Subglottic laryngitis--Changes in therapy approach over the past 20 years.
OBJECTIVE
To show changes in the management of subglottic laryngitis over the last twenty years in Croatia.


METHODS
We sent questionnaires to paediatricians and otolaryngologists (ENT) in 9 Croatian hospitals in 1993, 2003 and 2013. In the questionnaire we presented a case of a child with moderately difficult subglottic laryngitis, after which they had to answer questions about the management of this kind of a patient and common therapy practice in their hospitals. All data were categorical, described in absolute frequencies and with relative percentages. The Cochran-Armitage test for trend was used in the analysis of different treatments over the years among ENT and paediatricians. Associations were statistically significant if p<0.05.


RESULTS
During a twenty-year period main novelties included the introduction of racemic epinephrine use (ENT from 3.3% in 1993 to 92.3% in 2013; paediatricians from 17.2% in 1993 to 100.0% in 2013) and downfall of humidification (ENT from 60.0% to 23.3%; paediatricians from 60.0% to 12.0%), antibiotic (ENT from 53.0% to 2.3%; paediatricians from 21.0% to 0.0%) and antihistaminic use (ENT from 67.7% to 0%; paediatricians from 43.2% to 2%), while corticosteroids (both parenteral and nebulized form) remained the cornerstone in treatment of moderately severe subglottic laryngitis.


CONCLUSIONS
Main novelties included the use of racemic epinephrine and downfall of antibiotic, antihistaminic and humidification therapy use, while corticosteroids remained the cornerstone in the treatment of moderately severe subglottic laryngitis. Differences between approaches among specialities are minimized during 20-year period.
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center "Sisters of Mercy", Vinogradska cesta 29, 10000 Zagreb, Croatia. Electronic address: apangercic@gmail.com.
Ana
A
Penezić
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center "Sisters of Mercy", Vinogradska cesta 29, 10000 Zagreb, Croatia; Zagreb School of Medicine, Šalata 3b, 10000 Zagreb, Croatia.
Mirko
M
Ivkić
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center "Sisters of Mercy", Vinogradska cesta 29, 10000 Zagreb, Croatia.
Boris
B
Ivkić
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center "Sisters of Mercy", Vinogradska cesta 29, 10000 Zagreb, Croatia; Zagreb School of Medicine, Šalata 3b, 10000 Zagreb, Croatia.
Tomislav
T
Baudoin
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D017523:Croatia; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D000068998:Humidifiers; D007827:Laryngitis / Q000628:therapy*; D010036:Otolaryngology / Q000639:trends; D010372:Pediatrics / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000639:trends*; D064705:Racepinephrine / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents; D006633:Histamine Antagonists; D064705:Racepinephrine
Corticosteroids; History; Racemic epinephrine; Subglottic laryngitis; Therapy