Original ContributionsCharacterizations of life-threatening deep cervical space infections: A review of one hundred ninety-six cases☆
Section snippets
Materials and methods
We reviewed the medical records of 225 Taiwanese patients with a diagnosis of deep neck infection during the period from March 1996 to February 2002. All of them had been admitted to Kaohsiung Medical University Hospital for treatment. A total of 196 patients with complete medical records were enrolled in this study, including 131 men and 65 women. Their ages ranged from 1 to 86 years, and the mean age was 41.8 years. The details are shown in Figure 1.The
Results
The JMP4.0 software (SAS Institute, Cary, NC) was used for calculations. The results were shown in Table 3 (multiple regression) and Table 4 (logistic regression).Parameters Sum of Square F ratio P Value Age 90.81 4.29 0.04* Sex 46.49 2.2 0.14 Fever 2.07 0.1 0.75 Neck swelling 203.45 9.61 0.002* Neck pain 6.68 0.32 0.58 Trismus 132.93 6.28 0.01* Underlying disease 101.58 4.8 0.04* Respiratory difficulty 8.78 0.41 0.52 Complication 123.69 5.84 0.02* WBC >15000/mm3 2.39 0.11 0.73 CRP >100μg/ml 211.39 9.99 0.002* *P
Discussion
In our department, the treatment protocol had been formulated as follows: when a patient with the suspicion of deep neck infection was admitted, we performed thorough physical examination and laboratory studies, including a complete blood count with differentiating count, serum electrolytes, blood sugar, C-reactive protein, and liver and renal function tests. Imaging studies such as neck soft-tissue radiograph and neck computed tomography were used selectively. Empirical intravenous antibiotics
Conclusion
With the introduction of antibiotics and the improvement in dental care and oral hygiene, the incidence of deep neck infections had decreased significantly today, but they continue to be a cause of morbidity and mortality. In general, the combination of early radiologic diagnosis, intravenous antibiotic therapy, drainage of pus and appropriate culture, and maintenance of airway will lead to the good prognosis. Complications remain potentially fatal, but it can be successfully avoided if doctors
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Address correspondence to: Ling-Feng Wang, MD, Department of Otolaryngology, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.