Abstract
IntroductionDeep neck infection is a life-threatening condition, and intravenous antibiotic therapy is preferable in the early stages of the disease. However, in the advanced stages, surgical drainage should be performed. Although several surgical treatment strategies are available, it is necessary to standardize treatment according to the patient's general condition and history.Case presentationWe report the case of a 68-year-old man with a deep neck abscess and with severe diabetes mellitus and inflammation. Computed tomography identified a deep neck infection extending from the level of the epipharynx to that of the hyoid bone. We performed surgical drainage by transnasal endoscopy. The patient exhibited no evidence of either recurrent disease or post-surgical complications within 30 months of follow-up.ConclusionsThis case report provides evidence that transnasal endoscopic drainage should be recommended as a standard approach in patients with a deep neck abscess and with a severe general condition, diabetes mellitus, and inflammation.
Highlights
Deep neck infection is a life-threatening condition, and intravenous antibiotic therapy is preferable in the early stages of the disease
Case presentation: We report the case of a 68-year-old man with a deep neck abscess and with severe diabetes mellitus and inflammation
The patient exhibited no evidence of either recurrent disease or postsurgical complications within 30 months of follow-up. This case report provides evidence that transnasal endoscopic drainage should be recommended as a standard approach in patients with a deep neck abscess and with a severe general condition, diabetes mellitus, and inflammation
Summary
Deep neck infection is a life-threatening condition with various serious complications, such as, airway obstruction, cranial nerve palsy, descending necrotizing mediastinitis, internal carotid compression, and rupture [1]. Nagy et al reported successful treatment of 22/23 pediatric patients by transoral drainage of deep neck infections, including three cases of parapharyngeal abscess [4]. We report that transnasal endoscopy can be effective for the drainage of deep neck abscesses in patients in poor general condition, such as those with severe DM and inflammation. The lesion was due to deep neck infection extending from the epipharynx to the surrounding poststyloid space, CT did not show any typical features of abscess at this time (1 week before the operation) (Figure 2A). Due to the patient’s severe general condition and the anatomical location of the lesion, we instead chose to perform surgical drainage using a transnasal endoscopic approach under local anesthesia 1 week after CT scanning.
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