January 15, 2013

Video of Epiglottitis

The normal epiglottis is a very thin flap of tissue that closes over the windpipe when swallowing preventing food/liquids from going down the wrong way. Shown by the blue arrow in the picture, when the epiglottis becomes infected, it can swell in size to even obstruct the airway leading to death by asphyxiation. Indeed, epiglottitis is what is thought to have killed our first President George Washington.

Fortunately, epiglottitis is quite rare ever since the introduction and regular use of the Hib vaccine in the 1980s. Although rare, it is a problem that still occurs intermittently even today. Each time I've encountered it in the past, I unfortunately was always in a situation whereby video recording of the endoscopic exam was not possible.

Until one day, a patient with epiglottitis did walk into my clinic and I WAS able to video-record the endoscopic exam.

Briefly, this patient developed a severe sore throat with difficulty swallowing that occurred suddenly over a 24 hour period of time. Patient reported the severe sore throat was localized to the base of tongue region.

Without further ado, here's the endoscopic examination both before treatment and then again 1 week later after a course of antibiotics and steroids.

Note the markedly swollen epiglottis before treatment. Even after treatment, the epiglottis is still mildly swollen though much improved. Normal is shown in the picture above.

In 2018, I encountered another patient I was able to video record the exam over 7 days.

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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