Abstract
Maxillofacial space infection (MSI) is one of the most common conditions encountered in oral and maxillofacial surgery clinics. Early recognition and proper management of MSI could prevent a life-threatening event. Objectives: To report a series of MSI managed with antibiotics, surgical intervention and exogenous steroids as an adjunct, highlighting functional improvement following steroid administration. Methods: A retrospective cohort study was carried out from December 2013 to September 2016, involving 30 patients (n = 30, 22 males, 8 females) diagnosed with MSI. All patients were initially managed with intravenous empirical antibiotics, analgesics and removal of potential source of infection. A course of 3 doses of IV Dexamethasone 8 mg at an interval of 8 hours was started during the first day of hospital admission. Results: This series reports 30 patients presenting with MSI, who received prompt antibiotics and 3 doses of steroids as inpatients. Significant clinical improvement was noted in the form of amelioration of pain, rapid reduction in edema, and improved trismus, shortening hospital stay to an average of 3.5 days, and omission of surgical intervention in 50% of our cases. No adverse effects or drug reaction was noted. Conclusion: In conclusion, the value of synergistic use of corticosteroids with antibiotics in management of MSI is significant. Despite these promising findings, there is scarce evidence in the literature to fully support the use of corticosteroids in abscess management. The role of corticosteroids in treatment of MSI should be explored further.
Highlights
States in 2007 showed 302,507 visits attributed to facial cellulitis from dental origin [3]
A retrospective study done by Jundt JS et al (2012) on 42 patient records of inpatients treated for odontogenic infections reported a cost of $749,382 averaging $17,842 per person [4]
The present study offers a retrospective cohort analysis of Maxillofacial space infection (MSI) patients treated in Department of Oral and Maxillofacial Surgery, Hospital Sultanah Nora Ismail (Batu Pahat, Johor, Malaysia) managed with antibiotics, surgical intervention and exogenous steroids as an adjunct, highlighting functional improvement following steroid administration
Summary
A nationwide Emergency Department survey of 450 hospitals in 27 US states in 2007 showed 302,507 visits attributed to facial cellulitis from dental origin [3]. A retrospective study done by Jundt JS et al (2012) on 42 patient records of inpatients treated for odontogenic infections reported a cost of $749,382 averaging $17,842 per person [4]. Another nationwide inpatient sample taken in 2008 from 1056 hospitals in 42 US states shows 4044 hospital discharges with a primary diagnosis of mouth abscess/cellulitis, accounting for $98 million of hospitalization charges at a mean hospital charge of $24,240 per patient [5]
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