treatments for Ludwig’s Angina

Edetanlen

Saheeb²

2018

Med Princ Pract

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Objective: To compare the treatment outcomes in patients with early stage Ludwig’s angina who received intravenous antibiotics alone with those who received surgical decompression and intravenous antibiotics. Subjects and Methods: Individuals with early stage Ludwig’s angina were studied using a retrospective cohort study design from August 1997 to September 2017. Data were collected from case notes and logbooks. Appropriate statistical tests were chosen to analyze both the independent and outcome variables. Using 2-tailed test, a level of significance of 0.05 was chosen. Results: A total of 55 patients comprising 38 (69.1%) males and 17 (30.9%) females were studied. The conservative group had a higher number of cases that developed airway compromise (26.3%) when compared to those with surgical approach (2.9%). There was an association between the treatment approach and the development of airway compromise (χ²[1] = 4.83, p = 0.03). Conclusion: There was a higher incidence of airway compromise in patients treated with intravenous antibiotics alone than in those treated with surgical decompression and intravenous antibiotics.

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Surgical Management of Ludwig’s Angina

Abstract: A general discussion of issues related to the management of LA is presented. Based on our experience we conclude that there is a subset of patients with LA who can be managed safely with conservative management.

Cited by 22 publications

References 8 publications

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

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

Review article: Maxillofacial emergencies: Oral pain and odontogenic infections

Comparison of Outcomes in Conservative versus Surgical Treatments for Ludwig’s Angina

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