Efficacy of Spinal Needle Aspiration in Patients with Epiglottic Abscess: A Prospective, Randomized, Controlled Study.
OBJECTIVE
To evaluate the efficacy of spinal needle aspiration for symptom improvement in awake patients with epiglottic abscess (EA).


METHODS
Prospective randomized controlled study.


METHODS
Tertiary center.


METHODS
Twenty-two patients who were diagnosed with EA were randomly allocated to group A (needle aspiration and antibiotics) or group B (antibiotics only). Patients' characteristics, laryngoscopic findings of epiglottic swelling and arytenoid swelling by scope classification, and initial laboratory findings were analyzed. Needle aspiration was done under local anesthesia in awake patients using an 18-gauge spinal needle and indirect laryngoscope. Changes in the following symptoms during hospital stay were assessed: sore throat, hoarseness, dyspnea, odynophagia, and dysphagia.


RESULTS
Eleven patients were treated with needle aspiration and antibiotics, and 11 patients were treated with antibiotics only. There was no statistically significant difference between the 2 groups regarding age, sex, white blood cell count, C-reactive protein, presenting clinical symptoms, abscess size, and scope classification at time of diagnosis. Patients in both groups had significant improvement in all clinical symptoms. While there were no between-group differences in improvement for any of the symptoms, the length of hospitalization was significantly lower in group A (4.0 ± 1.9 days) than in group B (5.7 ± 1.2 days) (P = .037).


CONCLUSIONS
We did not find any significant additional benefit of needle aspiration for the treatment of EA, with the exception that needle aspiration reduced the length of hospitalization. Further proof with a large-scale study is needed.
Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea.
Young Chan
YC
Lee
Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea.
Jung-Woo
JW
Lee
Department of Otolaryngology, Samsung Changwon Hospital, Sungkyun-kwan University School of Medicine, Changwon, Korea.
Gi Cheol
GC
Park
Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea ygeun@hanmail.net.
Young Gyu
YG
Eun
D000038:Abscess / Q000628:therapy*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004826:Epiglottitis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007278:Injections, Spinal / Q000295:instrumentation; D007828:Laryngoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009339:Needles; D011446:Prospective Studies; D013396:Suction / Q000295:instrumentation*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents
abscess; aspiration; epiglottitis; symptom