Treatment Of Deep Neck Infections Research Articles

Intraoperative Wound Lavage System for Deep Neck Infection: A Retrospective Cohort Study.

Introduction Multiple solutions are currently used to cleanse a deep neck infection (DNI), and a variety of devices are available to deliver wound irrigation solutions. An essential difference between these devices is the pressure that the irrigation solution exerts over the wound tissue. Objective To compare low-pressure and high-pressure irrigation delivery systems for wound cleansing in DNI. Methods we designed a retrospective cohort study and reviewed the medical records of patients operated on due to DNI from June 2016 to December 2017 at our institution. One cohort included patients treated with an intraoperative irrigation method that exerts low pressure over the irrigated tissue, and the other cohort, to a system capable of generating higher pressure. The Pearson Chi-squared test was used to analyze the data. Results A total of 42 patients whose ages ranged from 16 months to 72 years were included. The low-pressure irrigation system was used in 18 patients, and the high-pressure system was used in 24 patients. No statistical differences were observed regarding the irrigation methods, the complexity of the DNI, and the overall outcomes. Conclusions The present is the first study in which low- and high-pressure systems for wound lavage were evaluated in the treatment of DNI. When comparing these methods, we did not find one to be superior to the other; however, the additional cost associated with the high-pressure devices may not justify their in head and neck procedures.

Surgical treatment of deep neck infections in 19 dogs.

Describe clinical features, treatment, and outcomes in dogs with deep neck infections. 19 dogs undergoing surgical treatment of deep neck infections from January 1, 2015, through December 31, 2020. Retrospective record review was conducted, with data collected including clinical signs; neutrophil-to-lymphocyte ratio (NLR); diagnostic imaging, surgical, and histopathologic findings; and follow-up. Spearman correlation and Wilcoxon rank sum were used to compare variables to NLR. All dogs had cervical swelling, and 9 were febrile. On CT, a distinct mass or abscess (7/13) or abscessed lymph node (4/13) was common, with contrast enhancement (10/13), fluid tracking (8/13), and displacement of the trachea, pharynx, or larynx (6/13) also frequently seen. Foreign material was suspected on CT for 4 dogs and was identified at surgery or histopathology for 4 dogs, only 1 of which was suspected on CT. Histopathology most commonly revealed pyogranulomatous inflammation (14/15). Increasing NLR was moderately correlated to a decreased duration of clinical signs before presentation (ρ = -0.548; P = .035) and an increased length of hospitalization (ρ = 0.645; P = .009). Bacterial culture was submitted for all dogs, and polymicrobial infections were common (8/19). Broad-spectrum empirical antimicrobials were commonly prescribed. Change in antimicrobial treatment based on culture was uncommon (3/19). All dogs survived to hospital discharge; 18 dogs with long-term follow-up had complete resolution of clinical signs. CT was useful to plan for surgery, and surgical treatment resulted in resolution of clinical signs in all dogs with long-term follow-up available. Empirical antimicrobial treatment, such as amoxicillin-clavulanic acid or ampicillin-sulbactam, should be considered.

Localised submental abscess consequent to an infected premolar socket: a case report

<p>Deep neck infections either cellulitis or abscess are localised initially within the potential spaces and fascial planes of the head and neck. These infections should not be ignored. One should not underestimate the necessity of appropriate and timely treatment of deep neck infections due to the late sequel of serious and potentially life-threatening nature of these infections. An intriguing patient of a limited submental/ suprahyoid pathology secondary to suppuration in the premolar socket was addressed with timely intervention surgically.</p><p><strong> </strong></p>

Retropharyngeal abscess as an example of a deep neck infection in children

Deep neck infections are severe complications of the inflammatory processes in the upper respiratory tract. They can be divided into retropharyngeal, parapharyngeal, peritonsillar and submandibular abscesses, depending on the affected region. Deep neck infections are considered as acute bacterial complications with a progressive course and life-threatening character and that’s why they require immediate wide-range, intravenous antibiotic therapy. A 7-year-old female patient presented to her general practitioner with persistent, recurrent fever lasting for 3 days. Fever subsided after 2 days of antibiotic therapy, but she developed trismus, severe sore throat, especially on the right side, radiating to the right ear and dysphagia. The patient was referred to the Pediatric Otolaryngology Department as a matter of urgency. On examination she had enlarged lymph nodes on the right side of the neck with limited head and neck movements to the right side and posteriorly. There was also an asymmetry of the pharynx behind the right palatopharyngeal arch observed. Laboratory blood tests showed high CRP level (3.84 mg/dl, n < 0.5). CT scan was performed and showed multiloculated abscess in right retropharyngeal space. Our patient was qualified for the surgical procedure – drainage of the abscess under general anaesthesia together with wide spectrum antibiotic therapy in a form of cefuroxime and clindamycin. During procedure a large amount of pus was evacuated, and a sample was sent for microbiological results. It showed growth of Staphylococcus hominis, probably multiplication of local physiological colonization. She also received anti-inflammatory drugs and has had physiotherapy throughout the hospitalization period to prevent torticollis. We observed gradual local and general improvement, together with normalization of the inflammatory markers. She was discharged from the hospital after 7 days of intravenous treatment. Accurate diagnosis and immediate proper treatment of deep neck infections are essential in prevention of further local (to the surrounding regions) and general expansion (like thrombosis, sepsis, meningitis) of the inflammatory process and of persistent changes (like stenosis of the respiratory tract). Fortunately, in the post-antibiotic era most patients are fully healed, further complications are almost unseen and mortality rates are low.

Multidisciplinary treatment of deep neck infection associated with descending necrotizing mediastinitis: a single-centre experience.

ObjectiveDeep neck infection (DNI) associated with descending necrotizing mediastinitis (DNM) is a highly lethal condition. This retrospective review was performed to share our experience performing multidisciplinary management of DNI associated with DNM during a 7-year period.MethodsWe reviewed 16 patients who had been surgically treated for DNM at Peking Union Medical College Hospital from April 2010 to July 2017. The clinical outcomes were analysed to determine the most appropriate therapeutic strategy.ResultsFive women and 11 men were included in this study. Their mean age was 54.9 ± 14.3 years. DNM-associated infections most commonly occurred secondary to odontogenic infections (n = 10). Thirteen patients required tracheotomy because of tracheal compression. All patients underwent unilateral or bilateral cervicotomy. Six patients with DNM localized in the upper mediastinal space underwent transcervical mediastinal drainage, while 10 patients with DNM extending to the lower mediastinum were treated by cervicotomy and video-assisted thoracoscopic surgery. Three patients died of multiple organ failure.ConclusionMultidisciplinary treatment can achieve favourable outcomes in >80% of patients with DNM. Early diagnosis, proper airway management, and adequate surgical drainage are crucial for reducing mortality in patients with DNM, and minimally invasive procedures also play an important role.

Analysis of 33 children with deep neck infection

To analyze the effective treatment of deep neck infection in children. Thirty-three cases of deep neck infection treated from September 2005 to May 2015 were retrospectively reviewed. To observe the effect of antibiotics and surgical drainage. All cases were cured, including one case who was complicated with carotid artery rupture and was timely cured by vascular interventional therapy, and the cure rate was 100%. Combined application of broad-spectrum antibiotics and effective surgical drainage are key to treat deep neck infection in children. The emergence of repeated small amount of bleeding in the nose and throat in children is an indicator for big neck vessel rupture and interventional vascular therapy may be considered.

A Study on 56 Cases of Deep Neck Infection

Deep neck infection is often seen in ENT practice and could become a life-threatening disease if it is not diagnosed promptly and is not treated properly. Airway management, proper antibiotics and management of purulent discharge are required. No criteria, however, exist for treatment of deep neck infection by surgery or by conservative management alone. The aim of this study was to review retrospectively cases of deep neck infection which were treated in Kurashiki Central Hospital and identify the characteristics of the surgical cases with bibliographic consideration. Descending necrotizing mediastinitis (DNM) is reviewed separately.

Application of radiographic images in diagnosis and treatment of deep neck infections with necrotizing fasciitis: a case report

The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.

深頸部感染症の診断と治療

深頸部感染症の診断と治療

Deep neck infections - complications and surgical treatment

Introduction: Deep infections of the neck are potentially life-threatening due to their descending spread towards the mediastinum along cervical fascia planes and possible development of thrombophlebitis of the internal jugular vein and sepsis. Aim: To review the possible complications of the deep neck infections and the methods for surgical treatment. To share our own clinical experience. Material: 29 patients with deep neck infections predominantly of tonsillar or dental origin, treated surgically at the Medical Institute of Ministry of the Interior during the last 5 years. Results: The following complications have been observed: 6 cases of acute respiratory insufficiency; 2 cases of sepsis; 2 - with descending mediastinitis and 1 - with acute hemorrhage from gastric stress ulcer. Conclusions: Early surgical intervention, application of antibiotics against aerobe and anaerobe bacteria and good coordination between otorinolaryngologists, surgeons, ICU and microbiologists is essential for the successful treatment of deep neck infection. Scripta Scientifica Medica 2007;39(1):59-62

A Case of Acute Deep Neck Infection in a Patient with Aplastic Anemia

Aplastic anemia often causes a life-threatening infection. We report a case of deep neck infection in a 30-year-old man with aplastic anemia treated with intensive antibiotics after admission, who rapidly recovered without surgery. The infection was caused by dental caries with an immunocompromised host via hemodyscrasia. He remains free from inflammation recurrence 5 months after treatment. We discuss the importance of early, appropriate treatment of deep neck infection associated with aplastic anemia occurring in immunocompromised patients.

深頚部感染症の７症例

Without appropriate and quick treatment, deep neck infection can lead to a severe and dangerous state. From April 1991 to December 1993, we treated seven patients with deep neck infection, five males and two females, 40 to 85 years of age. Their chief complaints were neck swelling with hyperemia and pain.Maintaining the air way is the first thing to do in the treatment of deep neck infection. In two patients who were close to death on arrival, tracheal intubation or tracheostomy was required, but the other five did not need any aid to respiration. The second emergency treatment is drainage of the deep neck abscess, if present.The CT scan was very helpful in demonstrating how far the infectious lesion extended in the neck. Abscess formation was found with CT scans in five patients, and drainage was performed in three of them. The other two patients appeared to have phlegmon on the CT scan and drainage was not done. These two patients developed disseminated intravascular coagulation syndrome (DIC), and one of them died of septic shock within 24 hours after admission. This patient had no problem with respiration on the first examination.In this series of patients with deep neck infection, the following two points should be emphasized: 1) Careful general follow-up is most important even if there is no problem with respiration, because severe and dangerous complications such as DIC or septic shock can develop from deep neck infections. 2) Surgical drainage should be tried even in patients with phlegmon.

The surgical treatment of deep neck infections

The surgical treatment of deep neck infections