Sublingual Space Research Articles

Radiological assessment of a rare potentially lethal acute neck infection in emergency: Ludwig’s angina (A case report)

Ludwig angina is a potentially lethal acute cellulitis of the floor of the mouth and neck, including submandibular, submental and sublingual spaces and ultimately leading to airway obstruction. Computed tomography (CT) of the neck with upper thorax has been used in emergency once the airway obstruction is secured to evaluate the severity of the infection, to assess any abscess and mediastinal extension. Therefore knowledge of imaging features of Ludwig’s angina is essential to ensure an accurate diagnosis and initiation of early treatment. CT also plays an important role in evaluation for need of surgical intervention. However, MRI is superior to CT because of its excellent soft tissue contrast and demonstration of various fascial compartments' involvement.

Controversy Over Tongue-Tie: Divisions in the Community of Healthcare Professionals

ABSTRACT While recent decades have seen a rapid rise in cases of infant tongue-tie and in surgery to correct it, a controversy is now raging over the condition. Opinion is especially divided over so-called posterior tongue-tie, a variant which is detected based on the “feel” of the sub-lingual space. Drawing on ethnographic research with clinicians in England, we clarify the professional and personal commitments involved in the controversy. Our analysis is informed by Douglas’ theory of cultural representations (grid-group theory), in which ideas of what is natural and unnatural constitute central metaphors.

Management of Ludwig's Angina at a Tertiary Care Hospital in Western Region of India

IntroductionLudwig’s angina is cellulitis of submandibular space, submental space, and sublingual space. The main causative factors include dental infections (dental caries with atypical periodontitis, pericoronitis, and dental procedures). Other predisposing conditions include poor dental hygiene, dental caries, malnutrition, diabetes mellitus, AIDS, and various other immunocompromised states. It presents as an acute onset and spreads very rapidly causing bilateral diffuse neck swelling, edema of floor of mouth, pain, fever, trismus, foul-smelling pus discharge, difficulty in swallowing, airway edema, and tongue displacement creating a compromised airway with stridor. So it requires early diagnosis and aggressive management.Material and methodsClinical data of all patients with clinical diagnosis of Ludwig’s angina managed at the Department of Otorhinolaryngology-Head and Neck Surgery, Sir Takhatsinhji (T) General Hospital and Government Medical College, Bhavnagar, India, from 2015 to 2019 were analyzed retrospectively in this study.ResultOver the review period, 30 cases were diagnosed as Ludwig’s angina, out of which 12 (40%) were males and 18 (60%) were females; male to female ratio was 1:1.5. The age of the patients ranged from six months to 64 years, with a mean age of 38.86 years. Fever, neck swelling, and neck pain were present in all patients.In 16 patients, incision and drainage were done under general anesthesia while the rest five patients required only local anesthesia. In six patients (20%), for maintenance of airway, tracheostomy was required. The most common complication was necrotizing fasciitis and death followed by septicemia. Mortality was observed in three patients (10%) in this study.ConclusionDespite improved outcomes compare to pre-antibiotic era, Ludwig's angina still remains a potentially life-threatening disease in ENT at present. Dental caries, uncontrolled diabetes mellitus, and malnutrition are commonly associated conditions. With early diagnosis, close airway observation, aggressive intravenous antibiotic treatment, and timely surgical intervention, morbidity, and mortality can be reduced.

Ludwig’s angina to retrosternal abscess: a complication of odontogenic infection

Ludwig's angina (LA) is a rapidly spreading cellulitis involving sublingual and submaxillary spaces. It arises most frequently from periapical and periodontal infection of the mandibular molars. Two major complications of LA are life-threatening upper airway obstruction and infectious seeding of the mediastinum, which are responsible for a high mortality rate. Other complications of LA include thrombophlebitis of the internal jugular vein, rupture of the carotid artery, metastatic abscesses and necrosis of the tongue. We have encountered two such cases, with a rapid spread of the inflammation resulting in various local and systemic complications. Awareness of such complications and early clinical as well as radiological diagnosis can lead to prompt surgical drainage, proper antibiotic therapy, and better survival chance. Recognised less often today, this rapidly progressive submaxillary cellulitis may still be fatal.

Iatrogenically Displaced Lower Wisdom Tooth Into Submandibular Space: A Case Report And Review On Retrieval Approaches

Accidental displacement of wisdom tooth and its elements are one of the uncommon complications. The common facial spaces involved during the displacement of lower wisdom teeth are Sub mandibular, Sublingual and Pterygomandibular spaces. Such complications have adverse physical and psychological impact over the patients. The management can vary from conservative observation to surgical retrieval; depending on the presenting clinical conditions, location and the relationship of the displaced elements with respect to the anatomic structures. Retrieval of a displaced root tip from these spaces may be complex due to poor visualization, limited access and under limited experience. This is a case report with a review on approaches for surgical retrieval, of a young male patient aged 28 years, who presented with a displaced mandibular third molar root into the Submandibular space during unsuccessful surgical removal by a general practitioner 2 weeks earlier. The presenting complaints were Limited mouth opening and pain during chewing on the right lower jaw. The case was managed surgically through extra oral approach under local anesthesia and MAC.

A Case of Suspected Lymphatic Malformation in the Sublingual, Submandibular and Parapharyngeal Spaces in an Elderly Patient

A Case of Suspected Lymphatic Malformation in the Sublingual, Submandibular and Parapharyngeal Spaces in an Elderly Patient

Transoral Excision of Sublingual and Submental Dermoid Cyst of the Floor of the Mouth: A Case Report

Background: A dermoid cyst is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. It usually presents as a non-tender, slow-growing swelling in the sublingual region. Case presentation: A large lesion was found in the sublingual and submandibular regions of a 15-yearold female patient who presented to our clinic with the chief complaint of a sublingual mass that had been present for many years but had enlarged over the last year. Computed tomography (CT) scans revealed a giant cystic mass that was a 4.6 x 3.3 cm flask-shaped cystic lesion with a non-enhancing wall in the midline of the sublingual space. Magnetic resonance imaging (MRI) with contrast revealed a well-defined cystic mass with heterogeneous fluid on all sequences. The histopathology report was suggestive of a dermoid cyst. The intraoral approach was preferred for surgery, and no recurrence or complaints were detected during the follow-up period. Conclusion: The pathological diagnosis of the presented case was an epidermoid cyst. For giant dermoid cysts, a surgical incision is considered an effective treatment of choice. This offers a good prognosis and very low chances of recurrence. To achieve the best cosmetic effects, an intraoral technique should be chosen whenever possible.

Fascial space infection patients reporting to department of oral and maxillofacial surgery at Dasmesh Institute of Research and Dental Sciences, Faridkot

This aim of this study is being conducted to assess the incidence of fascial space infection and its management in patients presenting to department of Oral and Maxillofacial Surgery at Dasmesh Institute of Research and Dental Sciences, Faridkot. This retrospective study was done the in the Department of Oral and Maxillofacial Surgery Dasmesh Institute of Research and Dental Sciences, Faridkot, India, from January 2015 to December 2020. Total 84 fascial space infection record of previous five year patients (reporting to Department of Oral and Maxillofacial Surgery was evaluated. Patients reported with fascial space infection with age group from 16-70 yrs and ASA I & I were included in this study. The age group most commonly involved was in the third and fourth decades of life. The mean age group was 33.55. Males (55.95%) were more commonly involved than females (44.05%). The most commonly involved space was Right submandibular space infection (17.86%) followed by left submandibular space infection 15.48, R buccal space infection (9.52%), Left buccal space infection (7.14%), Right infraorbital space infection (7.14%), Left pterygomandibular space infection (7.14%),Space infection wrt left submandibular space, submental space, left sublingual space(5.95%), Masticatory space infection with impending submandibular + submental cellulitis (5.95%).

Prognostic Significance of the Metastatic Lingual Lymph Node in Oral Tongue and Floor of Mouth Squamous Cell Carcinoma

The lingual lymph node (LLN) located on the internal surface of mylohyoid muscle is not currently included in oral cavity cancer surgery or conventional neck dissection. We investigated the risk factors for LLN metastasis and evaluated its oncologic significance in patients with oral tongue and floor of mouth squamous cell carcinoma. Adult patients (≥20years) undergoing upfront surgery and LLN dissection for oral tongue and floor of mouth squamous cell carcinoma between 2009 and 2018 were retrospectively analyzed. Patients who had relapsed after previous treatment or had neoadjuvant chemotherapy or had not undergone surgery were excluded. Association between clinicopathological risk factors (age, gender, tumor differentiation, stage, lymphatic invasion, perineural invasion, vascular invasion, metastatic lymph node ratio, and extranodal extension) and LLN metastasis was evaluated using logistic regression analysis. Disease-free survival in accordance with LLN metastasis was evaluated by the Kaplan-Meier method. A total of 51 patients were included, and LLN metastasis was found in 9 patients (17.6%). LLN metastasis was significantly associated with advanced nodal stage, poor tumor differentiation, and vascular invasion. Cox proportional-hazards regression models showed that LLN metastasis was associated with an 8.0-fold higher risk of mortality than the absence of LLN metastasis. Patients with LLN metastasis had significantly worse 5-year disease-free survival rate than those without metastasis (22.2% vs 85.7%; P<.001). This study suggests that LLN metastasis is a poor prognostic factor in patients with oral tongue and floor of mouth squamous cell carcinoma. The sublingual space should be carefully evaluated preoperatively and intraoperatively.

Angina ludovici-submandibular swelling

Ludwig's angina is firm, acute, toxic cellulitis of the submandibular and sublingual spaces bilaterally and of the submental space. As early as 1796, extraction of abscessed teeth was considered contraindicated because it might give rise to extensive inflammation and angina in a dangerous degree. Three fs became evident even before the first written description of the disease: it was to be feared, it rarely becomes fluctuant, and it was often fatal. A sensation of chocking and suffocation (angina) often was combined with the name of the author (Ludwig's) who fully described it in 1836. Here we report a case of Ludwig's angina in a 34-year-old female.

A rare anatomical variation of the submental artery.

The submental artery usually runs anteriorly on the inferior surface of the mylohyoid muscle, giving branches to that muscle and to the anterior belly of the digastric muscle, finally supplying the submental skin. Branches of it often perforate the mylohyoid muscle and enter the sublingual space. During a routine anatomy dissection, we encountered a case in which the main trunk of the submental artery perforated the mylohyoid muscle, where the sublingual artery usually runs. No branches coursed anteriorly to supply the submental skin. To our knowledge, this submental artery variation has not been reported in the English literature. Any surgical procedure in the submandibular area, such as the axial pattern submental local flap, requires knowledge of such arterial variations.

The Challenges of Treating Lipoblastoma in the Sublingual Space – A Case Report

The presence of lobulated tumour arising from immature adipose tissue is called lipoblastoma when occurring as localised or discrete lesion, and lipoblastomatosis when spread diffusely. The purpose of this case study is to report a case of an 18 – year old man who presented with lipoblastoma in the left sublingual space which was found to be in close proximity with the left sublingual gland. Magnetic resonance imaging (MRI) was taken and showed the tumour was confined within the sublingual space and no penetration was noted inferiorly through the mylohyoid muscle. Tumour dimension measured clinically was 3 cm x 2 cm x 2 cm and the anterior margin of the tumour crossed the midline and entered into the right sublingual space. Complete excision with sparing of neurovascular bundle was performed under general anaesthesia. Follow-up of 2 months showed complete remission of the lesion without any complications.

METHOD OF TREATMENT AND MAINTENANCE THERAPY OF PROSTHETIC STOMATITIS IN PATIENT WITH DIABETES MELLITUS

Relevance. Adaptation to prostheses and their further wearing is often associated with traumatic injuries of the oral mucosa. Mechanical traumas of the oral mucosa with removable laminar dentures, toxic effects of plastic components, the allergic effects of the prosthesis on the oral mucosa and the prosthesis wearer's body as a whole, as well as a stress factor considerably contribute to the occurrence of prosthetic stomatitis. Most often, a removable laminar denture acts as a combined stimulus. The manifestations of diabetic microangiopathies in the oral mucosa enhance the severity of prosthetic stomatitis in individuals with diabetes mellitus. The clinical picture of prosthetic stomatitis also depends on the size and condition of denture supporting area, for instance, atrophy of the edentulous jaws, conditions for anatomical retention of dentures. Therefore, the treatment of stomatitis in patients who wear removable laminar dentures is still a challenging problem in orthopaedic and therapeutic dentistry.&#x0D; Purpose and objective: to investigate available treatment approaches and maintenance therapy for managing prosthetic stomatitis in patients with diabetes mellitus who wear removable acrylic laminar dentures; to offer our newly developed treatment and maintenance therapy of prosthetic stomatitis in diabetic patients.&#x0D; Material and methods. The existing approaches and methods of treatment and maintenance therapy for prosthetic stomatitis in patients with diabetes mellitus were thoroughly investigated with clear focus on their advantages and disadvantages. The available methods to manage the complications caused by laminar denture wearing in patients with diabetes mellitus include topical remedies and oral hygiene products. The treatment of prosthetic stomatitis in patients who wear dentures is often reported as ineffective. Therefore, at present, it is relevant to search for new methods of treating prosthetic stomatitis under diabetes mellitus with the use of agents that boost the body antioxidant protection, stimulate tissue regeneration and epithelialisation.&#x0D; Results. The method we have developed for the treatment of prosthetic stomatitis in individuals with diabetes mellitus includes the application of 2% Thiotriazolin ointment for local treatment, and Thiotriazolin preparation for systemic therapy. Thiotriazoline is a domestic drug of polytropic action. It has membrane-stabilizing, antioxidant and reparative properties. Thiotriazoline stimulates tissue regeneration and epithelialisation processes, somewhat reduces the intensity of the inflammatory process. In dental practice, 2% Thiotriazolin ointment is recommended to treat ulcerative lesions of the oral mucosa and periodontal tissues. Our treatment method includes the following steps: after the denture adjustment and sanitation of the oral cavity done, patients are prescribed to apply 2% Thiotriazolin ointment onto the denture supporting areas, which are the most often traumatized, in particularly, onto the maxillary tubercles, along the transitional fold, in the sublingual, retromolar and retroalveolar spaces, daily for 7-10 days. The patients are also recommended to apply 2% Thiotriazolin ointment onto the inner surface of the prosthesis base. For systemic therapy, “Thiotriazolin” is prescribed to be taken by mouth in a dosage of 1 tablet of 100 mg per day for 30 day course.&#x0D; Supportive therapy involves Quvertin, while Lizak tablets are used for local prophylaxis. Following the oral sanitation, patients are prescribed to Lizak tablets (should be held in the mouth until dissolved slowly) 3-4 times a day for 5-7 day course. As part of a comprehensive supportive therapy, patients are prescribed Quvertin tablets, 1 tablet twice a day 30 minutes before meals (chew the tablet) for 30 day course.&#x0D; Conclusion. The proposed method of the therapy of prosthetic stomatitis in people with diabetes mellitus is quite easy to use, causes no side effects, produces a positive effect on the clinical course of the conditions, and enabled to achieve a stable remission after the disease, and, thus, can be recommended for implementing into dental practice. The described maintenance therapy for diabetic patients with prosthetic stomatitis is clinically effective, has no side effects, and can increase the periods of remission after the disease. This combination therapy can be recommended as an effective treatment option in therapeutic and orthopaedic dentistry.

A Rare Clinical Case of Lipoma in the Soft Tissues of the Sublingual Space: A Case Report

Summary This report presents clinical case with a histopathologically established lipoma of the sublingual space. Lipomas are benign mesenchymal neoplasms produced by adipocytes. Our search in the literature demonstrated that the development of lipomas in the sublingual space is extremely rare. In the oral cavity, it is seen in less than 5% of patients. In this paper, we describe clinical features, imaging diagnostic and histopathological features. Lipomas are characterized by slow growth and could be asymptomic, therefore diagnosis could be delayed. This report describes and discusses the case of a 64 years-old-man with a formation, located below the left tongue, for a period of 4 years. The patient had repeatedly consulted with Ear-Nose-Throat (ENT) specialists and dentists who recommended surgical treatment. During the last month of the monitoring, the formation had grown significantly and the chewing and speech function had gradually worsened.

Management of a Large Sublingual Dermoid Cyst

Abstract This case report highlights our management of a large sublingual dermoid cyst. A fifteen-year-old Irish male presented with a swelling in the floor of mouth and displacement of the tongue. Speech changes were noted on presentation. A magnetic resonance imaging (MRI) scan revealed a 7 × 4 × 3 cm mass in the submental and sublingual spaces. Fine needle aspiration suggested a dermoid cyst. We excised the cyst via an intraoral approach. Sublingual dermoid cysts are rare entities, and their management has been poorly described. Our case report illustrates the value of an intraoral surgical approach.

Mathematical model under E-health context for diagnosis of head and neck space Gram infection through CT imaging

The study aimed to investigate the head and neck space infection by Gram bacteria using mathematical model-based CT (computer tomography) under e-health (electronic health). Specifically, a total of 180 clinical patients with head and neck space infection were collected as the research subjects. CT/MRI examination was adopted to diagnose the disease. A mathematical model was then established to be applied in CT imaging. The cause and treatment effect were analyzed by summarizing the data, including basic information, bacterial culture, source and extent of infection, serious complications, and other factors. The results showed that the CT/MRI imaging based on the mathematical model can effectively diagnose the disease and assess the disease progress. There were more male patients than female patients with head and neck space infection, and more elderly patients than younger patients. A total of 42 patients had serious complications, accounting for 23.3% of the total patients. The most common one was descending mediastinitis, followed by respiratory obstruction, pneumonia, pericarditis, orbital infection, and multiple organ failure. There were many sources of infection in the head and neck space. The main cause was dental infection, and there were 137 cases, accounting for 76.1% of the total. Among them, odontogenic infections included tooth apical periodontitis, wisdom tooth pericoronitis, and periodontal disease. Other sources of infection included glandular infections, iatrogenic infections, and traumatic foreign bodies. The most common part affected by head and neck space infection was the submandibular space, and other parts included the masseter space, the cheek space, and the sublingual space. Severe complications of head and neck space infection were mainly inferior mediastinitis and respiratory obstruction. In the bacterial culture experiment, a total of 75 bacterial cultures of 180 patients were positive, and 62 strains of bacteria were cultured, including 11 kinds of gram-positive bacteria and 4 kinds of gram-negative bacteria. The main pathogens cultivated were Streptococcus viridans, Staphylococcus aureus, and Klebsiella pneumoniae. In laboratory tests, the values of WBC and hs-CRP in patients with severe complications were significantly higher than those in patients with common head and neck space infection. Imipenem and ornidazole were the most commonly used antibiotics in the clinical treatment of patients with severe complications. In conclusion, head and neck space infection is a serious infectious disease that may be life-threatening and requires timely and effective treatment.

Unusual Ludwig´s angina in systemic disabled patient related with periodontal disease

The Ludwig's angina is an infectious process involving submandibular, sublingual, and submental spaces bilaterally. They can rapidly progress to airway obstruction and hemodynamic instability. The most common cause of Ludwig's angina is apical dental infections, specifically involving the roots of second and third mandibular molars, which are contiguous to the submandibular space. Periodontal diseases are related with bone loss around dental roots and create a situation where the inflammatory drainage tends to assume a sulcular direction. The purpose of this article is to report a clinical patient with an unusual development of a periodontic-endodontic lesion leading to Ludwig's angina in patient whit diabetics, hypertension and chronic kidney disease. Thus, we can conclude that even if it is not common reports of angina associated with periodontal diseases we must attend to patient's correct care, initiating antibiotic therapy, maintenance of the airways, removal of infectious focus and control of comorbidities diseases.

Med Check: Atuzaginstat and Alzheimer’s Disease; Blood Cytokine Test and Suicidal Ideation; FDA and Dsuvia; Gocovri and Parkinson’s Disease

Back to table of contents Previous article Next article Med CheckFull AccessMed Check: Atuzaginstat and Alzheimer’s Disease; Blood Cytokine Test and Suicidal Ideation; FDA and Dsuvia; Gocovri and Parkinson’s DiseaseTerri D’ArrigoTerri D’ArrigoSearch for more papers by this authorPublished Online:1 Apr 2021https://doi.org/10.1176/appi.pn.2021.4.4FDA Puts Partial Hold on Atuzaginstat in Trials for Alzheimer’s DiseaseIn February the Food and Drug Administration (FDA) placed a partial clinical hold on Cortexyme Inc.’s investigational Alzheimer’s drug atuzaginstat because of adverse liver events reported by some participants taking the medication. Under the partial hold, no new participants will be enrolled in the open-label extension phase of Cortexyme’s ongoing phase 2/3 trial, which is evaluating the efficacy, safety, and tolerability of the drug in patients with mild to moderate Alzheimer’s disease. Participation will also be discontinued for patients who are currently enrolled in the open-label extension.The 643 patients who are enrolled in the double-blind, placebo-controlled randomized phase 2/3 trial will continue to receive the drug at their assigned dose. The adverse liver events have been reversible and without any known long-term effects on the patients in the trial, the company said in a statement.Blood Cytokine Test for Suicidal Ideation Looks PromisingCampbell Neurosciences Inc. has successfully completed a 30-patient clinical trial to assess blood levels of an inflammatory cytokine as a predictor for suicidal ideation, the company announced in February.There were three groups of patients in the trial: 10 with no history of personal or family psychiatric history and no suicide attempts, 10 with suicidal ideation as determined by a Hamilton Depression Rating Scale suicide item of greater than 2, and 10 with suicidal ideation who attempted suicide in the last six months. Those in the first group had a mean of 7.6 picograms of cytokine per milliliter of blood (pg/ml), whereas those in the second group had a mean of 28.9 pg/ml and those in the third group had a mean of 45.8 pg/ml.FDA Issues Warning to Dsuvia Manufacturer for False PromotionsIn February the FDA issued a warning letter to AcelRx Pharmaceuticals Inc. for disseminating false and misleading promotional communications regarding Dsuvia (sufentanil sublingual tablet). The drug is used to treat acute pain in adults that is severe enough to require an opioid analgesic but for which alternative treatments are inadequate. It is used in medically supervised health care settings such as hospitals, surgical centers, and emergency departments.The warning letter noted that a banner ad and a tabletop display with the catchphrase “Tongue and Done” are misleading because they imply that administering the drug requires only one simple step when in fact the prescribing information outlines a multistep process. The prescribing information requires that the health care professional visually confirm the tablet’s placement in the sublingual space of the patient’s mouth and to remove and dispose of the tablet if it is not.“The multiple steps involved in the administration of Dsuvia reflect the complexity of use of Dsuvia,” the agency said in a statement. “Given the potency and the small size of the tablet, the risk of misplaced tablets is a serious safety concern to the patient and others ... Therefore, by oversimplifying the administration process, these presentations create a misleading impression about the safe administration of Dsuvia. These presentations are particularly concerning considering a REMS program was required for Dsuvia to ensure that the benefits of the drug outweigh the risk of respiratory depression that can result from accidental exposure.”The warning letter also noted that the banner ad mentions dosing intervals but neglects to state the maximum number of tablets that should be administered in a 24-hour period.Gocovri Approved to Treat Off Episodes in Parkinson’s DiseaseGocovri (amantadine), Adamas Pharmaceuticals Inc.’s drug for treating dyskinesia in patients with Parkinson’s disease (PD) who receive levodopa-based treatment, now has a second indication: In February it won FDA approval as an adjunctive treatment to levodopa/carbidopa in patients with PD who are experiencing “off” episodes. During off episodes, motor symptoms like stiffness or tremor return even though the patient is taking medication for PD.In two placebo-controlled phase 3 clinical trials that evaluated the efficacy and safety of Gocovri for the treatment of dyskinesia, 198 patients with PD who were experiencing off episodes received either 274 mg of the drug once per day or placebo. At 12 weeks, patients who took Gocovri experienced significantly less off time and dyskinesia compared with those who took placebo. ■ ISSUES NewArchived

Floor of Mouth Neurofibroma: A Rare Presentation

Solitary sporadic neurofibromas are uncommon benign tumours of the neural sheaths of the peripheral nervous system. Solitary sporadic neurofibromas of the oral cavity and floor of mouth are extremely rare. We present the case of a 36-year-old male who presented with a 3-month history of a soft non-tender floor of mouth mass. MRI demonstrated a cystic septated lesion filling the left sublingual space. The lesion was excised via an external approach. Histology and immune assay unexpectedly demonstrated a neurofibroma.

Ludwig's Angina: Analysing Clinical Profile and Microbiology with Antibiotic Sensitivities at a Tertiary Care Hospital.

Introduction: Ludwig’s angina is a form of severe diffuse cellulitis secondary to an odontogenic infection that presents as acute onset and spreads rapidly, bilaterally affecting the submandibular, sublingual and submental spaces resulting in a state of emergency. Early diagnosis and immediate treatment planning could be a life-saving.Aim: To assess the age sex distribution, comorbidity factors, association with odontogenic infection, management protocol, organisms isolated and their antibiotic resistance.Patients and Methods: Retrospective record based study, over 2 years period at JSS hospital, Mysuru.Results: This study showed ludwig’s angina to have male preponderance with M:F =1.6:1, most commonly occurring above 40 years of age (61.8%). Commonest etiology was Odontogenic infections 26 cases (76.5%). Diabetes Mellitus (DM) was the commonest comorbidity (32.4%). The cornerstone of treatment was incision and drainage with intravenous empirical antibiotics in 94.1% cases, followed by tooth extraction in all patients with dental caries. A total of 25 bacterial strains were isolated from 32 patients. The bacteria were found to be 88% gram-positive and 12% gram-negative. Alpha hemolytic Streptococcus was the most common organism. Gram positive bacteria showed resistance to penicillin, cotrimoxazole and erythromycin being sensitive to ceftriaxone.Conclusion: A male : female ratio of 1.6:1 and odontogenic infection accounting for 76.5% cases mirrors previous statistics. DM patients had increased risks of complications with longer hospital stays. Incision and drainage must be done immediately to reduce airway compromise and mortality. Empirical antibiotics therapy with ceftriaxone and metronidazole would be ideal till we wait for pus culture and sensitivity reports