Abstract
Deep neck space infections (DNSI) are inflammation often with abscess collection within potential fascial spaces in the head and neck region. The incidence of DNSIs is relatively higher in populations of low socioeconomic status This study aimed at analyzing the pattern of presentation and management of DNSIs seen at our facility over 10 years. Data were extracted from patients’ case notes and medical records. A total of 72 patients (47 males and 25 females) were studied with a Male to Female ratio of 1.88:1. The patients’ ages ranged from 4years to 80 years with mean age of 46.2±21.3 years. the commonest presenting complaints were pain (95.8%), dysphagia (81.9%) and odynophagia (70.8%). The mean duration of complaints prior to presentation was 10.9±4.1days. Majority of the DNSIs were of odontogenic origin (56.9%) and diabetes mellitus (26.4%) was the most commonly encountered co-morbid condition. Submandibular and sublingual infections were the most common (40.3%) followed by peritonsillar space infections (23.6%) and retropharyngeal and prevertebral space infections (16.7%). S. aureus (15.3%) was the most commonly isolated organism among the rest with the infection being polymicrobial in 33.3% of the patients. The commonest complications were septicaemia (18.1%), necrotizing fasciitis (12.4%) and mediastinitis (2.8%). In Sub-Saharan Africa, DNSIs can affect all age groups; appear to have more morbidity in people with low socioeconomic class and co-morbidities. They can be managed with a combination of incision and drainage and intravenous antibiotics. Attention to oro-dental hygiene may help reduce the incidence of DNSI as majority are found to be linked with odontogenic and pharyngo-tonsillar conditions.
Highlights
Deep neck space infections (DNSI) are inflammation often with abscess collection within potential fascial spaces in the head and neck region
[2] The management of these infections often require multidisciplinary team. Common sources of such infections include dental, tonsillar and salivary gland infections, foreign body impaction and malignancies. [3,4,5] Odontogenic conditions have been implicated in many DNSIs [6,7,8] while some others reported tonsillar-related infections as the most common aetiology. [9, 10] Less reported causes include salivary gland infections, foreign body impaction and iatrogenic
Many studies have reported significant relationship between low socioeconomic status and incidence of DNSIs. [15,16,17] The presence of co-morbidities such as diabetes mellitus, HIV/AIDS, Malnutrition, anaemia and chronic alcoholism have been linked with increased morbidity in DNSIs. [6, 15,16,17]
Summary
Deep neck space infections (DNSI) are inflammation often with abscess collection within potential fascial spaces in the head and neck region. [1] These fascial spaces are potential lacunae that can get infected. These infections may be associated with significant morbidity and mortality. [2] The management of these infections often require multidisciplinary team. Common sources of such infections include dental, tonsillar and salivary gland infections, foreign body impaction and malignancies. [9, 10] Less reported causes include salivary gland infections, foreign body impaction (commonly fishbone impaction into the palatine tonsils or the floor of mouth) and iatrogenic. 198 Moses Ikechukwu Ajaero et al.: A Review of Deep Neck Space Infections: Perspective from a Sub-Saharan African Center causes. The procedure may be done with local anesthesia, in cases of retropharyngeal abscesses, general anesthesia is required. [18] The burden of care is further heightened by long hospital stay
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