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International Journal of Otolaryngology
Volume 2011, Article ID 231816, 4 pages
Case Report

Ludwig's Angina—A Controversial Surgical Emergency: How We Do It

1Otolaryngology/Head & Neck Surgery Department, University College Dublin, Dublin 4, Ireland
2Otolaryngology/Head & Neck Surgery Department, St. Vincent's University Hospital, Dublin 4, Ireland

Received 24 August 2010; Revised 25 March 2011; Accepted 26 April 2011

Academic Editor: Collin S. Karmody

Copyright © 2011 Wael Hasan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To review the current protocols used for management of Ludwig's angina and to assess the efficacy of conservative measures in these cases. Methods. A retrospective review of patients who were admitted to our institution for management of Ludwig's angina between 2003 and 2010. Results. Two patients were identified. Both were managed successfully with conservative measures and close airway observation. None needed an emergency intubation or surgical tracheostomy. There were no mortalities, and both had a short hospital stay. Conclusion. Recently, management of Ludwig's angina has evolved from aggressive airway management into a more conservative one. This is based on close airway observation on a specialised airway unit and a serial clinical airway assessment. Improved imaging modalities, antibiotic therapy, surgical skills, and clinical experience are the key factors behind this change in practice.