Prevalence of odontogenic deep neck space infections (DNSI): a retrospective analysis of 76 cases of DNSI

Abstract

<p class="abstract"><strong>Background:</strong> Deep Neck Space Infections (DNSI) are serious diseases that involve several spaces of neck. Commonest sources of DNSI are dental and oropharyngeal infections. With widespread use of antibiotics, the prevalence of DNSI has been reduced but odontogenic DNSI are still common due to poor oral hygiene. Management mainly comprises of airway management, antibiotic therapy and surgical intervention. This study was conducted to find out the prevalence, distribution, presentation, sites involved, bacteriology and management of odontogenic DNSI.</p><p class="abstract"><strong>Methods:</strong> This retrospective study was done from October 2010 to January 2013 and included 76 patients with DNSI. Then, etiological factors of DNSI were studied and prevalence of odontogenic DNSI was calculated. All parameters including age, sex, co-morbidities, presentation, site, bacteriology and interventions required in odontogenic DNSI cases were studied.</p><p class="abstract"><strong>Results:</strong> Odontogenic infections were the most common etiological factor in DNSI, with a prevalence of 34.21% among DNSI. Toothace was commonest symptom, followed by neck swelling, pain and odynophagia. Submandibular space involvement (42.30%) was the most common clinical presentation of odontogenic DNSI patients, followed by Ludwig’s angina and masticator abscess.</p><strong>Conclusions:</strong> DNSI are common and life threatening infections. For management, early diagnosis is essential. In developing countries majority of DNSI are of odontogenic origin. In our country lack of adequate nutrition, poor orodental hygiene, tobacco and beetle nut chewing and smoking has increased the prevalence of odontogenic DNSI. So, prevention of odontogenic DNSI can be achieved by making population aware of oral and dental hygiene and by conducting regular check-up camps at community level.

A study on presentation, etiology, complications and management of deep neck space infections: our experience

“…In present study, submandibular abscess was followed by Ludwig's angina, masticator abscess and parapharyngeal abscess which can be correlated well with odontogenic spread. Similar findings were reported by study of Meher et al, Zamiri et al, Rega et al and Kataria et al 12,[14][15][16] Second most common cause was tonsillopharyngeal infection and was found to be more common in pediatric age group. Dental infection followed by tonsillar infection, as a cause of deep neck space infection, later being common in pediatrics, was reported by many studies.…”

A study of deep neck spaces infection in present era at tertiary care teaching hospital

“…Among these 63 patients, 42 were males and 20 were females. Which is comparable with Parhiscar et al, Kataria et al, Sethi et al, Mumtaz et al 10,12,17,18 This may indicate that men pay less attention to oral hygiene as well as having habit of smoking and pan masala in our region.…”

“…In study done by Kataria et al and Sharma et al 55.26% males and 44.74% females and 71.11% males and 28.89% females affected respectively which is similar to our study. 12,13 Out of 120 cases of deep neck spaces infection sixty three (52.5%) were Odontogenic in origin. This is followed by tonsillitis (18.3%), salivary gland infection (14.1%), infected lymphadenopathy (10%), infected cyst (2.5%) and foreign body (2.2%).…”

“…In studies done by Parhiscar et al and Kataria et al the most common organism isolated was Streptococcus being 39% and 23.8%. 10,12 Management of airway obstruction in deep neck spaces infection is challenging. In this study we noticed 7 patients (5.8%) with airway obstruction who required tracheostomy.…”

A catastrophic cervical necrotizing fasciitis after tooth extraction

“…Overall, dental infection (43 %) remains the most common cause of cervical necrotizing fasciitis, but malnutrition, poor dental hygiene, smoking, and tobacco and beetle nut chewing may also increase the prevalence rate of odontogenic DNSI [3,4]. For effective management, early diagnosis is important.…”