Abstract
The purpose of this study is to describe the Minimally Invasive Intraoral Approach (MIIA) performed on selected cases of abscesses and neck phlegmons of odontogenic origin when the infection has not spread beyond the inferior mandibular margin. This technique allows us to avoid cervicotomy by a direct approach to the abscess, draining it through the oral cavity. If the limits have already been crossed, then cervicotomy is necessary. The aim of the study is to show the surgical outcomes that we have achieved during a time span of two years, and to show the effectiveness of the MIIA and its results. We selected 66 patients with abscesses and neck phlegmons, from January 2018 to June 2020. Among these cases, five patients were excluded as it was not possible to recover medical records from database. The MIIA technique has been performed on 16 patients (26.2%) when a successful dental extraction and drainage of the submandibular lodge were accomplished. The patients who underwent the MIIA surgery have all perfectly healed and did not suffer from relapses during the follow-up. The results show the achievement of excellent healing, underlining the lower impact required by MIIA when compared to a more traditional approach through cervicotomy.
Highlights
An increasing number of patients with dental symptoms admitted to the Emergency Room (ER) has been recorded
The purpose of this study is to describe the Minimally Invasive Intraoral Approach (MIIA) performed on selected cases of abscesses and neck phlegmons of odontogenic origin when the infection has not spread beyond the inferior mandibular margin
The results show the achievement of excellent healing, underlining the lower impact required by MIIA when compared to a more traditional approach through cervicotomy
Summary
An increasing number of patients with dental symptoms admitted to the Emergency Room (ER) has been recorded. This kind of infection forces the patient to undergo complex surgery Such an invasive surgical treatment is based on the extraction of an untreatable tooth and involves cervicotomy in order to clean the infected tissues and the placement of a Redon drainage. All of this inevitably results in a longer hospitalization. We obtained our best results among all the patients selected for MIIA when positioning a drainage device to improve the anti-gravity discharge of liquid from the residual cavity by contraction of the suprahyoid muscles. We proceed to show all of the surgical outcomes achieved during a time span of two years, alongside the criteria and algorithms used for surgical decision-making
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