A dangerous cause of airway obstruction: deep neck infection

doi:10.22514/sv.2020.16.0101

Cited by 4 publications

(5 citation statements)

References 45 publications

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“…Private practitioners often choose to treat these patients in an operating room rather than their own clinics due to the potential risks for sepsis or airway complications, although this may result in exorbitant costs for the patient greatly exceeding what would be incurred for clinical management in an outpatient setting [5]. Hospital-based treatment of these infections is associated with the following: an average ICU stay of 1-3 days, an average ward stay of 3-4 days, and an average hospital cost of approximately $4000-10,000 [7][8][9]. Furthermore, Hospital-based treatment of odontogenic infections is on the rise in the US as states restrict Medicare dental benefits to emergency-only [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Hospital-based treatment of these infections is associated with the following: an average ICU stay of 1-3 days, an average ward stay of 3-4 days, and an average hospital cost of approximately $4000-10,000 [7][8][9]. Furthermore, Hospital-based treatment of odontogenic infections is on the rise in the US as states restrict Medicare dental benefits to emergency-only [8,9]. These are challenging facts facing many surgeons in the community.…”

Section: Discussionmentioning

confidence: 99%

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Novel Approach for Management of Deep Space Neck Infections: a Case Report

Moxley¹

2023

Open Access J Dent Oral Surg

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When patients present with deep space neck infections, typically the treatment involves Incision and Drainage (I&D) with an extraoral incision that could measure several centimeters in length, as well as antibiotic administration. While this approach is effective in managing these types of infections, it is not without limitations. Most notably, patients treated with I&Ds often are subject to prolonged hospitalization due to sepsis and they complain of a permanent, unsightly scar in the facial or cervical region once healed. In this case report, a 28-year-old male patient presenting to the emergency room with a right mandibular space collection of suppuration is treated with a modified version of the Seldinger technique which provided adequate abscess drainage and a more cosmetically-pleasing outcome once healed. Furthermore, this patient was treated bedside under local anesthesia as opposed to in an operating room under general anesthesia. While this technique may not be indicated for every patient presenting with deep space neck infections, it is a less-invasive approach that was effective for this patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Novel Approach for Management of Deep Space Neck Infections: a Case Report

Moxley¹

2023

Open Access J Dent Oral Surg

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“…[2][3][4][5][6][7][8] In scenarios where the infections are located in the lower head and upper cervical region, the patient's life could be threatened within minutes by airway obstruction. 9 Therefore, once the pus cavity is formed, prompt surgical drainage establishment is imperative to remove purulence and provide a healing environment.…”

Section: Discussionmentioning

confidence: 99%

“…Airway obstruction is inclined to happen under this circumstance, thus putting the patient's life at risk. 9 Effective treatment usually includes an incision adequate for thorough exploration of the involved spaces and a drain placement to the abscess cavity. Traditional drainage method is merely gravity-dependent.…”

Section: Introductionmentioning

confidence: 99%

Multifunctional Irrigation-Assisted Vacuum Drainage versus Traditional Drainage in the Treatment of Odontogenic Deep Fascial Infection: A Retrospective Cohort Study

Qian

Zhou³

et al. 2021

IDR

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Odontogenic deep fascial space infection in the head and neck is a common potentially fatal clinical problem. Traditional drainage method is considered laborious and gravity-dependent. In this study, we aimed to evaluate the clinical effect of a modified multifunctional irrigation-assisted vacuum drainage (MIVD) by comparing it with the traditional drainage method in the treatment of odontogenic deep fascial infection. Patients and Methods: Patients diagnosed with odontogenic deep fascial space infection in the Second Affiliated Hospital, Zhejiang University School of Medicine, China between March 2018 and March 2021 were studied. We divided the patients into two groups based on the drainage method they received: patients with the MIVD device were included in the MIVD group, patients with traditional drainage were included in the traditional group. Data were collected retrospectively including baseline characteristics and treatment outcome variables. Results: A total of 65 patients were included. All the patients were eventually cured. There were no significant differences in age, gender, diabetes, end stage renal disease, autoimmune diseases, other systemic diseases, tobacco use, number of the infected spaces, preoperative white blood cell count and C-reactive protein between the two groups. The number and frequency of manual irrigation by clinicians (MIC), time required for white blood cell count to return to normal levels (TWBC), time required for C-reactive protein to return to normal levels (TCRP), the length of hospitalization and the length and total cost of antibiotics use were significantly less in the MIVD group. There was no significant difference in the cost of hospitalization between the 2 groups. Conclusion:The MIVD device significantly reduced the number and frequency of MIC, TWBC, TCRP, the length of hospitalization and the length and total cost of antibiotics use in comparison with the traditional drainage method. It provided a favorable treatment method for patients with odontogenic deep fascial space infection in the head and neck.

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“…As bacteria and their byproduct penetrate through the surrounding tissue, the infection spreads rapidly among the potential spaces due to loose anatomical structure of soft tissues, causing symptoms such as swelling and erythema of involved skin, limited mouth opening and swallowing difficulty [2]. For infections in lower head and neck, the airway could even be obstructed [3–5]. Other life‐threatening complications include osteomyelitis, descending mediastinitis, necrotizing fasciitis, sepsis and Lemierre's syndrome [6–10].…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Multifunctional Irrigation‐assisted Vacuum Drainage, Vacuum Sealing Drainage and the Penrose Drain in Treating Severe Multi‐space Deep Fascial Infection in the Head and Neck

Qian

He²,

Qi³

et al. 2022

World j. surg.

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Background We aimed to compare multifunctional irrigation‐assisted vacuum drainage (MIVD), vacuum sealing drainage (VSD) and the Penrose drain in treating severe multi‐space deep fascial infection (DFI) in head and neck. Methods A retrospective study was conducted on 113 patients who had suffered from severe multi‐space DFI in head and neck and underwent surgical treatment. Patients were divided into the MIVD group, the VSD group, and the Penrose group according to their treatment. Baseline characteristics and clinical outcome data regarding infection control, clinicians’ workload, surgical procedure required, and cost were analyzed. Results Duration of antibiotic administration was significantly shorter using MIVD and VSD than Penrose drains (p = 0.002 with MIVD, p = 0.008 with VSD). Hospital stay in the MIVD group was shorter than the Penrose group (p = 0.034). Compared to the other two groups, more times of manual irrigation were needed in higher frequency in the Penrose group (p < 0.001). Longer Incision and more surgical operation were required in the VSD group than the other two groups (p < 0.001). The treatment cost in the VSD group was higher than the MIVD group (p = 0.045) and the Penrose group (p < 0.001). Conclusions In the treatment of severe multi‐space DFI in head and neck, MIVD and VSD are superior to the Penrose drain in infection control and reduction in clinicians’ workload. Meanwhile, MIVD, with fewer surgical procedures required and less cost, seems to be a more promising method than VSD.

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A dangerous cause of airway obstruction: deep neck infection

Cited by 4 publications

References 45 publications

Novel Approach for Management of Deep Space Neck Infections: a Case Report

Novel Approach for Management of Deep Space Neck Infections: a Case Report

Multifunctional Irrigation-Assisted Vacuum Drainage versus Traditional Drainage in the Treatment of Odontogenic Deep Fascial Infection: A Retrospective Cohort Study

Comparative Study of Multifunctional Irrigation‐assisted Vacuum Drainage, Vacuum Sealing Drainage and the Penrose Drain in Treating Severe Multi‐space Deep Fascial Infection in the Head and Neck

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