Ten years of deep neck space abscesses

Area of Science:

• Otolaryngology
• Infectious Diseases
• Public Health

Background:

• Deep neck space abscesses (DNSAs) present a growing public health concern due to increasing incidence and potential for severe morbidity and mortality.
• While dental infections have been traditionally implicated, emerging evidence suggests a potential link between reduced tonsillectomy rates and the rise in DNSAs.

Purpose of the Study:

• To investigate the changing incidence of deep neck space abscesses over a 10-year period.
• To identify associated risk factors, including tonsillitis, dental hygiene, smoking, and diabetes.
• To explore the potential relationship between tonsillectomy rates and the incidence of DNSAs.

Main Methods:

• Retrospective cohort study analyzing patient data from a single hospital over a decade.
• Identification of patients using clinical codes for deep neck space abscesses.
• Extraction of data on infection source, management, lifestyle risk factors, comorbidities, and demographics.

Main Results:

• A significant increase in DNSA incidence was observed, rising from 1 case in 2006 to 15 cases in 2015 (correlation 0.9, p=0.00019).
• Identified risk factors included concurrent or recent tonsillitis (44%), poor dental hygiene (21%), smoking (42%), and diabetes (17%).
• Tonsillitis was highlighted as a prominent risk factor associated with the rising incidence of DNSAs.

Conclusions:

• The incidence of deep neck space abscesses is on the rise, with tonsillitis, smoking, and dental infections as significant contributing factors.
• This study supports the growing evidence implicating tonsillitis in the increasing rates of DNSAs.
• The findings question whether current thresholds for performing tonsillectomies may be set too high, potentially contributing to the observed increase in abscess cases.