Efficacy of spinal needle aspiration for epiglottic abscess in 90 patients with acute epiglottitis

Abstract

Conclusion. Patients with epiglottic abscesses showed more severe symptoms than those with acute epiglottitis and were at increased risk of airway compromise. All 11 patients with epiglottic abscesses underwent spinal needle aspiration; all were cured without severe complications. These findings indicate that spinal needle aspiration is both safe and effective in patients with epiglottic abscesses. Objectives. Acute epiglottitis is a disease that may become serious or even fatal because of sudden upper airway obstruction. An epiglottic abscess may result from a coalescent epiglottic infection due to acute epiglottitis or secondary infection of an epiglottic mucocele. There have been few reports comparing acute epiglottitis with epiglottic abscess. We therefore assessed the clinical characteristics of each condition, as well as the efficacy of spinal needle aspiration and drainage of epiglottic abscesses. Patients and methods. We retrospectively reviewed the records of 90 hospitalized patients diagnosed with acute epiglottitis and epiglottic abscess by flexible nasopharyngolaryngoscopy between March 2006 and February 2008. All patients were treated with medication; in addition, those with epiglottic abscess underwent spinal needle aspiration. Results. Of 90 patients, 79 had acute epiglottitis and 11 had epiglottic abscesses. Acute epiglottitis was most common in May (16.5%) and epiglottic abscesses were most common in June (27.3%). The most common symptoms were sore throat (91.1%), dysphagia (38.9%), voice change (33.3%), and dyspnea (16.7%). All patients were treated with antibiotics and steroids. The mean length of hospitalization was 5 days. No patient required a tracheostomy or orotracheal intubation.