Deep Neck Infection: Analysis of 80 Cases

Overview

Journal Braz J Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2008 Jun 24

PMID 18568205

Citations 19

Authors

Alexandre BabA Suehara

Antonio Jose Goncalves

Fernando Antonio Maria Claret Alcadipani

Norberto Kodi Kavabata

Marcelo Benedito Menezes

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Deep neck infections are serious diseases that involve several spaces in the neck. The most dreadful complication is descending necrotizing fasciitis, which needs early diagnosis and aggressive treatment.

Aim: To analyze 80 treated cases of deep neck infection and propose a schematic guideline for managing this disease.

Method: The authors present a retrospective analysis of 80 treated cases of deep neck infection, from June 1997 to June 2003.

Results: Odontogenic and tonsilar causes were the more frequent ones. Submandibular and parapharyngeal spaces were the most frequent location of deep neck infection. Staphylococcus aureus and Streptococcus sp were the microorganisms more commonly isolated.

Conclusions: Airway control should be priority in managing deep neck infections and if the patient has to be submitted to surgery special care should be taken at the moment of intubation - when curare must never be used. CT scan is the gold-standard imaging evaluation for the diagnosis of deep neck infection. Morbi-mortality is high when associated with septic shock and mediastinitis. Our mortality rate was 11.2% and only one, in five patients with mediastinitis, survived.

Citing Articles

Navigating the Airway Maze: Challenges and Strategies in Deep Neck Space Infections.

R M, R H, M V, R D, A S, M H Cureus. 2024; 16(10):e72337.

PMID: 39583498 PMC: 11585483. DOI: 10.7759/cureus.72337.

Antibiotic susceptibility of orofacial infections in Bratislava: a 10-year retrospective study.

Vavro M, Dvoranova B, Czako L, Simko K, Galis B Clin Oral Investig. 2024; 28(10):538.

PMID: 39304566 PMC: 11415437. DOI: 10.1007/s00784-024-05937-3.

Neck Space Infection: A Retrospective Study of 40 Cases at a Tertiary Care Center in Sibu, Malaysia.

Wong C, Chew S Indian J Otolaryngol Head Neck Surg. 2024; 76(3):2391-2403.

PMID: 38883552 PMC: 11169142. DOI: 10.1007/s12070-024-04475-4.

A rare case: Descending necrotizing mediastinitis.

Ayvaci B, Gokdag E Turk J Emerg Med. 2022; 22(4):230-232.

PMID: 36353386 PMC: 9639737. DOI: 10.4103/2452-2473.357345.

Role of early extraction of odontogenic focus in deep neck infections.

Trevino-Gonzalez J, Santos-Santillana K, Cortes-Ponce J, Gonzalez-Andrade B, Morales-Del-Angel J Med Oral Patol Oral Cir Bucal. 2022; 28(1):e25-e31.

PMID: 36173714 PMC: 9805327. DOI: 10.4317/medoral.25536.

References

Durazzo M, Pinto F, Loures M, Volpi E, Nishio S, Brandao L . [Deep neck spaces and their significance in cervical infections]. Rev Assoc Med Bras (1992). 1997; 43(2):119-26. DOI: 10.1590/s0104-42301997000200008. View

Cmejrek R, Coticchia J, Arnold J . Presentation, diagnosis, and management of deep-neck abscesses in infants. Arch Otolaryngol Head Neck Surg. 2002; 128(12):1361-4. DOI: 10.1001/archotol.128.12.1361. View

Levitt G . The surgical treatment of deep neck infections. Laryngoscope. 1971; 81(3):403-11. DOI: 10.1288/00005537-197103000-00008. View

Blomquist I, Bayer A . Life-threatening deep fascial space infections of the head and neck. Infect Dis Clin North Am. 1988; 2(1):237-64. View

Nicklaus P, Kelley P . Management of deep neck infection. Pediatr Clin North Am. 1996; 43(6):1277-96. DOI: 10.1016/s0031-3955(05)70519-8. View

Bahu S, Shibuya T, Meleca R, Mathog R, Yoo G, Stachler R . Craniocervical necrotizing fasciitis: an 11-year experience. Otolaryngol Head Neck Surg. 2001; 125(3):245-52. DOI: 10.1067/mhn.2001.118182. View

Estrera A, Landay M, Grisham J, Sinn D, Platt M . Descending necrotizing mediastinitis. Surg Gynecol Obstet. 1983; 157(6):545-52. View

Moncada R, Warpeha R, Pickleman J, Spak M, Cardoso M, Berkow A . Mediastinitis from odontogenic and deep cervical infection. Anatomic pathways of propagation. Chest. 1978; 73(4):497-500. DOI: 10.1378/chest.73.4.497. View

Tom M, Rice D . Presentation and management of neck abscess: a retrospective analysis. Laryngoscope. 1988; 98(8 Pt 1):877-80. DOI: 10.1288/00005537-198808000-00017. View

10.

Georgalas C, Kanagalingam J, Zainal A, Ahmed H, Singh A, Patel K . The association between periodontal disease and peritonsillar infection: a prospective study. Otolaryngol Head Neck Surg. 2002; 126(1):91-4. DOI: 10.1067/mhn.2002.121318. View

11.

Chen M, Wen Y, Chang C, Huang M, Hsiao H . Predisposing factors of life-threatening deep neck infection: logistic regression analysis of 214 cases. J Otolaryngol. 1998; 27(3):141-4. View

12.

Shockley W . Ludwig angina: a review of current airway management. Arch Otolaryngol Head Neck Surg. 1999; 125(5):600. DOI: 10.1001/archotol.125.5.600. View

13.

Sakaguchi M, Sato S, Ishiyama T, Katsuno S, Taguchi K . Characterization and management of deep neck infections. Int J Oral Maxillofac Surg. 1997; 26(2):131-4. DOI: 10.1016/s0901-5027(05)80835-5. View

14.

Holt G, McManus K, Newman R, POTTER J, Tinsley P . Computed tomography in the diagnosis of deep-neck infections. Arch Otolaryngol. 1982; 108(11):693-6. DOI: 10.1001/archotol.1982.00790590015005. View

15.

Johnson J, Tucker H . Recognizing and treating deep neck infection. Postgrad Med. 1976; 59(6):95-100. DOI: 10.1080/00325481.1976.11714389. View

16.

Virolainen E, Haapaniemi J, Aitasalo K, Suonpaa J . Deep neck infections. Int J Oral Surg. 1979; 8(6):407-11. DOI: 10.1016/s0300-9785(79)80078-2. View

17.

Parhiscar A, Har-El G . Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol. 2001; 110(11):1051-4. DOI: 10.1177/000348940111001111. View

18.

Heindel D . Deep neck abscesses in adults: management of a difficult airway. Anesth Analg. 1987; 66(8):774-6. View

19.

Furst I, Ersil P, Caminiti M . A rare complication of tooth abscess--Ludwig's angina and mediastinitis. J Can Dent Assoc. 2001; 67(6):324-7. View

20.

Munoz A, Castillo M, Melchor M, Gutierrez R . Acute neck infections: prospective comparison between CT and MRI in 47 patients. J Comput Assist Tomogr. 2001; 25(5):733-41. DOI: 10.1097/00004728-200109000-00011. View