Deep neck infections: a single-centre analysis of 100 cases in the West of Scotland

This study reviews the clinical presentation, investigation, and management of deep neck infections in our department. We aimed to identify predisposing factors for serious complications, with a view to improving prognostication. This was a single-centre analysis of patients presenting to the OMFS department at Queen Elizabeth University Hospital (Glasgow) with head and neck abscesses who underwent surgery between February 2021 and January 2022. The following clinical data were analysed and compared: age, gender, Scottish Index of Multiple Deprivation (SIMD) rank, admission duration, infection source/ aetiology, treatment modality, signs and symptoms at presentation, complications (return to theatre, airway compromise, necrotising fasciitis, or mediastinitis), imaging modality, microbiology results, inflammatory markers, and antibiotic therapy. Of the 100 patients included, the average SIMD rank was 3.6, with most patients in decile 1. Eighty-seven infections (87%) were odontogenic, with over half of the patients having no signs of systemic inflammatory response syndrome (SIRS) at admission. We demonstrate that C-reactive protein (CRP) level at presentation, even in the absence of SIRS, is indicative of prolonged admission, the need for repeat multiaxis imaging, and repeated surgeries. We also demonstrate that the incidence of deep neck infections (DNI) is strongly correlated with SIMD rank.