OBJECTIVE: To review cases of adult acute epiglottis in a tertiary government hospital and describe the clinical presentations, diagnostics performed, management and outcomes.
METHODS:
Design: Retrospective Chart Review
Setting: Tertiary Government Hospital
Participants: Records of patients admitted by or referred to the Department of Otolaryngology Head and Neck Surgery with a diagnosis of acute epiglottis from January 2008 to August 2014 were identified from the department census and charts were retrieved from the Hospital Record Section and evaluated according to inclusion and exclusion criteria. Information regarding demographic data, clinical features, laboratory and other diagnostic examinations, medical management, and length of hospital stay were collected.
RESULTS: There were 20 cases in 7 years and 8 months. Most were male, 18 to 37-years-old, presenting with dysphagia, odynophagia and a swollen epiglottis on laryngoscopy. Abnormal soft-tissue lateral radiographs of the neck and leukocytosis were seen in 73% and 83%, respectively. Intravenous antibiotics and corticosteroids were administered in all cases, and mean hospital stay was 11.2 days.
CONCLUSION: Adult acute epiglottis should be highly suspected in patients presenting with dysphagia, odynophagia, and muffling of the voice even with a normal oropharyngeal examination. History of respiratory infection, co-morbidities, smoking and alcohol intake, concomitant laryngeal pathology and supraglottic structure insults contribute to development of the disease. Laryngoscopy is still the gold standard in diagnosis. Airway protection is mandatory but prophylactic intubation or tracheostomy are not advised. Intravenous antibiotics are necessary and corticosteroids may be of benefit.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Laryngoscopy ; Hyperemia ; Edema ; Deglutition Disorders ; Adrenal Cortex Hormones

OBJECTIVE: To present an atypical case of a live fish lodged in the throat of a pediatric patient and discuss its management.
METHODS:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
RESULT: An 8-year-old girl swallowed a live fish when she accidentally fell in a body of water. Failed attempts to remove the live fish prompted consult in the emergency room of our hospital, where removal of the foreign body was successfully done using Mixter right angle forceps assisted with a gloved finger. Transient cyanosis and unresponsiveness during extraction was overcome with oxygen by mask and she regained consciousness. She was allowed to go home as no other untoward events or complications were observed.
CONCLUSION: All ingested foreign bodies particularly in children require immediate attention. The survival of patients with upper aerodigestive and airway foreign bodies depends on early recognition and prompt multidisciplinary management.

Human ; Female ; Pharynx ; Consciousness ; Water ; Foreign Bodies ; Deglutition ; Tertiary Care Centers ; Surgical Instruments ; Emergency Service, Hospital ; Cyanosis ; Attention ; Oropharynx