LUDWIG’S ANGINA

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The Correct answer is d)sublingual & submental cellulitis



Oxford Handbook of ENT and Head and Neck Surgery (Oxford Handbooks)LUDWIG’S ANGINA

It is suppuration of the floor of the mouth.
Cause:
  • Dental infection or spread of suppuration from another area.
Clinical picture:
  • General: Fever, malaise, irritability, airway obstruction, and severe pain.
  • Local:
  1. External swelling: submandibular with signs of acute inflammation with cervical lymph node enlargement.
  1. Internal swelling: edema of the mucosa – elevation of the floor of the mouth – protrusion of the tongue.
  2. Trismus, dysphagia – salivation – change of voice.
Complications:
    1. Laryngeal edema ® suffocation.
    2. Spread to other spaces.
Treatment:
  • All cases should be hospitalized. Initial therapy in the early stages is tried with aggressive parenteral broad spectrum antibiotics, hydration and analgesics.
  • Surgical drainage is required in most of the cases. This is done through an external submandibular incision below and parallel to the body of the mandible.

  • Tracheostomy in case of laryngeal obstruction.

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