Skip to main content
×
×
Home

How to avoid life-threatening complications following head and neck space infections: an algorithm-based approach to apply during times of emergency. When and why to hospitalise a neck infection patient

  • O Gallo (a1), G Mannelli (a1), M S Lazio (a1) and R Santoro (a1)
Abstract
Background:

Head and neck space infections present with a potential mortality rate of 40–50 per cent. This paper proposes an algorithm-based management of head and neck space infection to prevent life-threatening events.

Methods:

A total of 225 patients with head and neck space infection were prospectively analysed at our institution. An experimental scoring system determined the level of clinical risk for the development of major complications. Accordingly, patients were classified into three risk groups: low-, intermediate- and high-risk.

Results:

Only intermediate- and high-risk patients were hospitalised. Intermediate-risk patients received intravenous medical therapy with daily re-evaluation; 18 of them required delayed surgery. Of the high-risk patients, three required immediate surgical treatment and five received delayed surgery, while in five cases medical therapy was the only treatment received. Low-risk patients were treated in an out-patient setting.

Conclusion:

The algorithm-based management of head and neck space infection was successful in enabling the avoidance of lethal complications onset.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      How to avoid life-threatening complications following head and neck space infections: an algorithm-based approach to apply during times of emergency. When and why to hospitalise a neck infection patient
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      How to avoid life-threatening complications following head and neck space infections: an algorithm-based approach to apply during times of emergency. When and why to hospitalise a neck infection patient
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      How to avoid life-threatening complications following head and neck space infections: an algorithm-based approach to apply during times of emergency. When and why to hospitalise a neck infection patient
      Available formats
      ×
Copyright
Corresponding author
Address for correspondence: Dr Giuditta Mannelli, Clinic of Otorhinolaryngology Head and Neck Surgery, Department of Surgery and Translational Medicine, University of Florence, Azienda Ospedaliera Universitaria Careggi, Via Largo Brambilla 3, Florence 50134, Italy E-mail: mannelli.giuditta@gmail.com
References
Hide All
1 Sakarya, EU, Kulduk, E, Gundogan, O, Soy, FK, Dundar, R, Kilavuz, AE et al. Clinical features of deep neck infection: analysis of 77 patients. Kulak Burun Bogaz Ihtis Derg 2015;25:102–8
2 Ovassapian, A, Tuncbilek, M, Wentzel, EK, Joshi, CW. Airway management in adult patients with deep neck infections: a case series and review of the literature. Anesth Analg 2005;100:585–9
3 Miller, B, Khalifa, Y, Feldon, SE, Friedman, DI. Lemierre syndrome causing bilateral cavernous sinus thrombosis. J Neuroophthalmol 2012;32:341–4
4 Colmenero Ruiz, CC, Labajo, AD, Yanez Vilas, IY, Paniagua, J. Thoracic complications of deeply situated serious neck infections. J Craniomaxillofac Surg 1993;21:7681
5 Levine, TM, Wurster, CF, Krespi, YP. Mediastinitis occurring as a complication of odontogenic infection. Laryngoscope 1986;94:747–50
6 Huang, TT, Tseng, FY, Yeh, TH, Hsu, CJ, Cen, YS. Factors affecting the bacteriology of deep neck infection: a retrospective study of 128 patients. Acta Otolaryngol 2006;126:396401
7 Brito, TP, Hazboun, IM, Fernandes, FL, Bento, LR, Zappelini, CE, Chone, CT et al. Deep neck abscesses: study of 101 cases. Braz J Otorhinolaryngol 2017;83:341–8
8 Meher, R, Jain, A, Sabharwal, A, Gupta, B, Singh, I, Agarwal, AK. Deep neck abscess: a prospective study of 54 cases. J Laryngol Otol 2005;119:299302
9 Reynolds, SC, Chow, AW. Life-threatening infections of the parapharyngeal and deep fascial spaces of the head and neck. Infect Dis Clin North Am 2007;21:557–76
10 Beck, HJ, Salassa, JR, McCaffey, T, Hermans, PE. Life-threatening soft tissue infections of the neck. Laryngoscope 1984;94:354–61
11 Uluibau, IC, Jaunay, T, Goss, AN. Severe odontogenic infections. Aust Dent J 2005;50:S7481
12 Lee, YQ, Kanagalingam, J. Bacteriology of deep neck abscesses: a retrospective review of 96 consecutive cases. Singapore Med J 2011;52:351–5
13 Vieira, F, Allen, SM, Stocks, RM, Thompson, JW. Deep neck infection. Otolaryngol Clin North Am 2008;41:459–83
14 Lin, HT, Tsai, CS, Chen, YL, Liang, JG. Influence of diabetes mellitus on deep neck infection. J Laryngol Otol 2006;120:650–4
15 Oliver, ER, Boyd Gillespie, M. Deep neck space infections. In: Cummings Flint, PW, Haughey, BH et al. , eds. Otolaryngology – Head and Neck Surgery, 5th edn. St Louis: Mosby, 2010;201–8
16 Wang, LF, Tai, CF, Kuo, WR, Chien, CY. Predisposing factors of complicated deep neck infections: 12-year experience at a single institution. J Otolaryngol Head Neck Surg 2010;39:335–41
17 Yellon, RF. Head and neck space infections. In: Bluestone, CD, Casselbrant, ML, Stool, SE et al. , eds. Pediatric Otolaryngology, volume 2, 4th edn. Philadelphia: Saunders, 2003;1681–701
18 Sueara, AB, Gonçalves, AJ, Alcadipani, FA, Kavabata, NK, Menezes, MB. Deep neck infection: analysis of 80 cases. Braz J Otorhinolaryngol 2008;74:253–9
19 Bartlett, JG, Gorbach, SL. Anaerobic infections of the head and neck. Otolaryngol Clin North Am 1976;9:655–78
20 Brook, I. Microbiology and management of peritonsillar, retropharyngeal and parapharyngeal abscesses. J Oral Maxillofac Surg 2004;62:1545–50
21 Boscolo-Rizzo, P, Marchiori, C, Zanetti, F, Vaglia, A, Da Mosto, MC. Conservative management of deep neck abscesses in adults: the importance of CECT findings. Otolaryngol Head Neck Surg 2006;135:894–9
22 Daramola, OO, Flanagan, CE, Maisel, RH, Orland, RM. Diagnosis and treatment of deep neck space abscesses. Otolaryngol Head Neck Surg 2009;141:123–30
23 Nagy, M, Backstrom, J. Comparison of the sensitivity of lateral neck radiographs and computed tomography scanning in pediatric deep-neck infections. Laryngoscope 1999;109:775–9
24 Crespo, AN, Chone, CT, Fonseca, AS. Clinical versus computed tomography evaluation in the diagnosis and management of deep neck infection. Sao Paulo Med J 2004;122:259–63
25 Boscolo-Rizzo, P, Stellin, M, Muzzi, E, Mantovani, M, Fuson, R, Lupato, V et al. Deep neck infections: a study of 365 cases highlighting recommendations for management and treatment. Eur Arch Otorhinolaryngol 2012;269:1241–9
26 Gallo, O, Deganello, A, Meccariello, G, Spina, R, Peris, A. Vacuum-assisted closure for managing neck abscesses involving the mediastinum. Laryngoscope 2012;122:785–8
27 Yuen, H, Loy, A, Johari, S. Urgent awake tracheotomy for impending airway obstruction. Otolaryngol Head Neck Surg 2007;136:838–42
28 Boscolo-Rizzo, P, Da Mosto, MC. Submandibular space infection: a potentially lethal infection. Int J Infect Dis 2009;13:327–33
29 Boscolo-Rizzo, P, Marchiori, C, Montolli, F, Vaglia, A, Da Mosto, MC. Deep neck infections: a constant challenge. ORL J Otorhinolaryngol Relat Spec 2006;68:259–65
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 25
Total number of PDF views: 147 *
Loading metrics...

Abstract views

Total abstract views: 331 *
Loading metrics...

* Views captured on Cambridge Core between 6th November 2017 - 19th July 2018. This data will be updated every 24 hours.