International Journal of Head and Neck Surgery

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VOLUME 8 , ISSUE 1 ( January-March, 2017 ) > List of Articles

RESEARCH ARTICLE

Ludwig's Angina: Report of 40 Cases and Review of Current Concepts in Emergency Management in a Rural Tertiary Facility Teaching Hospital

S Kumar, M Ambikavathy

Citation Information : Kumar S, Ambikavathy M. Ludwig's Angina: Report of 40 Cases and Review of Current Concepts in Emergency Management in a Rural Tertiary Facility Teaching Hospital. Int J Head Neck Surg 2017; 8 (1):11-14.

DOI: 10.5005/jp-journals-10001-1298

Published Online: 00-03-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective

To review the current protocols and assess their efficacy in the emergency management of cases presenting with Ludwig's angina.

Materials and methods

A retrospective study of patients diagnosed with Ludwig's angina, admitted and treated in our institution between November 2007 and December 2012.

Results

There were 40 cases with 24 males (60%) and 16 females (40%), ages ranged between 16 and 80 years. Duration of symptoms was between 3 days and 2 weeks. The most common cause was dental infections seen in 23 cases (57.5%), one of them was a pregnant lady. Six were due to habitual tooth pricking with a broom stick (15%). In 3 patients it was due to submandibular duct stenosis secondary to calculi (7.5%). Five patients had diabetes as underlying disease (12.5%). Facial trauma contributed in 2 patients (5%) and in 1 patient it was due to carcinoma buccal mucosa (2.5%). All the patients were treated with systemic broad spectrum antibiotics, intravenous fluids, and analgesics. Twenty patients (50%) underwent tracheostomy with surgical decompression through small incisions under local/ general anesthesia. Ten patients (25%) were subjected to incision and drainage with subsequent removal of the diseased teeth. Ten patients (25%) were managed conservatively with antibiotics, analgesics, and under close supervision for airway compromise. There were no complications recorded and no mortality.

Conclusion

Ludwig's angina is a life-threatening surgical emergency. Early diagnosis and immediate surgical intervention can save lives. The appropriate use of parenteral antibiotics complemented with airway protection and surgical decompression remains the standard treatment protocol in advanced cases of Ludwig's angina.

How to cite this article

Ambikavathy M, Kumar S. Ludwig's Angina: Report of 40 Cases and Review of Current Concepts in Emergency Management in a Rural Tertiary Facility Teaching Hospital. Int J Head Neck Surg 2017;8(1):11-14.


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