Use of bedside sonography for diagnosing acute epiglottitis in the emergency department: a preliminary study.
OBJECTIVE
The purpose of this study was to investigate the ability of sonography to identify acute epiglottitis in the emergency department.


METHODS
Fifteen patients with a final diagnosis of acute epiglottitis from indirect laryngoscopy by an otolaryngologist were enrolled in the study. To compare the normal epiglottis and acute epiglottitis, 15 healthy volunteers were assigned to a control group. The sonographic appearances of the epiglottitis and the pre-epiglottic space were recorded. The anteroposterior diameter of the epiglottis at the midpoint and both edges in a transverse view was measured in all participants.


RESULTS
A statistically significant difference (P < .001) was observed in the anteroposterior diameter of the epiglottis at the midpoint and both lateral edges between the patients and healthy volunteers. However, there was overlap in the ranges for the midpoint but no overlap in both lateral edges between groups. The upper-limit value for the healthy control group was 3.2 mm at both lateral edges, whereas the cutoff values of the right and left edges were 3.7 and 3.6 mm, respectively, according to the lower-limit value for the epiglottitis group.


CONCLUSIONS
The anteroposterior diameter of the epiglottis was significantly different between the patients with epiglottitis and the healthy volunteers. Because of this significant difference in the anteroposterior diameter of the epiglottis, sonography can be used as a rapid, noninvasive, and effective diagnostic tool for identifying cases of epiglottitis in the emergency department.
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea.
Dong Ryul
DR
Ko
Yong Eun
YE
Chung
Incheol
I
Park
Hye-Jeong
HJ
Lee
Jong Woo
JW
Park
Je Sung
JS
You
Tae Nyoung
TN
Chung
Yoo Seok
YS
Park
Sung Phil
SP
Chung
Seungho
S
Kim
D000208:Acute Disease; D000328:Adult; D004636:Emergency Service, Hospital; D004825:Epiglottis / Q000000981:diagnostic imaging; D004826:Epiglottitis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography