Epiglottitis. Twenty-year study with tracheotomy.

One hundred and seventy patients with acute epiglottitis were admitted to the Childrens Hospital of Los Angeles between the years 1957 to 1977. No deaths occurred in any of these patients, all of whom were treated with tracheotomy to support and ensure the airway. The records of 147 of these patients were available for review. No serious complications occurred from tracheotomy in any of the patients in this study. Tracheotomy is a safe method for caring for the airway problem in epiglottitis in a setting such as is available at the Childrens Hospital of Los Angeles. The median range of total days with tracheotomy was five to six days, and the median range for total days of hospitalization was six to seven days. Complications were never severe and in the extreme, merely prolonged hospitalization by a few days. This highly lethal disease is curable with antibiotics and an artificial airway, and it is questionable whether conservative medical measures with observation should be acceptable. The establishment of an airway, whether by tracheotomy or endotracheal intubation, is mandatory in the treatment of this disease.