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June 1988

Acute Supraglottitis (Epiglottitis): To Look or Not?

Am J Dis Child. 1988;142(6):597. doi:10.1001/archpedi.1988.02150060031021

In this issue of AJDC, Mauro et al1 have presented some challenging data. This study reports their observations on direct examination of the epiglottis in sequential fashion, taking care not to touch the epiglottis, nor to visualize the glottis, in children presenting with acute stridor. The review of this report by expert referees, members of the editorial board, ad hoc consultants, and the chief editor resulted in divergent opinions on the safety of the methods used, the actual numbers of children involved, the rate of complications, the potential "danger" if this method were applied across a broader spectrum of children with stridor, and the adequacy of follow-up. I originally rejected this report on the basis of potential "danger" and on the variable assessments, from which I could not gain a clear consensus for acceptance. The authors responded, in spirited but logical fashion, requesting that the