Deep neck space infections: our experience
Keywords:Deep neck space, Parapharyngeal, Retropharyngeal, Ludwigs angina, Parotid abcess
Background: Deep neck space infections (DNSI) are serious diseases that involve several spaces in the neck. The common primary sources of DNSI are tonsil infections, dental infections, salivary gland infections, foreign bodies and malignancies. With widespread use of antibiotics and early detection facilities, the prevalence of DNSI has been reduced. Common complications of DNSI include airway obstruction, jugular vein thrombosis, and sepsis. Treatment principally comprises airway management, antibiotic therapy, and surgical intervention. This study was conducted to investigate the age and sex distribution of patients, symptoms, presentation, sites involved, bacteriology, and management and complications of DNSI.
Methods: A prospective study of deep neck space infections was done during the period July 2015 to February 2017 i.e. 20 months who attended the outpatient and were admitted as inpatient in Shadan hospital, Hyderabad.50 Cases were included in the study. All parameters including age, gender, co-morbidities, presentation, site, bacteriology, complications, and investigations were studied.
Results: Due to advent of antibiotics, deep neck space infections are in decreasing trend with admission rate accounting to 3% of total inpatients in our hospital. The common age group found to be affected is 10-20 years (28%). Out of all deep neck space infections, Ludwigs infections was common (32%) followed by peritonsillar infections (25%).
Conclusions: Infection of the deep neck spaces is a common and potentially life threatening ENT disease and requires an interdisciplinary approach. Tooth infections and foreign body impaction are the commonest causes of these infections. Diabetes Mellitus is an important predisposing factor. Complications such as mediastinitis, septic shock and pleural effusion are possible; hence the surgeon should be cautious.
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