Park Hyun Ho, Lee Jong Cheol, Lee Tae Hoon, Kwon Joong Keun, Nam Jung Kwon
Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Auris Nasus Larynx. 2012 Apr;39(2):204-7. doi: 10.1016/j.anl.2011.08.005. Epub 2011 Sep 7.
To validate the Friedman stage and define the proper timing for airway intervention in adult cases of acute supraglottitis, we evaluated the clinical courses and management of adult patients.
202 adult patients with acute supraglottitis were included in this study. The diagnosis of supraglottitis was established by flexible nasolaryngoscopic examination. Friedman stages were classified in each patient. In this study, the first three days of serial nasolaryngoscopic findings for each patient were evaluated.
All patients were treated successfully with only conservative methods. There were no significant differences between patients with Friedman stages I or II/III. Among the patients that had serial nasolaryngoscopic findings, only one patient presented with progressive swelling of the epiglottis, and there were no cases of persistent swelling.
The airway intervention threshold should be raised from Friedman stages II-III. And, airway intervention should not be needed if patients are tolerant of their respiratory discomfort.
为验证弗里德曼分期并确定成人急性会厌炎气道干预的合适时机，我们评估了成年患者的临床病程及治疗情况。
本研究纳入了202例成年急性会厌炎患者。通过软性鼻咽喉镜检查确诊会厌炎。对每位患者进行弗里德曼分期。在本研究中，评估了每位患者连续三天的鼻咽喉镜检查结果。
所有患者仅通过保守治疗方法均成功治愈。弗里德曼I期或II/III期患者之间无显著差异。在有连续鼻咽喉镜检查结果的患者中，仅1例患者出现会厌进行性肿胀，无持续性肿胀病例。
气道干预阈值应从弗里德曼II - III期提高。并且，如果患者能够耐受呼吸不适，则无需进行气道干预。
