2025 The Journal of emergency medi…

Floor of the Mouth Ultrasound Assessment in Ludwig's Angina.

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The Journal of emergency medicine Vol. 74 : 86-91 • Jul 2025

BACKGROUND: Ludwig's angina is a rapidly progressive infection of the floor of the mouth (FOM) that can lead to airway compromise if not promptly diagnosed and treated. Although diagnosed clinically, computed tomography is often used for confirmation. DISCUSSION: In this article, we present a novel point-of-care ultrasound technique for evaluating the FOM which assisted in accurately diagnosing a patient who presented to the Emergency Department with Ludwig's angina. The FOM ultrasound (FOMUS) protocol utilizes both linear and curvilinear probes for transdermal evaluation of the anterior neck and lateral mandible. By combining B-mode (brightness mode), color Doppler, and patient positioning techniques, it allows for effective assessment of deep space infections in the submandibular region. CONCLUSION: The novel FOMUS protocol offers a potential standardized approach to imaging the FOM for the diagnosis and management of Ludwig's angina. Further research on the proposed FOMUS protocol is needed to evaluate its diagnostic accuracy and define its clinical utility.

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