Navigating the Airway Maze: Challenges and Strategies in Deep Neck Space Infections

This study is intended to analyze the clinical profile and outcomes of the patients diagnosed with deep neck space infections. Deep neck space infections (DNSI) are commonly caused by nodal and odontogenic origins. Here in our study, we stress the need for appropriate investigations, early surgical intervention, and skillful airway management for the successful outcome of deep neck space infections. Effective management of deep neck space infections includes deep neck space exploration and treating the primary cause, such as dental extraction, removal of foreign body, and mastoidectomy. We highlight the importance of addressing the primary cause; failure to do so can lead to recurrent or persistent infection, which increases morbidity and mortality. This spectrum of disease presents a clinical challenge for both otorhinolaryngologists and anaesthesiologists because of compromised airways. Methods In this retrospective study, we evaluated 20 patients affected by deep neck space infections presented to the Otorhinolaryngology department, KMC Speciality Hospitals (I) Ltd., Trichy, Tamil Nadu, India, from May 2023 to April 2024 and managed them by deep neck space exploration. Results In our study, 80% were males and 20% were females. 30% of the patients were within the age group of 50-60 years. The common risk factor in our study was diabetes. Regarding the aetiology, 45% of the cases were of nodal origin, whereas 30% were odontogenic infections. Submandibular space is most commonly involved (25%), followed by parapharyngeal and multiple space infections (20%). About 30% of the patients had Streptococcus species as the causative organism in the culture and sensitivity report. Out of 20 patients, four required airway support, out of which an emergency tracheostomy had to be performed for three patients, and one patient was managed by endotracheal intubation at the time of presentation. All 20 patients had to undergo surgery, out of which 19 patients recovered successfully. One patient experienced a fatal outcome secondary to sepsis.