[Cervico-facial necrotizing fasciitis]

Area of Science:

• Otolaryngology
• Infectious Diseases
• Surgical Critical Care

Background:

• Cervical fasciitis is a severe, life-threatening infection of the neck's fascial planes.
• Often originating from benign pharyngeal or dental infections, it can rapidly progress to extensive necrosis and mediastinal involvement.
• It constitutes a critical Ear, Nose, and Throat (ENT) emergency requiring immediate, expert intervention.

Purpose of the Study:

• To highlight the critical nature of cervical fasciitis.
• To emphasize the necessity of prompt diagnosis and multidisciplinary management.
• To outline essential treatment protocols and expected patient outcomes.

Main Methods:

• Review of clinical presentation and management of cervical fasciitis.
• Emphasis on urgent referral to tertiary centers for advanced imaging and surgical intervention.
• Discussion of intensive medical care requirements for managing complications.

Main Results:

• High mortality rate (5-10%) and significant morbidity, including pneumopathy (1/3), hemodynamic failure, and mediastinitis (1/2).
• Prolonged intensive care unit stays with extended mechanical ventilation, intubation, and tracheostomy durations.
• Functional and esthetic sequelae observed in approximately 50% of patients.

Conclusions:

• Cervical fasciitis necessitates vigilant recognition of early signs of severe sepsis from head and neck infections.
• Immediate CT imaging, surgical drainage, and comprehensive intensive care are vital for patient survival.
• Inadequate initial treatment and self-medication may contribute to disease progression.