Laryngeal abscess

Case contributed by Dr Ian Bickle

Presentation

Five day history of dysphagia and hoarse voice. Raised inflammatory markers. Diagnosed as a new diabetic on admission.

Patient Data

Age: 70 years
Gender: Male
CT

Tracheostomy and NG tubes in situ.

Surgical emphysema and inflammatory change in the soft tissues of the mediastinum and neck in keeping with recent tracheostomy.

Subglottic collection superior to the tracheostomy which totally occludes the airway.  Fluid extends superolateral to the right side of the laryngeal cartilage.

Thickening of the false cords, more pronounced on the right. The true cords are thickened, worse on the right. 

No enlarged cervical nodes.

Right maxillary sinus mucosal thickening.

Case Discussion

Laryngeal abscesses are very uncommon.1

This case presented with an airway emergency due to total airway occlusion meriting an emergency tracheostomy.

At surgery edematous false cords were identified and pockets of pus. 

False cord biopsy:  abscess.  No evidence of malignancy.

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