ENTtoday
  • Home
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

What Is the Role of Laryngoscopy in Angioedema Isolated to the Lips, Without Laryngeal Symptoms?

by Temitope A. Adeyeni, MS; Aaron Domack, MD; Christopher Britt, MD • August 17, 2020

  • Tweet
  • Email
Print-Friendly Version

TRIO Best PracticeTRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.

You Might Also Like

No related posts.

Explore This Issue
August 2020

Background

Angioedema is defined as acute onset subcutaneous nonpitting or watery edema commonly localizing to the airway structures. Angioedema can be hereditary (C1 esterase deficiency) or acquired (angiotensin-converting enzyme inhibitors [ACEI], allergic reactions, and idiopathic etiologies). Regardless of etiology, the clinical presentation is similar but will vary in severity. In the head and neck, the face, lips, palate, and tongue are the most commonly involved subsites, with laryngeal involvement occurring less frequently (Laryngoscope. 2000;110:2016–2019). Depending on the sites of involvement and symptoms, patients can be stratified and managed accordingly.

Flexible laryngoscopy (FL) is a critical part of the angioedema workup because it localizes and qualifies the extent of airway involvement. Ideally, it would be used in cases that are suspicious for airway involvement. In practice, however, it is common to find that every patient presenting with angioedema will undergo FL, even when edema is limited to one facial subsite without airway symptoms. FL is generally a safe and efficient way to quickly evaluate the airway structures, so it is vulnerable to overuse. Theoretical complications associated with FL include epistaxis, emesis, aspiration, lacerations, ecchymoses, and perforations. These complications are rare and do not typically warrant deferral of the procedure. Patients more commonly report pain in the nose and throat, as well as discomfort in the forms of gagging sensation and/or transient dyspnea. Alternative forms of imaging used to evaluate the function of the larynx and vocal fold mobility include computed tomography scans and magnetic resonance imaging. However, they are not as useful in cases of angioedema, because they are not feasible as modalities of point-of-care testing. They take longer to perform, require nonportable advanced equipment, and tend to be more expensive than FL. The purpose of this review was to query the literature in an attempt to stratify patients who present with angioedema of any etiology of the head and neck into groups that do or do not need an endoscopic airway evaluation.

Best Practice

Patients with isolated face and lip angioedema, with no signs/symptoms of laryngeal and pharyngeal involvement, can be individually assessed for the need of FL. Symptomatic patients or those with multiple subsite involvement or oropharyngeal involvement require FL.

Pages: 1 2 | Single Page

Filed Under: Laryngology, TRIO Best Practices Tagged With: clinical outcomes, treatmentIssue: August 2020

You Might Also Like:

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Keeping Watch for Skin Cancers on the Head and Neck
    • Vertigo in the Elderly: What Does It Mean?
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Vertigo in the Elderly: What Does It Mean?
    • What Happens to Medical Students Who Don’t Match?
    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?
    • Resident Unions Are Growing in Popularity in Otolaryngology
    • Is Caring for the Homeless and Uninsured Really Someone Else’s Problem?
    • Otolaryngology Practices Use Digital Tools to Pre-authorize—With Mixed Results
    • A Look at the Past, Present, and Future of DEI Medical Education Initiatives
    • Barbie, Bullying, and Bravery: Ending Workplace Bullying Requires Strong Leadership

Polls

Do you think resident unions are a positive development for otolaryngology?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2023 The Triological Society. All Rights Reserved.
ISSN 1559-4939