Videolaryngoscope-assisted coblation of epiglottic cysts

Rising Incidence of Acute Epiglottitis in Eastern China: An Eight-Year Retrospective Study and Its Association with the 24 Solar Terms

Purpose

This study aimed to investigate the clinical characteristics of acute epiglottitis (AE) patients in East China and examine the correlation between the incidence of AE and the 24 solar terms (24 STs).

Methods

A retrospective, observational study was conducted on patients diagnosed with AE between January 2014 and December 2021 at a single-center medical institution in East China. The clinical characteristics of patients with AE and their correlation with the 24 STs were investigated.

Results

A total of 287 patients with AE were included in this study, among which there were 179 males (62.37%) and 108 females (37.63%), with a mean age of 47.79 ± 13.83 years (range 16-87 years). Of these patients, 100 (34.84%) had at least one comorbidity and the most common comorbidities were hypertension, smoking and type 2 diabetes. The duration of hospitalization was 3 days (IQR, 1-16 days). All patients, except for one who required tracheal intubation, were cured with intravenous antibiotic administration and the combined use of corticosteroids. The incidence of AE showed significant fluctuations between the 24 STs and the highest number of cases occurred during the Summer solstice (24 cases, 8.36%).

Conclusion

The incidence of AE was seen to increase annually in this study. The main features of AE are sore throat, dysphagia, odynophagia and fever, which may be accompanied by inflammation in surrounding areas. A clear correlation exists between the incidence of AE and the fluctuations within the 24 STs, notably with the peak incidence observed during the Summer solstice, which approximately corresponds to June 21 to July 7 in the Gregorian calendar.

Difficult endotracheal intubation due to a large epiglottic cyst: A case report

RATIONALE

An epiglottic cyst is a type of benign tumor that is formed due to the obstruction of the mucinous duct and the retention of glandular secretion. In such cases, the glottis is not visible as it is covered by the enlarged epiglottic cyst. When conventional anesthesia is administered in such patients, they might have difficulty ventilation since the epiglottic cyst can easily form a flap and move with external pressure changes and can cause the blockage of the glottis due to the loss of consciousness and the relaxation of the throat muscles of the patient. If endotracheal intubation is not initiated and effective ventilation is not established, the patient may suffer from hypoxia and other accidents.

PATIENT CONCERNS

A 48-year-old male presented to the otolaryngology department with a foreign body sensation in the throat.

DIAGNOSES

A large epiglottic cyst was diagnosed.

INTERVENTIONS

The patient was planned to undergo epiglottis cystectomy under general anesthesia. After induction of anesthesia, the cyst severely covered the glottis and made endotracheal intubation difficult. The anesthesiologist rapidly adjusted the position of the laryngeal lens; thus, the endotracheal intubation was successful under the visual laryngoscope.

OUTCOMES

The endotracheal intubation was successful under the visual laryngoscope and the operation went well.

LESSONS

Patients with epiglottic cysts are more likely to have difficult airways after induction of anesthesia. Anesthesiologists should take preoperative airway assessment seriously, efficiently handle difficult airway and intubation failure, and make quick and correct choices to ensure patient safety.

Clinical effect of CO2 laser resection of the epiglottic cyst under micro-laryngoscope suspension

BACKGROUND

Epiglottic cysts are common diseases and have multiple morbidity, and traditional surgery causes intraoperative bleeding and postoperative recurrence.

OBJECTIVE

To investigate the therapeutic effect of CO₂ laser resection on epiglottic cyst when compared with traditional surgery.

METHOD

Eighty patients with epiglottic cysts were randomly enrolled into the CO₂ laser group (44 patients) and the high-frequency electrocautery group (36 patients).

RESULTS

The CO₂ laser group had a shorter operation time, less blood loss and fewer intraoperative ruptured cysts (p < .05). The duration of sore throat and the time before wound redness and swelling subsidence in the CO₂ laser group were significantly shorter than those in the high-frequency electrocautery group (p < .05). Within one year after the operation, the incidence of epiglottic scar contracture in the CO₂ laser group was significantly lower than that in the high-frequency electrocautery group (p < .05).

CONCLUSION

The CO₂ laser group has the advantages of minimally invasive, less bleeding, short operation time and less postoperative complications, and it is worthy of applying as clinical routine to treat epiglottic cysts.