Noor Alam Ansari, Iqbal A Muhammad Khyani, Sultan Ahmed, Murtaza Ahsan Ansari.
Management of Ludwig’s Angina : A Multi Centric Study..
Pak J Otolaryngol Jan ;29(1):03-5.

PURPOSE OF STUDY: To evaluate mode of presentation, management and methods of airway control in the disease. STUDY DESIGN: Multi centric, prospective study. SUBJECTS AND METHODS: 30 patients were included in the study (20 males & 10 females) between the ages of 8 to 78 years (mean 45.5 years) who were presented and treated between January 2010 to December 2011 in the department of Otorhinolaryngology and head and neck surgery of three different tertiary care hospitals. Etiology, microbiology, associated systemic disease, treatment, airway management, duration of hospital stay and outcomes were reviewed. RESULTS: Most common age group involved was 3rd decade (36.6 %) and 66.6% patients were male. Most of the patients were from poor socioeconomic class. Dental infection was documented as most common cause (66.6%) of ludwig’s angina. Streptococcus viridance was the commonest organism found on culture and sensitivity of pus. 18 patients presented with airway compromise where surgical decompression was undertaken with satisfactory results. Tracheostomy was not required in any case. No post-operative complications were recorded. All except one patient made uneventful recoveries and they were discharged after 3 to 26 days of hospitalization (mean 14.1 days). CONCLUSION: Prompt diagnosis ,broad spectrum intravenous antibiotic therapy, parenteral antiinflammatory steroid and surgical decompression can avoid tracheostomy which has its own implications. This significantly reduces the morbidity and mortality in patient suffering from Ludwig’s angina.

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