A reappraisal of the radiologic findings of acute inflammation of the epiglottis and supraglottic structures in adults

W. R. Nemzek, Richard W Katzberg, M. A. Van Slyke, L. S. Bickley

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

PURPOSE: To evaluate the radiologic characteristic of acute inflammation of the epiglottis and supraglottic structures in adults. METHODS: The clinical and radiographic findings in 27 adult patients with epiglottitis (average age, 43 years; range, 28 to 81 years) were compared with those of a control group of asymptomatic subjects (n = 15; average age, 48 years; range, 24 to 79 years). Unusual clinical aspects in the current series included two patients who were positive for human immunodeficiency virus, 1 with acquired immunodeficiency syndrome and Kaposi sarcoma, 3 with emphysematous epiglottitis, 1 with abscess formation, and 1 with laryngeal carcinoma. One patient required emergency tracheostomy. One patient died of pneumonia. RESULTS: The ratio of the soft-tissue parameters to the anteroposterior width of the C-4 vertebral body yielded three key parameters of high statistical significance in adult epiglottitis. The ratio of the width of the epiglottis to the anteroposterior width of C-4 should not be greater than 0.33 (sensitivity, 96%; specificity, 100%). The ratio of the prevertebral soft tissue to C-4 should not exceed 0.5 (sensitivity, 37%; specificity, 100%) and the ratio of the width of the hypopharyngeal airway to the width of C-4 should be less than 1.5 (sensitivity, 44%; specificity, 87%). The aryepiglottic folds were enlarged in 85%, and the arytenoids were swollen in 70% of the patient population (specificity, 100%). CONCLUSION: These defined radiologic parameters should aid in the diagnosis of acute epiglottitis in adults.

Original languageEnglish (US)
Pages (from-to)495-502
Number of pages8
JournalAmerican Journal of Neuroradiology
Volume16
Issue number3
StatePublished - 1995

Fingerprint

Epiglottis
Epiglottitis
Inflammation
Kaposi's Sarcoma
Tracheostomy
Abscess
HIV-1
Pneumonia
Acquired Immunodeficiency Syndrome
Emergencies
Carcinoma
Control Groups
Population

Keywords

  • Larynx, epiglottis
  • Neck, inflammation
  • Neck, radiography

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

A reappraisal of the radiologic findings of acute inflammation of the epiglottis and supraglottic structures in adults. / Nemzek, W. R.; Katzberg, Richard W; Van Slyke, M. A.; Bickley, L. S.

In: American Journal of Neuroradiology, Vol. 16, No. 3, 1995, p. 495-502.

Research output: Contribution to journalArticle

Nemzek, W. R. ; Katzberg, Richard W ; Van Slyke, M. A. ; Bickley, L. S. / A reappraisal of the radiologic findings of acute inflammation of the epiglottis and supraglottic structures in adults. In: American Journal of Neuroradiology. 1995 ; Vol. 16, No. 3. pp. 495-502.
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abstract = "PURPOSE: To evaluate the radiologic characteristic of acute inflammation of the epiglottis and supraglottic structures in adults. METHODS: The clinical and radiographic findings in 27 adult patients with epiglottitis (average age, 43 years; range, 28 to 81 years) were compared with those of a control group of asymptomatic subjects (n = 15; average age, 48 years; range, 24 to 79 years). Unusual clinical aspects in the current series included two patients who were positive for human immunodeficiency virus, 1 with acquired immunodeficiency syndrome and Kaposi sarcoma, 3 with emphysematous epiglottitis, 1 with abscess formation, and 1 with laryngeal carcinoma. One patient required emergency tracheostomy. One patient died of pneumonia. RESULTS: The ratio of the soft-tissue parameters to the anteroposterior width of the C-4 vertebral body yielded three key parameters of high statistical significance in adult epiglottitis. The ratio of the width of the epiglottis to the anteroposterior width of C-4 should not be greater than 0.33 (sensitivity, 96{\%}; specificity, 100{\%}). The ratio of the prevertebral soft tissue to C-4 should not exceed 0.5 (sensitivity, 37{\%}; specificity, 100{\%}) and the ratio of the width of the hypopharyngeal airway to the width of C-4 should be less than 1.5 (sensitivity, 44{\%}; specificity, 87{\%}). The aryepiglottic folds were enlarged in 85{\%}, and the arytenoids were swollen in 70{\%} of the patient population (specificity, 100{\%}). CONCLUSION: These defined radiologic parameters should aid in the diagnosis of acute epiglottitis in adults.",
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N2 - PURPOSE: To evaluate the radiologic characteristic of acute inflammation of the epiglottis and supraglottic structures in adults. METHODS: The clinical and radiographic findings in 27 adult patients with epiglottitis (average age, 43 years; range, 28 to 81 years) were compared with those of a control group of asymptomatic subjects (n = 15; average age, 48 years; range, 24 to 79 years). Unusual clinical aspects in the current series included two patients who were positive for human immunodeficiency virus, 1 with acquired immunodeficiency syndrome and Kaposi sarcoma, 3 with emphysematous epiglottitis, 1 with abscess formation, and 1 with laryngeal carcinoma. One patient required emergency tracheostomy. One patient died of pneumonia. RESULTS: The ratio of the soft-tissue parameters to the anteroposterior width of the C-4 vertebral body yielded three key parameters of high statistical significance in adult epiglottitis. The ratio of the width of the epiglottis to the anteroposterior width of C-4 should not be greater than 0.33 (sensitivity, 96%; specificity, 100%). The ratio of the prevertebral soft tissue to C-4 should not exceed 0.5 (sensitivity, 37%; specificity, 100%) and the ratio of the width of the hypopharyngeal airway to the width of C-4 should be less than 1.5 (sensitivity, 44%; specificity, 87%). The aryepiglottic folds were enlarged in 85%, and the arytenoids were swollen in 70% of the patient population (specificity, 100%). CONCLUSION: These defined radiologic parameters should aid in the diagnosis of acute epiglottitis in adults.

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