Isolated uvular edema as an emergency – a retrospective monocentric analysis

Introduction Isolated edema of the uvula is often caused by mechanical stimuli, and the question arises whether it should be monitored and treated in the same way as angioedema (AE) of other origins in the head and neck region, which is potentially life-threatening.

Material and methods We conducted a retrospective analysis of all patients who presented with and were treated for isolated uvular edema at the ENT University Hospital Ulm over a period of 13 years (2010-2023).

Results 83.6% of patients were male, 16.4% female. The average age of the patients was 48 years (15-84). 40.4% of the patients had art. hypertension as a pre-existing condition, 13.5% OSAS. 26.9% of the patients had an ACE inhibitor in their own medication, 9.6% an AT-1 blocker and 42.3% no medication. The most likely cause of the edema was assumed to be mechanical irritation in 67.3%, an infectious etiology in 21.8%, a drug-related etiology in 27.3% and an allergic etiology in 10.9%. In 25.5% there were several differential diagnoses. 78.2% of the patients were treated with glucocorticoids, 7.3% with antibiotics, 30.9% with an H1 blocker and 32.7% with a combination. In no case did the edema progress to the surrounding tissue or other symptoms occur during the documented course.

Conclusion Isolated uvular edema occurs more frequently due to mechanical irritation and/or upper respiratory tract infection. Based on the available data, isolated uvular edema may require less rigorous monitoring compared to other head and neck region. It is also debatable whether ACE inhibitors must be discontinued in cases of isolated uvular edema.

Publication History

Article published online:
19 April 2024