Drexel University College of Medicine, 2900 W Queen Lane, Philadelphia, PA 19129, United States.
Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77555, United States.
Am J Otolaryngol. 2020 May-Jun;41(3):102411. doi: 10.1016/j.amjoto.2020.102411. Epub 2020 Feb 1.
Ludwig's angina, a rapidly progressive cellulitis causing airway obstruction, has traditionally been managed with antibiotics and surgical intervention. More controversial is the use of steroids in the management of patients with this condition. This article summarizes the literature of steroid use in the management of Ludwig's angina.
The study used a narrative review method alongside the PRISMA guidelines for systematic reviews. PubMed, Ovid Medline, Cochrane, and Web of Science were searched for cases of Ludwig's angina with documented steroid use in patient management. Inclusion criteria were articles in the English language with direct patient outcomes. There were 17 articles selected with 31 patient cases.
Most reports of steroid use in Ludwig's angina in the literature are case reports, with one retrospective review, and one letter to the editor. Dexamethasone was the steroid of choice in most cases reviewed. All patient cases reported used antibiotics alongside their steroid use, and 27 out of 31 patient cases required surgery. Most patients recovered with no further sequelae or complications. Three (9.68%) patients suffered mortality due to unrelated causes.
Primary literature reporting the use of steroids in the management of Ludwig's angina includes few cases. While the role steroids have in these cases remains uncertain, the articles summarized do not suggest an adverse influence, and may suggest a benefit.
路德维希咽峡炎是一种迅速进展的蜂窝织炎，可导致气道阻塞，传统上采用抗生素和手术干预进行治疗。在这种情况下使用类固醇的争议更大。本文总结了类固醇在路德维希咽峡炎治疗中的应用文献。
该研究采用叙述性综述方法，并遵循 PRISMA 系统评价指南。在 PubMed、Ovid Medline、Cochrane 和 Web of Science 上搜索有记录类固醇用于患者管理的路德维希咽峡炎病例的文献。纳入标准为直接报告患者结局的英文文章。共选择了 17 篇文章，涉及 31 例患者。
文献中类固醇在路德维希咽峡炎中的应用大多是病例报告，仅有一篇回顾性研究和一篇给编辑的信。在大多数回顾的病例中，地塞米松是首选的类固醇。所有使用类固醇的患者病例均同时使用了抗生素，31 例患者中有 27 例需要手术。大多数患者康复，无进一步的后遗症或并发症。3 例（9.68%）患者因非相关原因死亡。
报告类固醇在路德维希咽峡炎治疗中应用的主要文献包括少数病例。虽然类固醇在这些病例中的作用仍不确定，但总结的文章并未表明有不良影响，反而可能表明有益。
