Effectiveness and Therapeutic Impact of CT-Guided Percutaneous Drainage for Deep Neck Abscesses

Zexing Cheng,Xiaoming Tang,Juebo Yu

doi:10.4236/ijohns.2015.46066

Zexing Cheng, Xiaoming Tang + Show 1 more

Open Access

https://doi.org/10.4236/ijohns.2015.46066

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Abstract

Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patients with DNA will be identified. Methods: We retrospectively studied 29 patients who presented to the department of otolaryngology with deep neck abscesses between April 2011 and April 2015. These 29 patients were managed with CPD after antibiotic therapy or needle aspiration failed. Data on patient demographics, location of infection, existing comorbidity, duration of hospitalization, treatment received, and complications were reviewed. Results: The average age of 29 patients, including 18 men and 11 women, was 56 years old. Abscess was found in parapharyngeal space (n = 16), submandibular space (n = 7), retropharyngeal space (n = 5) and pretracheal space (n = 1). The maximum transverse diameter of abscess ranged from 4.8 cm to 8.0 cm (mean 6.03 cm). Positive cultures were found in 24 cases and the most common pathogen found was Streptococcus viridans. Average hospital stay was 6.7 days. Deep neck abscesses were completely removed without residual in all patients. No one had complications and no one died during and after CPD. Conclusion: CPD is a safe and highly effective procedure for treating patients with deep neck abscesses who do not respond to antibiotics therapy. This technique can also provide reliable evidence on pathogens responsible for deep neck abscesses and help otolaryngologists choose effective treatment to achieve better clinical success rate. We recommend that most deep neck abscesses should be managed initially by CPD before resorting to open surgery.

Highlights

Deep neck abscesses are defined as collections of pus contained within fascial planes and spaces of head and neck
Of 29 patients undergoing CT-guided percutaneous drainage (CPD), immediate technical success was achieved in all patients with precise placement of catheter in deep neck abscess cavities
The widespread availability of antibiotics has reduced the incidence of deep neck abscesses drastically [2] [3]

Summary

Introduction

Deep neck abscesses are defined as collections of pus contained within fascial planes and spaces of head and neck. Open surgical incision-and-drainage procedure with appropriate administration of antibiotics remains the mainstay of treatment for deep neck abscesses. It usually involves neck incisions and exploration, which exposes patients to a cosmetically undesirable scar and a risk of neurovascular injury. CT-guided percutaneous drainage (CPD) has been used recently to remove abscesses in patients who do not have airway compromise [1] [7]. Some studies have suggested that CPD of deep neck abscesses is a less invasive and an effective alternative to open surgery in select cases [1] [7]

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