Paraglottic and Pre-epiglottic Space Abscess in Adults: Report of Two Cases
Publish place: Iranian Journal of Otorhinolaryngology، Vol: 32، Issue: 3
Publish Year: 1399
نوع سند: مقاله ژورنالی
زبان: English
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JR_IJOTO-32-3_009
تاریخ نمایه سازی: 24 تیر 1399
Abstract:
Introduction: Acute epiglottitis or supraglottitis is a rapidly progressing upper respiratory tract infection that can often threaten the airway patency. Epiglottic abscess that expands to the paraglottic (PGS) or preepiglottic (PES) space and acute airway obstruction constitute rare complications, exclusively presented in adults. Case Report: We report two cases. In the first case flexible fiberoptic Rhino-Pharyngo-Laryngoscopy showed epiglottitis that was obstructing the airway and abscesses on the lingual surface of the epiglottis. Abscesses were opened using laser CO2. In the following days flexible fiberoptic endoscopy revealed persisting protrusion of the left hemilarynx. A CT scan was performed showing an abscess in the paraglottic space. Under direct laryngoscopy the abscess was drained. In the second case endoscopic examination revealed epiglottitis that did not cause airway obstruction. The patient was admitted for follow-up and treated with intravenous antibiotics. On the 5th day showed an exacerbation of her symptoms. A CT scan was performed that showed the existence of an abscess in the preepiglottic space. She was taken to surgery and the abscesses were drained through a cervical- U shaped- incission. Conclusion: Existance of an abscess means, by default, an adequate surgical treatment to ensure the airway, and immediate drainage under direct laryngoscopy or through an external approach. Diagnosis is based exclusively on medical history and clinical examination. CT scan is necessary to reveal secret abscesses and silent extension of the infection inside pre-epiglottic and paraglottic space even if epiglottitis is mild. Postoperative management includes proper care of the surgical wound and antibiotics.
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Authors
Giorgos Sideris
Department of Otolaryngology, Attikon University Hospital, Athens, Greece. Rimini ۱, Chaidari, Athens ۱۲۴ ۶۲, Greece
Marilia Sapountzi
Department of Otolaryngology, Attikon University Hospital, Athens, Greece. Rimini ۱, Chaidari, Athens ۱۲۴ ۶۲, Greece
Pavlos Maragoudakis
Department of Otolaryngology, Attikon University Hospital, Athens, Greece. Rimini ۱, Chaidari, Athens ۱۲۴ ۶۲, Greece
Alexander Delides
Department of Otolaryngology, Attikon University Hospital, Athens, Greece. Rimini ۱, Chaidari, Athens ۱۲۴ ۶۲, Greece