Publication:

Bedside emergency tracheostomy in Ludwig neck- a dilemma: case report

A stony hard rigid neck is the typical presentation in the angina of Von Ludwig. Suddenly with excruciating pain generalized severe cellulitis of the neck is noticed. It flares up quickly and extends on either side, in the submandibular, sublingual and submental triangles thereby manifesting as a medical emergency. This necessitates a prompt diagnosis and intervention medical or surgical as the case maybe, lest a life maybe lost. A neck swelling secondary to self-manipulation of a loose dental plate with impacted wire is being reported. This odontogenic infection had accessed the deeper tissues of a neck with elevation of the floor of the mouth obstructing the airway with consequent breathlessness and stridor; with need to regain his airway by emergency tracheostomy. At the same time a cervical fasciotomy was undertaken to drain the potentially involved spaces.