title: Acute supraglottitis in adults: what's the optimal airway intervention?
abstract: OBJECTIVE
  To validate the Friedman stage and define the proper timing for airway intervention in adult cases of acute supraglottitis, we evaluated the clinical courses and management of adult patients.
  
  
  METHODS
  202 adult patients with acute supraglottitis were included in this study. The diagnosis of supraglottitis was established by flexible nasolaryngoscopic examination. Friedman stages were classified in each patient. In this study, the first three days of serial nasolaryngoscopic findings for each patient were evaluated.
  
  
  RESULTS
  All patients were treated successfully with only conservative methods. There were no significant differences between patients with Friedman stages I or II/III. Among the patients that had serial nasolaryngoscopic findings, only one patient presented with progressive swelling of the epiglottis, and there were no cases of persistent swelling.
  
  
  CONCLUSIONS
  The airway intervention threshold should be raised from Friedman stages II-III. And, airway intervention should not be needed if patients are tolerant of their respiratory discomfort.
authors: Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
authors: Hyun Ho
authors: HH
authors: Park
authors: Jong Cheol
authors: JC
authors: Lee
authors: Tae Hoon
authors: TH
authors: Lee
authors: Joong Keun
authors: JK
authors: Kwon
authors: Jung Kwon
authors: JK
authors: Nam
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000145:classification / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D059525:Supraglottitis / Q000145:classification / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D003907:Dexamethasone