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Related Experiment Videos

Predicting deep neck space abscess using computed tomography.

Joseph L Smith1, Jack M Hsu, Jakwei Chang

  • 1Department of Otolaryngology and Communication Sciences, Upstate Medical University, Syracuse, NY 13210, USA. jlsmithii@yahoo.com

American Journal of Otolaryngology
|June 27, 2006
PubMed
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Computed tomography (CT) is valuable for diagnosing deep neck space infections (DNSIs), but objective measures like Hounsfield units do not reliably distinguish abscess from phlegmon, necessitating clinical judgment for surgical drainage decisions.

Area of Science:

  • Radiology
  • Otolaryngology
  • Infectious Diseases

Background:

  • Deep neck space infections (DNSIs) are serious conditions requiring accurate diagnosis.
  • Computed tomography (CT) with contrast is a key imaging modality for evaluating DNSIs.
  • Improving the diagnostic accuracy of CT can optimize treatment decisions and patient outcomes.

Purpose of the Study:

  • To evaluate objective CT measures, specifically Hounsfield units, for enhancing the positive predictive value in diagnosing deep neck space abscesses.
  • To determine if quantitative CT parameters can reliably differentiate between abscess and phlegmon in DNSIs.
  • To identify clinical variables that may improve the diagnostic accuracy of CT for DNSIs.

Main Methods:

  • Retrospective analysis of 32 patients surgically treated for DNSIs.

Related Experiment Videos

  • Inclusion of patients with CT scans suggestive of abscess within 24 hours pre-surgery.
  • Calculation of average Hounsfield units for abscesses and comparison with clinical variables (WBC, temperature) and surgical findings (presence of pus).

    • Main Results:

    • Hounsfield unit measurements were unreliable in distinguishing abscess from phlegmon.
    • No statistically significant differences were found in clinical variables (WBC, temperature) between groups with and without pus.
    • A substantial rate of negative exploration (25%) occurred despite pre-operative CT findings.

    Conclusions:

    • Clinical assessment remains crucial for surgical drainage decisions in DNSIs, even with CT guidance.
    • Objective CT measures, such as Hounsfield units, have limitations in differentiating abscess from phlegmon.
    • A negative surgical exploration rate of approximately 25% should be anticipated in cases selected for drainage of suspected deep neck abscesses.