HEAD AND NECK INFECTIONS

Abstract

Objectives: To analyse the risk factors responsible for different head and neckinfections secondary to dental causes. DESIGN: Retrospective study. Settings: Department ofENT and Head & Neck Surgery, Allied Hospital, Punjab Medical College, Faisalabad. Period:October 2011 to September 2014. Patients and Methods: The study consisted of 50 patientswho presented with history of head and neck infections secondary to dental causes in thedepartment of ENT and Head & Neck Surgery at Allied Hospital Faisalabad. Inclusions criteria:Patients of head and neck infections of either sex ranging from 12 to 57 years of age and havinghistory of dental infections / extractions were included in the study. Exclusion Criteria: Patientshaving head and neck infections secondary to some other cause other than dental etiologywere excluded from the study. Data Analysis: SPSS software, version 10 was used to analysethe data. Chi square test was applied to analyse the data. Results: In our study 62 % patientswith head and neck infections were males while 38 % patients were females. Age ranged from12 years to 57 years with mean age 33.68 years. 96% of our patients presented with deep neckabscesses while only 02% of the patients had osteomyelitis of maxilla and further 02% of thepatients presented with necrotizing fasciitis of the submandibular region. 58% of the patientshad dental infections whereas 42% patients were having dental extraction as the root causeresponsible for these head and neck infections. Moreover, all the patients had poor oro-dentalhygiene. It was also observed that 76% of the patients, having history of dental extraction, weretreated by unqualified dental practitioners without adequate aseptic conditions. Twelve patientsout of fifty (24%) were found to have diabetes mellitus and one patient each was suffering frommalignancy and chronic renal failure. 10 (20%) of our patients were smokers. Some of thepatients (16%) were having anemia. Two patients out of fifty (04%) were suffering from pulmonarytuberculosis. Treatment: All these patients were managed with adequate parentral antibioticsand surgical interventions. We had to perform an emergency tracheostomy in one patient. Allthe patients had good response to the management without any complication. Conclusions:Dental infections and dental extractions are still an important cause for potentially life threateninghead and neck infections in developing countries like Pakistan. Unhygienic dental practicesand lack of proper dental care facilities along with immunocompromizing conditions such asdiabetes mellitus are most common risk factors for these avoidable head and neck infections.Therefore it is necessary that unhygienic dental practices as well as practices by unqualifieddental practitioners should be strictly banned.