Pathological characteristics of the epiglottis relevant to acute epiglottitis

Objective

The characteristic swelling of acute epiglottitis is thought to be caused by histological factors in the epiglottis. We investigated the relationships between histological findings and the pathology of acute epiglottitis.

Methods

We examined 23 autopsy cases. For 16 of these, histological assessments were performed. In the remaining 7 subjects, physiological saline was injected at the lingual tonsil.

Results

These histological findings revealed abundant laryngeal glands on the laryngeal surface compared with the lingual surface. With regard to the blood vessels and lymphatic vessels, more of these vessels tended to be apparent on the lingual surface compared with the laryngeal surface. In each of the physiological saline injected subjects, almost no swelling of the lingual tonsil occurred, but the lingual surface of the epiglottis was swollen, and morphological changes had occurred that resembled those in acute epiglottitis.

Conclusion

Periepiglottic tissues are rich in lymphatic tissues, and it appears easy for inflammation to spread to the epiglottis itself via the gland's own rich networks of blood and lymphatic vessels. In addition, according to the video observation, it appeared that the liquid ingredient that exudes at the inflamed the lingual tonsil may cause swelling the lingual surface of the epiglottis.