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2015 ; 67
(Suppl 1
): 134-7
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Treatment and prognosis of deep neck infections
#MMPMID25621269
Motahari SJ
; Poormoosa R
; Nikkhah M
; Bahari M
; Shirazy SM
; Khavarinejad F
Indian J Otolaryngol Head Neck Surg
2015[Mar]; 67
(Suppl 1
): 134-7
PMID25621269
show ga
Deep neck infections could have serious threats for life of patients, if not
noticed adequately. Early diagnosis and correct treatment planning can save the
patient's lives and prevent complications of disease extension and also surgical
procedures that in some instances may be performed in an emergent situation with
higher complication rates. Herein, we have studied 815 cases of deep neck
abscesses and infections with especial consideration to treatment and prognosis.
In a retrospective case review, we studied 815 cases admitted in our medical
center from 1998 until the year 2013. Only patients with abscesses or infections
deeper than superficial layer of deep cervical fascia were included in this
study, based on the review of their medical records. From 815 cases (485 males
and 330 females) surgery was indicated and performed in 428 cases and the rest
were treated medically. In cases with dental infections as the etiologic factor,
dental procedures were performed as early as possible (extraction in almost all
cases). Tracheostomy was performed in five cases. All of the patients in medical
treatment group and most of the surgically managed patients were discharged while
were stable with relative or complete resolution of their symptoms. One of our
patients, a 15 year old boy died with symptoms suggestive for mediastinitis and
air way compromise. Early diagnosis and medical management can be effective in
treating deep neck infections. Dental infections and also procedures are the
major cause in our patients, although tonsillitis and peritonsillar abscess also
were important leading causes with almost equal numbers in our series. Extraction
of the infected tooth as early as possible while medical treatment is continued
can be very helpful. In some cases it may be necessary to perform surgical
exploration of the neck more than once, and finally, malignant neoplasia,
somewhere in the head and neck should be considered in some cases, as in one of
our patients with left side submandibular abscess whose underlying disorder was
tongue SCC with neck metastasis. Prognosis can be excellent in both medically and
surgically managed groups if started and designed early and promptly.
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