Presentation and characteristics of deep neck space abscesses: a retrospective study of 128 cases in a single institution

Shaden Al Riyami

doi:10.18203/issn.2454-5929.ijohns20252824

Authors

Shaden Al Riyami Department of Otorhinolaryngology, Al Nahda Hospital, Muscat, Sultanate of Oman

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20252824

Keywords:

Deep neck space abscesses, Incision and drainage, Microbiology, Complications, Airway compromise, Neck swelling, Fever, Pain, Staphylococcus aureus

Abstract

Background: Despite the development of antibiotic therapy, deep neck space abscesses continue to be potentially life-threatening conditions because of possible airway compromise and other complications. The purpose of this study was to present incidence, clinical features, management and outcomes of deep neck space abscesses, in patients admitted to a tertiary care facility over a 3-year period.

Methods: Medical records of the patients diagnosed to have deep neck space abscesses in the Al Nahda Hospital from January 2009 to December 2011 were reviewed retrospectively. Data on demographic characteristics, clinical presentation, imaging modalities, treatment methods, microbiology, and outcomes were obtained.

Results: A total of 30 patients (17 females and 13 males) with age ranging from 5 months to 71 years (mean age: 28.0 years) were analyzed. Majority of them presented with neck swelling, fever and pain. The parapharyngeal space (24%) was the commonest anatomical location. The majority of patients (81%) underwent incision and drainage, those remaining (19%) received intravenous antibiotics only. Culture was positive in just 17% of cases and Staphylococcus aureus was the most common organism. No patient required airway intervention. Diabetes was the most common predisposing factor.

Conclusions: Early detection and treatment are essential to avoid sequelae related with deep neck space abscesses. Surgical drainage is still the cornerstone in treatment after abscesses formation. A larger, multicenter prospective study is desirable to shed further light on the correlation between risk factors, age and treatment results.

Metrics

Metrics Loading ...

References

Almuqamam M, Gonzalez FJ, Sharma S, Kondamudi NP. Deep neck infections. InStatPearls. StatPearls Publishing; 2024.

Loperfido A, Stasolla A, Giorgione C, Mammarella F, Celebrini A, Acquaviva G. Management of deep neck space infections: a large tertiary center experience. Cureus. 2023;15(2):34974. DOI: https://doi.org/10.7759/cureus.34974

Cobzeanu BM, Moisii L, Palade OD. Management of Deep Neck Infection Associated with Descending Necrotizing Mediastinitis: A Scoping Review. Medicina 2025;61:325. DOI: https://doi.org/10.3390/medicina61020325

Velhonoja, J., Lääveri, M., Soukka, T. et al. Deep neck space infections: an upward trend and changing characteristics. Eur Arch Otorhinolaryngol. 2020;277:863-72. DOI: https://doi.org/10.1007/s00405-019-05742-9

Bhardwaj R, Makkar S, Gupta A, Khandelwal K, Nathan K, Basu C, Palaniyappan G. Deep Neck Space Infections: Current Trends and Intricacies of Management. Indian J Otolaryngol Head Neck Surg. 2022;74(2):2344-9. DOI: https://doi.org/10.1007/s12070-020-02174-4

Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003;24(2):111-7. DOI: https://doi.org/10.1053/ajot.2003.31

Huang TT, Liu TC, Chen PR. Deep neck infection: an analysis of 185 cases. Head & Neck. 2004;26(10):854–60. DOI: https://doi.org/10.1002/hed.20014

Brook I. Microbiology and management of deep facial infections and Lemierre syndrome. ORL J Otorhinolaryngol Relat Spec. 2003;65(2):117-20. DOI: https://doi.org/10.1159/000070776

Boscolo-Rizzo P, Marchiori C, Montesco MC, Vaglia A, Da Mosto MC. Deep neck infections: a study of 365 cases highlighting recommendations for management and treatment. Eur Arch Otorhinolaryngol. 2012;269(4):1241-9. DOI: https://doi.org/10.1007/s00405-011-1761-1

Bakir S, Tanriverdi MH, Gün R, Yorgancilar E, Yildirim M, Tekbaş G, et al. Deep neck space infections: a retrospective review of 173 cases. Am J Otolaryngol. 2012;33(5):567-73. DOI: https://doi.org/10.1016/j.amjoto.2011.01.003

Vieira F, Allen SM, Stocks RM, Thompson JW. Deep neck infection. Otolaryngol Clin North Am. 2008;41(3):459-83. DOI: https://doi.org/10.1016/j.otc.2008.01.002

Eftekharian A, Roozbahany NA, Vaezi A, Narimani N. Deep neck infections: a retrospective review of 112 cases. Eur Arch Otorhinolaryngol. 2009;266(2):273-7. DOI: https://doi.org/10.1007/s00405-008-0734-5

Yang SW, Lee MH, See LC, Huang SH, Chen TM, Chen TA. Deep neck abscess: an analysis of microbial etiology and the effectiveness of antibiotics. Infect Drug Resist. 2008;1:1-8. DOI: https://doi.org/10.2147/IDR.S3554

Galioto NJ. Peritonsillar Abscess. Am Fam Physician. 2017;95(8):501-6.

Herzon FS. Harris P. Peritonsillar abscess: Incidence, current management practices, and a proposal for treatment guidelines. Laryngoscope. 1987;97(1):989-91.

Kieff DA, Bhattacharyya N, Siegel NS, Salman SD, Shapiro J. Selection of drainage procedure for peritonsillar abscess: needle aspiration versus incision and drainage versus tonsillectomy. Otolaryngol Head Neck Surg. 1999;120(3):335-40. DOI: https://doi.org/10.1016/S0194-5998(99)70370-0

Hsueh WD, Choi AJ, Laury AM, Scott TM, Kuan EC, Tajudeen BA, et al. Improving outpatient follow-up adherence after inpatient otolaryngology consultation. Laryngoscope. 2023;133(2):364-70.