Ten years of deep neck space abscesses

Abstract

BackgroundThe incidence of deep neck space abscesses, which can result in significant morbidity and mortality, is rising. The aetiology is thought to be dental. However, this study suggests a reduction in tonsillectomies may be associated with the rise.MethodIn a retrospective cohort study, patients were identified by a clinical code within one hospital over 10 years. Evidence of preceding infection source, management, lifestyle risks, comorbidities and demographics were extracted.ResultsFifty-two patients were included: 23 (44 per cent) had concurrent or recent tonsillitis; 11 (21 per cent) had poor dental hygiene; 22 (42 per cent) were smokers; and 9 (17 per cent) had diabetes. The incidence of deep neck space abscess cases increased from 1 in 2006, to 15 in 2015 (correlation value 0.9; p = 0.00019).ConclusionThe incidence of deep neck space abscess cases is increasing. Risk factors include tonsillitis, smoking and dental infection. This paper adds to the growing evidence that deep neck space abscesses are increasingly related to tonsillitis, and questions whether the threshold for tonsillectomy has been raised too high.

Unrevealed foreign body in the deep neck space: A case report

“…Without early diagnosis and treatment, residual foreign bodies remain a major cause of mortality. [3][4][5][6][7][8][9] Moreover, retained foreign bodies might lead to long-term sequelae as chronic infection and neurological or functional impairment. 2 Foreign bodies as etiology cause of DNSI are extremely rare.…”

“…2 Foreign bodies as etiology cause of DNSI are extremely rare. [6][7][8] Si-Youn Song et al described a 50-year-old patient with a blade of a grass cutter suddenly dislodged on impact and penetrated his neck. However, unlike our case, this patient had a 7-mm-sized linear skin laceration and the foreign body was vaguely palpable on clinical examination.…”

Deep Neck Space Infection: Clinical Outcomes of Patients Treated in a Tertiary Care Center

“…Martínez et al (10) reported that 65.2% of the patients had infection located in the peritonsillar region and 0.9% in the submandibular region. Buckley et al (8) stated that infection was located in the parapharyngeal region at the rate of 60%. Moreover, Prabhu and Nirmalkumar (2) detected that, in 52% of the patients, infection was in the submandibular region, and Motahari et al (18) revealed that infection was detected in the submandibular region in 45% of the 815 patients.…”

“…As a result, this complications such as airway obstruction, vascular pathologies (deep vein thrombosis), pleural or pericardial complications, empyema, mediastinitis, and vertebral osteomyelitis can be seen and these complications may result in serious morbidity or be fatal in patients due to sepsis or respiratory distress (7). Besides, death is often associated with mediastinal invasion or vascular complications in patients with DNSI (6,8). Therefore, a complete physical examination and appropriate treatment should be initiated promptly for the correct management of DNSI patients (2).…”

A Study of Factors that Contribute to the Severe Progression of Peritonsillar Abscess

“…difficult for inflammation to spread to the surrounding tissue. 1,2 Furthermore, peritonsillar abscess onset is common among young men or those in their prime. 3 In elderly individuals, peritonsillar abscess is rare because of tonsillar atrophy; however, patients who develop deep neck abscess caused by peritonsillar abscess are older than the age group of those with peritonsillar abscess.…”