Decompression of Ludwig Angina under Cervical Block

Abstract

LUDWIG angina is a potentially lethal, rapidly spreading cellulitis involving the floor of the mouth and neck. 1 Without aggressive management it often results in life threatening upper airway obstruction. 2 Prompt airway management is critical, but the presence of swelling of the neck, glottic edema, elevation of the tongue, trismus, or pharyngeal edema create formidable problems. 1 There is no consensus in the literature regarding airway management. The published recommendations vary and are based on each author's personal experience and available resources. We report a patient with Ludwig angina and severe airway compromise who presented at a remote field hospital. We successfully relieved airway obstruction by surgical decompression alone, using a cervical plexus block.