The incidence of epiglottic cysts in a cohort of adults with acute epiglottitis

Clin Otolaryngol. 2010 Feb;35(1):18-24. doi: 10.1111/j.1749-4486.2009.02069.x.

Abstract

Objective: To evaluate the effects of a coexisting epiglottic cyst on the clinical course and airway management of acute epiglottitis in adults. A review of the airway risk factors were studied in adults with acute epiglottitis in South Korea from 1997 to 2009.

Design: Retrospective chart review.

Setting: Academic tertiary care referral medical center.

Participants: The study included 117 adult patients that were diagnosed with acute epiglottitis laryngoscopically over a period of 12 years. Two distinct groups were identified: one with acute epiglottitis associated with an infected epiglottic cyst (n = 29, 25%) and the other with acute epiglotittis without a cyst (n = 88, 75%).

Main outcome measures: Patient background data, clinical manifestations, laboratory data, airway management, outcomes, and recurrence were recorded.

Results: Eight (28%) out of 29 patients with an infected epiglottic cyst required airway intervention compared to the four (5%) out of 88 patients without a cyst. The difference between the two groups was statistically significant (P = 0.001). Five out of six patients with recurrent acute epiglottitis had a coexisting epiglottic cyst. The recurrence of acute epiglottitis in patients with a cyst was significantly more frequent (P = 0.003). Twelve patients (10%) required airway intervention. There was no mortality found in this study. Logistic regression analysis showed that an older age, dyspnoea, a high pulse rate, and the presence of an epiglottic cyst were associated with an increased risk for airway obstruction.

Conclusions: The results of this study showed that a pre-existing epiglottic cyst might be associated with a suppurative infection of the supraglottis. Infected epiglottic cysts increased the risk for airway obstruction and recurrence of acute epiglottitis.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Cysts / epidemiology*
  • Cysts / pathology
  • Epiglottis / pathology*
  • Epiglottitis / epidemiology*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult