Publication:

A study on presentation, etiology, complications and management of deep neck space infections: our experience

Background To analyze our experience in presentation, etiology, complications and difficulties encountered in diagnosis and management of deep neck space infections.

Methods 52 cases of deep neck space infections were analyzed within the period of November 2013 to November 2015 in ENT OPD at GMC Latur. Patients with airway compromise or in failures were managed with intubation or tracheostomy. All patients were investigated with detail history, hematological and radiological investigations like X- Ray, USG or CT scan. Although all patients were treated with intravenous antibiotics, surgical drainage was the definitive management.

Results Study includes 29 males and 23 females. Neck pain was most common presentation in 90.38% with airway compromise being most common complication. Submandibular (34.61%) and peritonsillar (21%) space were commonly involved with odontogenic and upper airway infections being leading causes. Diabetes was common comorbidity found among patients. Staphylococcus aureus being common isolate (Klebsiella in diabetics). Surgical drainage with antibiotics as per culture sensitivity was treatment modality of choice.

Conclusions Early diagnosis and appropriate management is key for better outcome. Odontogenic etiology being most common correlates well with poor oral hygiene and tobacco chewing. Surgical drainage and antibiotics are the treatment modalities. Complications and associated comorbidities affect the course of DNSI and hence require appropriate management.