Comparison of nasotracheal intubation and tracheostomy in management of acute epiglottitis

Abstract

12 Patients with acute epiglottis were treated by nasotracheal intubation (group A) and compared with 11 patients treated by tracheotomy (group B). In group A a clinical group score did not correlate with the severity of inflammation and the size of the epiglottis. Lateral radiographs of the neck demonstrated abnormal supraglottic structures in all ten patients who were so examined. Two patients did not have radiographic examinations because of rapid deterioration of their clinical condition, necessitating immediate treatment, however, none of them needed endotracheal intubation prior to arrival in the operating room. All tolerated the nasotracheal tube well without accidental extubation. Neither assist ventilation nor sedation was necessary. Ig group B, throat and blood cultures were positive for Hemophilus influenzae, tybe b, in all cases. There was no serious complication or mortality in either group of patients (Protocol A or B). The significant differences between the two groups were in the durations of intubation (55 vs. 86 hours) and hospital stays (4.5 vs. 6.7 days).