Kimura H, Asai M, Aso S, Watanabe Y, Fujisaka M
Department of Otolaryngology, Faculty of Medicine, Toyama Medical and Pharmaceutical University.
Nihon Jibiinkoka Gakkai Kaiho. 1997 May;100(5):518-23. doi: 10.3950/jibiinkoka.100.518.
Adult supraglottitis is an acute inflammation of the supraglottic structures first reported by Shapiro et al. While multiple anatomical sites in the larynx and oropharynx are inflamed, the epiglottis is not always the most involved area. In this paper, we refer to "adult supraglottitis" as "acute supraglottitis" because pediatric supraglottitis is rare in Japan. There have been no reports of acute supraglottitis in Japan to date. We report a clinical study of 15 cases of acute supraglottitis. In addition, we investigated whether acute supraglottitis can be recognized as a special form of acute laryngitis, the same as epiglottitis. Thirteen of 15 patients had severe sore throat or pain on swallowing. Oropharyngeal and laryngeal examinations revealed that the most involved area in the oropharynx and larynx was the aryepiglottic folds and the arytenoids. Five patients with edema extending from the aryepiglottic folds to the arytenoids complained of referred otalgia on swallowing. Strep. Pyogenes, Strep, pneumoniae, alpha-strep., and Staph aureus were isolated from the oropharynx. All patients were hospitalized because of severe presenting symptoms. Treatment consisted of intravenous antibiotics, including piperacillin, clindamycin, flomoxef, aspoxicillin, and cefotiam. Nine patients also received intravenous steroids. Signs and symptoms of supraglottitis resolved within 10 days in every case. No patient required airway intervention. Acute supraglottitis manifested more severe clinical symptoms than acute laryngitis. the local inflammatory findings of this disease were different from those of acute laryngitis and epiglottitis. therefore, we propose that acute supraglottitis is a special form of acute laryngitis.
成人会厌炎是一种会厌上结构的急性炎症，最早由夏皮罗等人报道。虽然喉和口咽的多个解剖部位都会发炎，但会厌并不总是受累最严重的部位。在本文中，我们将“成人会厌炎”称为“急性会厌炎”，因为小儿会厌炎在日本很少见。迄今为止，日本尚无急性会厌炎的报道。我们报告了一项对15例急性会厌炎患者的临床研究。此外，我们研究了急性会厌炎是否可被视为与会厌炎相同的急性喉炎的一种特殊形式。15例患者中有13例有严重咽痛或吞咽疼痛。口咽和喉部检查显示，口咽和喉部受累最严重的部位是杓会厌襞和杓状软骨。5例杓会厌襞至杓状软骨有水肿的患者诉说吞咽时牵涉性耳痛。从口咽分离出化脓性链球菌、肺炎链球菌、甲型链球菌和金黄色葡萄球菌。所有患者因症状严重而住院。治疗包括静脉使用抗生素，如哌拉西林、克林霉素、氟氧头孢、阿扑西林和头孢替安。9例患者还接受了静脉使用类固醇。所有病例的会厌炎体征和症状均在10天内消退。无一例患者需要气道干预。急性会厌炎表现出比急性喉炎更严重的临床症状。这种疾病的局部炎症表现与急性喉炎和会厌炎不同。因此，我们认为急性会厌炎是急性喉炎的一种特殊形式。
