Accuracy of computerized tomography in deep neck infections in the pediatric population

Vural, Cetin; Güngör, Anıl; Comerci, S. C. D.

doi:10.1016/s0196-0709(03)00008-5

Cited by 104 publications

(107 citation statements)

References 15 publications

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“…Also, clinical characteristics of our DNI patient population are consistent with those of other studies. The percentage of RP versus PP abscesses in this study (71% vs.26%) and in the 306 total cases of DNI presenting at our institution over this time period (59% versus 41%) are similar to previously reported proportions of 50-85% RP and 11-44% PP [4,6,9]. In addition, only associations can be reported, as each decision to proceed to surgery was made using both clinical and radiologic data.…”

Section: Discussionsupporting

confidence: 86%

“…Ultrasound is valuable for screening on initial presentation, but demonstrates a limited ability to define deep neck spaces [17]. Previous studies demonstrate that CT imaging upon presentation is helpful in delineating between cellulitis and abscess and for guiding initial management in the treatment of pediatric DNIs [2][3][4]6,8,13]. Some findings on initial CT, such as diameter of abscess above 2 cm and presence of peripheral enhancement, correlate with a higher likelihood of failing medical management [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Needing surgery was defined as those patients who underwent surgery and revealed purulent drainage and those patients who did not initially undergo surgery but then presented as medical treatment failures [6][7][8][9]. Not needing surgery was defined as those patients who underwent surgery but did not reveal purulent drainage and those patients who underwent medical treatment with resolution of their DNI.…”

Section: Methodsmentioning

confidence: 99%

“…Multiple studies have evaluated the utility of CT imaging for the initial evaluation of pediatric DNIs [3,5,6]. However, no study to date has analyzed the utility of follow-up CT imaging for pediatric DNIs.…”

Section: Introductionmentioning

confidence: 99%

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The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients

2015

Int J Otorhinolaryngol

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Objective: To evaluate the utility of follow-up CT imaging for predicting the need for surgical intervention in pediatric patients with deep neck infections (DNI) admitted for a trial of observation with medical management.Methods: Pediatric patients admitted with DNI from January 2000 to February 2009 who underwent a CT scan, initial medical management, and repeat CT scan were identified and separated into two cohorts: patients who underwent surgical intervention and patients treated with medical management. Necessity of surgical intervention following the repeat CT scan was determined and the predictive values of CT imaging characteristics and clinical characteristics for identifying necessary surgical interventions were calculated.Results: 62 patients met inclusion criteria. Of the 32 patients who underwent surgical intervention following their second CT scan, 75% revealed an abscess. Of the 30 patients who continued with medical management following the second CT scan, 10% failed medical management. The combination of increased size, increased peripheral enhancement, and walling off of collections on subsequent CT imaging yielded 83% specificity for identifying patients who needed surgical intervention. Interpretation of the collection as a phlegmon or abscess on the repeat CT scan by the radiologist yielded 96% sensitivity for identifying patients who needed surgical intervention. Conclusion:Follow-up CT imaging can assist with determining the need for surgical intervention in children with deep neck infections initially managed medically.Citation: Elmaraghy CA, Mahida JB, Pluto CP, Minneci PC, Deans KJ, et al. The Utility of a Second CT Scan in the Management of Parapharyngeal and

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients

2015

Int J Otorhinolaryngol

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“…Derin boyun enfeksiyonu olduğu düşünülen hastalara tanı konulduğu anda sistemik antibiyoterapi başlanmalıdır (11). Olguların büyük bir kısmı betalaktamaz pozitif bakteriler ile oluşmakta ve betalaktamaz dirençli antibiyotiklerin kullanılması gerekmektedir (12). Tarafımızca tedavi edilen hastaların enfeksiyonunun apse formasyonuna ilerlemesi durumu cerrahi gerektirir.…”

Section: Discussionunclassified

Deep Neck Infections: A Retrospective Analysis of Eighty Five Cases

Hacı¹,

Açıkalın²,

Bayram³

et al. 2016

Haseki

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ÖzAmaç:Çalışmamızda derin boyun enfeksiyonlarının klinik bulguları ve tedavi sonuçları değerlendirilmiştir. Derin boyun enfeksiyonları hızla ilerleyen ve ölümcül komplikasyonları olabilen hastalıklardır.Yöntemler:Parafarengeal, submandibular ve peritonsiller apselerden oluşan derin boyun enfeksiyonlarını değerlendirdiğimiz ve 85 hastalık retrospektif olarak planladığımız bir çalışmadır. Bulgular:Derin boyun enfeksiyonu tanısı alan 85 hastanın, 33'ü 18 yaş altı (çocuk grubu), 52'si 18 yaş üstü idi (erişkin grup). Hastaların yaşlarının dört ile 56 arasında olduğu gözlendi (ortalama 24,109±14,003). Her iki grupta en sık görülen şikayetler; ateş, trismus, ağrı ve odinofaji idi. Erişkinlerde derin boyun enfeksiyonu en sık peritonsiller alanda, çocuklarda ise parafarengeal alanda gözlenmiştir. Tüm hastalara intravenöz antibiyoterapi başlanmış ve bazı hastalara cerrahi drenaj uygulanmıştır. En sık intravenöz antibiyotik olarak ampisilin-sulbaktam tek başına ya da metronidazol ile kombine edilerek kullanılmıştır.Sonuç: Birçok derin boyun enfeksiyonu olgusu intravenöz antiyotik ile tedavi edilebilmektedir. Eğer iyileşme olmaz ise bu hastalara cerrahi drenaj uygulamak gerekmektedir.AnahtarSözcükler:Apse, boyun, parafarengeal bölge Aim: In our study, we assessed symptoms and treatment outcomes in patients with deep neck infections (DNI). It often has a rapid onset and can cause lethal complications. Methods:A retrospective designed study of 85 patients diagnosed with DNI such as peritonsillar, parapharyngeal, and submandibular abscesses.Results: A total of 85 patients were diagnosed with DNI. 33 of the 85 patients were younger than 18 (group of children), and 52 were older than 18 years of age (group of adults). The mean age of the patients was 24.109±14.003 (4-54) years. Trismus, fever, odynophagia and pain were the most common complaints in both groups. In the adults group, the peritonsillar space was the most common site of infection (49%). In children group, the parapharyngeal space was the most common site of infection (35%). All patients were given intravenous antibiotic therapy and additional drainage of the abscess was also carried out for some of the patients. Most frequently, intravenous ampicillin-sulbactam alone or in combination with metronidazole was administrated to the patients. Conclusion:Most of the cases of DNI can be treated with intravenous antibiotics in spite of the fact that if there is no clinical healing, drainage is needed. GirişDerin boyun enfeksiyonları, boyunda yer alan potansiyel boşluklarda başlayan ve tedavi edilmediği takdirde hızla apse formasyonuna dönüşebilen hızlı başlangıcı olan enfeksiyonlardır (1). Erken tanı konulmadığı ya da yetersiz tedavi uygulandığı durumlarda derin boyun enfeksiyonları hayati yapılara komşulukları sebebi ile ciddi komplikasyonlara sebep olmaktadır (2). Bizim çalışmamızda Haseki Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Kliniği'nde yatırılarak tedavi edilen 85 hastanın klinik özellikleri ve tedavi sonuçları incelenmiştir.

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Pediatric Mediastinitis as a Complication of Methicillin-Resistant Staphylococcus aureus Retropharyngeal Abscess

Wright¹,

Stocks²,

Armstrong³

et al. 2008

Arch Otolaryngol Head Neck Surg

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Accuracy of computerized tomography in deep neck infections in the pediatric population

Cited by 104 publications

References 15 publications

The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients

The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients

Deep Neck Infections: A Retrospective Analysis of Eighty Five Cases

Pediatric Mediastinitis as a Complication of Methicillin-Resistant Staphylococcus aureus Retropharyngeal Abscess

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