Review Article

Acute Adult Supraglottitis: Current Management and Treatment

Authors: Mohannad Al-Qudah, MD, FAAOHNS, S. Shetty, MD, M. Alomari, MD, Maen Alqdah, FRCPC, FCCP

Abstract

Acute adult supraglottitis can be a serious, life-threatening disease because of its potential for sudden upper airway obstruction. Symptoms and signs of this disease may be nonspecific and may resemble those of upper respiratory tract infection. Unexplained sore throat with tenderness of the anterior neck over the hyoid bone warrant careful examination by flexible laryngoscopy to rule out laryngeal congestion and edema. Laboratory tests are usually not helpful in picking up the diagnosis. Following diagnosis, patients should be hospitalized, started on intravenous antibiotics and their airway closely monitored, as airway obstruction may develop.


Key Points


* Acute adult supraglottitis (ASS) is a distinct clinical entity from epiglottitis in children. It is characterized by a slower onset, more oropharyngeal symptoms, less localization to the epiglottis, and inflammation extending to the supraglottic structures. In addition, it carries less risk of acute airway obstruction.


* Neck tenderness and a severe sore throat in adults should prompt a flexible laryngoscopy, which provides an accurate and safe tool for diagnosis.


* Selective airway intervention is recommended, provided close airway monitoring is maintained in the setting where immediate airway support is available, yet when in doubt, early intubation is the safest approach to prevent death.

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