Clinical and Radiological Evaluation of Abscesses Detected on Computed Tomography in Neck Infections

The objective of this study is to evaluate the clinical and radiological findings of neck abscesses detected by contrast-enhanced computed tomography (CT) in emergency patients, and to analyze treatment approaches and the impact of abscess localization on outcomes.

This retrospective study included patients admitted between January 2018 and January 2024 with a CT-confirmed neck abscess. Data included demographics, abscess characteristics (size, side, location, extension), treatment methods, microbiological and pathological results, complications, and prognosis. Statistical analysis was performed using the Kruskal-Wallis test for age and abscess size, and the Chi-square test for location and treatment.

Ninety-two patients (32 women; mean age: 37.79±16.49 years) were evaluated. The most frequent abscesses were peritonsillar (n=36) and odontogenic (n=33). The median abscess sizes were 30 mm (interquartile range, IQR: 18) and 18 mm (IQR: 11). Twelve patients showed extension to adjacent spaces. Local drainage with intravenous antibiotics was the most common treatment. Microbial growth was detected in 18 cases. Two patients (2.2%) died during follow-up, both requiring surgical drainage under general anesthesia. Peritonsillar abscesses were smaller than odontogenic and other deep neck abscesses (p<0.001). The treatment method showed no correlation with abscess size or etiology (χ²(3)=2.65, p=0.580).

Deep neck infections most commonly arise from peritonsillar and odontogenic sources. Contrast-enhanced CT is crucial for diagnosis, treatment planning, and early detection of complications. Although no significant association was found between abscess size and treatment method, larger abscesses more often required drainage under general anesthesia. Prompt imaging and timely intervention remain vital to reduce morbidity and mortality.