Deep Neck Infections: Treatment, Biological Predictive Factors and Outcome in 111 Patients

The purpose of this study is to emphasize the importance of clinical, biological and radiological evaluation for optimal management of patients with deep neck infections. The records of 111 patients treated for deep neck infection were retrospectively reviewed. Admission scores as the LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score, the neutrophil/lymphocyte (N/L) ratio and a predictive score for potential cervical abscess drainage (SAID) have been validated, helping to provide optimal therapy for these patients. Statistically, no significant correlation was observed between the localization and the complications rate. In our series, the statistical analysis demonstrated that clinical combination of cervical swelling (P < 0.001), floor of mouth swelling (P = 0.003) and SAID (P = 0.008) is associated with surgical management. After univariate analysis, a biological factor (the white blood cell neutrophil count) (P = 0.003) and the biological scores NLR (P = 0.003; OR 4.13), LRINEC (P = 0.018; OR 2.93) and SAID (P < 0.001; OR 5.46) were found to be significantly associated with complications. On the other hand, our results demonstrated a significant association (P = 0.002) between the prescription of corticosteroid therapy and the length of hospitalization. Our results confirmed that the white blood cell neutrophil count as biological factor and the biological scores NLR, LRINEC and SAID were found to be significantly associated with complications. Moreover, our study demonstrated a significant association between the prescription of corticosteroid therapy and the length of hospitalization.