Full Project – The management of ludwig’s angina among adult patient

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CHAPTER ONE

• INTRODUCTION
  • BACKGROUND OF THE STUDY

Ludwig’s Angina was coined after the German physician, whiliem Friend rich von Ludwig who first described this condition in 1936 as a rapidly and frequently Ederma of the neck and floor of the mouth (Historical perspective Dent Ass. 2012). With a progressive swelling of soft tissues and elevation and posterior displacement of the tongue, the most life threatening complication of Ludwig’s Angina is airway abstraction. (Historical perspective dent assoc, 2012).

Prior to development of antibiotic mortality for Ludwig’s Angina exceeded 50% as a result of antibiotic theraphy, along with improved imaging modalities and surgical techniques, mortality, currently averages approximately 8% ( Historical perspective dent assoc, 2012).

Once infection develops, it spread continuously to the sublingual space. Infection can also spread continuously to involve the pharyngo-maxilary and retropharyngeal space, there by enriching the airway-journal of general internal medicine (2012). Other courses include peritonsillar or raphatyngeal abscesses, mandibular fracture, opral lace ration/piecing or submandibular sialadentitis, and oral malignancy. (Journal of general internal medicine 2010).

Predisposing factors include dental caries, vecent dental treatment, systematic illness, such as diabetes mellitus, malnutrition, alcoholism. Comprised ummune system such as aids and organ transplantation. (Journal general internal medicine 2010).

With a treatment, it is frequently fatal from the risk of asphyxia with a mortality rate of 50%, the aggressive surgical intervention, the antibiotic introduction and the improvement of dental care have determined a significant and reduction of the mortality rate to less than 10% (Journal general internal medicine 2012).

Ludwig’s Angina otherwise known as angina ludwig’s is a serious potential life threatening cellulitis dead link or connective tissue infection and it left untreated, may obstruct the airway and necessitating tracheotomy, it is a German physician, wilhem friendrich von Ludwig’s who first described this condition in 1836. Other names include Angina Maliga and Angina strangularis. (Rowky, 2013).

Ludwig’s Angina should not be confused with Angina pectoris which is also otherwise community known as “Angina”.

The word “Angina” comes from a Greek word Angina, meaning “strangling” not the feeling of chest pain, through there may be chest pain in Ludwig’s Angina if the infection spread into retrosternal space (ollapalill, 2013).

The life threatening nature of this condition generally necessitate surgical management with involvement of critical care and physicians such as those in a intensive care unit (ollapelill, 2013).

In Ludwig’s Angina, the submandibular space is the primary site of infection.

This space is subdivided by the mylohyoid muscle into the submaxillary space inferiorly. The majority of cases of Ludwig’s Angina are ondontogenic in etiology, primary resulting from infection of the second and third molars. The root of these teeth penetrate the mylohyoid ridge such that any abscess, or dental infection, has direct access to the submaxillary space once infection develops. It spreads contiguously to the sublingual space infection can also spread contagiously to involve the pharyngomaxillary and retropharyngeal space, there by encioching the airway.

Other cause include peritonsillar or parapharangeal abscess, mandibular fractures, oral laceration/pierching or submandibular sialadentities and oral caries, recent dental treatment, systemic illness such as diabetes mellituss, malnutrition, alcoholism, compromised immune system such as AIDs and organ transplantation. Without a treatment, it is frequently fatal from the risk and asphyxia with a mortality rate of 50%. The aggressive surgical intervention, the antibiotic introduction. And the improvement of dental care have determined a significant reduction of the mortality rate to less than 10%.

• STATEMENT OF THE PROBLEM

Ludwig’s Angina is common in adult from 30-60 years. This is because the set of permanent teeth his fully erupted. The root of infection in most cases is from infection lower molar or from pericoronitis. Although, the wide spread involvement seen in Ludwig’s Angina usually develop in otherwise healthy individuals (Larwin et al 2010).

• PURPOSE OF THE STUDY
  • To find out some of the possible causes and predisposing factors of Ludwig’s Angina among adult patient in Zamfara metropolis.
  • To find out the prevalence of Ludwig’s Angina among adult patient in Zamfara metropolis.
  • To know the measure for management, prevention controlling and treatment of Ludwig’s Angina among adult patient in Zamfara metropolis.
• SIGNIFICANCE OF THE STUDY

The importance of the study is to create awareness about Ludwig’s Angina to the people of Zamfara and its environments especially the public of Niger that report to FMC with cases of Ludwig’s Angina.

Also, this research aim to enlighten people about the implication or implication associated with Ludwig’s Angina. This personnel, state and federal government agencies and parastatals, and other non-government organizations.

This study will serve as a recommendation to possible measure of treatment, prevention and condition and facilitate the creation of more dental clinic with training of more dentist and auxillary dental personnel.

• RESEARCH QUESTION
  • What are the possible couses and predisposing factors of Ludwig’s Angina among adult patient in Zamfara metropolis?
  • What are the prevent it Ludwig’s Angina among adult patient in Zamfara metropolis?
  • What are the measure for management, prevention, controlling and treatment of Ludwig’s Angina among adult patient in Zamfara metropolis?
• RESEARCH HYPOTHESIS

HO: there is significant difference in which causes, predisposing factors, and other conditions that are contributing to the onset and spread as well as the management prevention control and treatment of Ludwig’s Angina can be identified.  

• SCOPE OF THE STUDY

This study indicate the content limit of the incidence of Ludwig’s Angina among the people in Zamfara metropolis attending the Federal Medical Centre Hospital (FMC) Zamfara state and was measure and analyzed to cover all the patient attending such health facility.

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Full Project – The management of ludwig’s angina among adult patient