Sir.—Doctors Gwinn and Lee have done an excellent job presenting the clinical and roentgenographic findings in acute epiglottitis in the February issue of the Journal (130:195, 1976). Their brief paragraph regarding treatment of this condition is anachronistic however.1
Several published articles2-7 and personal experience dictate that in 1976 nasotracheal intubation is the treatment of choice in acute epiglottitis, and tracheostomy has no place except in those rare cases where intubation cannot be accomplished.
Hopefully, pediatricians reading this RADIOLOGICAL CASE OF THE MONTH will benefit from the diagnostic discussion, but base their therapeutic decisions on other information and save their patients from needless tracheostomy.
DILIBERTI JH. Acute Epiglottitis. Am J Dis Child. 1976;130(6):676. doi:10.1001/archpedi.1976.02120070102024