Nasotracheal intubation--a modality in the management of acute epiglottitis in adults.

Acute epiglottitis in adults is usually treated by close observation or tracheostomy. In the last decade, this therapeutic attitude has been challenged by the impressive results obtained by nasotracheal intubation in the treatment of pediatric cases. Many authors have suggested the use of nasotracheal intubation in adults as well as in children: it would be a natural complement to close observation when airway shunting becomes advisable thus rendering tracheostomy unnecessary. Three conditions have to be met before safe nasotracheal intubation can be considered: interested anesthesiological service, supportive otolaryngological assistance, and dependable nursing care. The case of a young woman treated by close observation proceeding to nasotracheal intubation, as the sole way to secure the airway is presented.