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Related Experiment Videos

Deep neck abscesses: the Singapore experience.

Yan Qing Lee1, Jeevendra Kanagalingam

  • 1Department of ENT (Otorhinolaryngology), Tan Tock Seng Hospital, Singapore.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|September 22, 2010
PubMed
Summary

Deep neck abscess management was reviewed in 131 patients. Diabetes and older age are risk factors, with Klebsiella pneumoniae common in diabetics. Surgical drainage remains key, but needle aspiration may suffice for small abscesses.

Related Experiment Videos

Area of Science:

  • Otorhinolaryngology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Deep neck abscesses are serious infections requiring prompt management.
  • Understanding trends in etiology, bacteriology, and risk factors is crucial for optimizing treatment.
  • Tan Tock Seng Hospital, Singapore, provides a valuable case series for analysis.

Purpose of the Study:

  • To review the experience with deep neck abscesses at Tan Tock Seng Hospital.
  • To identify key trends in patient demographics, causes, and microbiology.
  • To improve the clinical management and outcomes of deep neck abscesses.

Main Methods:

  • Retrospective chart review of 131 patients diagnosed with deep neck abscesses between 2004 and 2009.
  • Analysis of patient demographics, etiology, bacteriology, comorbidities (especially diabetes mellitus), radiology, treatment, complications, and outcomes.
  • Statistical review of risk factors and treatment modalities.

Main Results:

  • The median age was 51.0 years, with 41.2% having diabetes mellitus.
  • The parapharyngeal space was most commonly involved; odontogenic and upper airway infections were leading causes.
  • Klebsiella pneumoniae was the most common organism, particularly in diabetic patients (50.0%).
  • Surgical drainage was performed in 82.4% of patients; 42 suffered complications.
  • Multi-space abscesses, diabetes, and complications were associated with prolonged hospitalizations.
  • Old age and diabetes are identified as risk factors for deep neck abscesses and their sequelae.

Conclusions:

  • Surgical drainage and adequate antibiotic coverage are the cornerstones of deep neck abscess treatment.
  • Therapeutic needle aspiration may be a viable alternative for small, uncomplicated abscesses.
  • Empiric antibiotic choices should consider likely dental sources and the prevalence of Klebsiella in diabetics.
  • Airway obstruction must be anticipated in multi-space and floor of mouth abscesses.