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Related Experiment Videos

Deep neck infections: a constant challenge.

Paolo Boscolo-Rizzo1, Carlo Marchiori, Francesca Montolli

  • 1ENT Department, University of Padua, Treviso Regional Hospital, Treviso, Italy. paolo.boscolorizzo@unipd.it

ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|May 9, 2006
PubMed
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Deep neck infections (DNIs) remain a serious threat despite antibiotics, often leading to severe complications. Older age, diabetes, and multiple-space involvement are key risk factors for life-threatening outcomes in patients with DNIs.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Deep neck infections (DNIs) persist as a significant clinical challenge despite advances in antibiotics and dental care.
  • Complex anatomy and potential for lethal complications make DNIs a serious concern.

Purpose of the Study:

  • To review institutional experience with DNIs.
  • To identify predisposing factors for life-threatening complications associated with DNIs.

Main Methods:

  • Retrospective review of 167 patients diagnosed with DNIs between 1995 and 2003.
  • Statistical analysis (chi-squared, Fisher's exact, Student's t-tests) to determine associations between complications and patient factors.

Main Results:

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  • Commonly involved spaces: lateral pharyngeal and submandibular.
  • Most frequent causes: upper airway infections (47.5%) and odontogenic infections (27.9%).
  • Life-threatening complications (18.6%) included airway obstruction, mediastinitis, jugular vein thrombosis, and pneumonia. Factors associated with complications: older age, higher WBC count, abscess, systemic disease, diabetes, anterior visceral space, and multiple-space involvement.

    • Conclusions:

    • DNIs continue to cause significant morbidity and mortality, even with antibiotic use.
    • Antibiotic resistance and misuse may alter clinical presentation, making DNIs less predictable.
    • Vigilant clinical assessment is crucial for patients with risk factors like advanced age, diabetes, and extensive infection spread.