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Sir.—I recently had the privilege of being requested to critique the article by Mauro and colleagues. Following are some of my thoughts.
This is an excellent article that really tries to shine light where we need it most.
The greatest limitation of this study is that it covers only six cases of acute epiglottitis. Therefore, no conclusion can be drawn regarding the safety and advisability of direct visualization of the epiglottis in these patients.
The authors should be encouraged strongly to continue their study until they have accumulated a meaningful number of acute epiglottitis cases so as to make conclusions regarding criteria for as well as the safety of the actual visualization.
Other means of visualization, such as the flexible nasopharyngoscope, should be included in that study.
Correlations of 19 criteria were examined and their predictive values for epiglottitis and laryngotracheitis were studied. Unfortunately, only three of the 19 criteria
BELLENS EE. Oropharyngeal Examination for Suspected Epiglottitis. Am J Dis Child. 1988;142(12):1263. doi:10.1001/archpedi.1988.02150120017007