Cavernous Sinus Involvement and Near Miss Mediastinitis following Mandibular Tooth Infection Treated during the COVID-19 Pandemic: Clinical Diagnosis and Treatment

Inchingolo, Alessio Danilo; Ceci, Sabino; Limongelli, Luisa; Corriero, Alberto; Curatoli, Luigi; Azzollini, Daniela; Mezzapesa, Pietro Paolo; Marinelli, Grazia; Malcangi, Giuseppina; Coloccia, Giovanni; Ribezzi, Mario; Massaro, Maria Grazia; Bordea, Ioana Roxana; Lorusso, Felice; Brienza, Nicola; Favia, Gianfranco; Quaranta, Nicola; Inchingolo, Francesco

doi:10.1155/2022/8650099

Cited by 4 publications

(5 citation statements)

References 79 publications

(106 reference statements)

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“…In the literature, several studies described the possible evolution of sialadenitis in DNI, especially for elderly and immunocompromised people [13]. In 10% of the cases that we collected, DNIs were related to infections of unknown origin, and this data is supported by recent literature reports showing that in up to 25% of cases of DNIs, it is not possible to identify the primary source of infection [14].…”

Section: Discussionsupporting

confidence: 77%

Management of Deep Neck Space Infections: A Large Tertiary Center Experience

Loperfido¹,

Stasolla²,

Giorgione³

et al. 2023

Cureus

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Introduction: Deep neck space infections (DNIs) represent serious bacterial infections affecting the deep cervical space and fascial planes of the neck. This study aims to describe our clinical and surgical experience in the management of DNIs, emphasizing the importance of appropriate imaging in the diagnostic setting and the role of the multidisciplinary approach according to the severity of the infection.Methods: In this retrospective study, we describe 85 patients affected by DNIs coming to the Otolaryngology department observation from the Emergency Room of San Camillo Forlanini Hospital in Rome from January 2006 to December 2021 and treated both by pharmacological and surgical therapy.Results: 54 patients (64%) were male, and 31 (36%) were female, with a mean age of 50.5 years. The most common cause of DNI was odontogenic, accounting for 70% of all collected cases. In 68 patients (80% of all cases), the surgical approach consisted of an extended unilateral cervicotomy, whereas in 17 patients (20% of all cases), a bilateral cervicotomy was performed. Surgical revision was required in 15 cases (18%). A tracheostomy was necessary in seven cases. The overall survival rate was 96.5%.Conclusions: DNI represents a serious and life-threatening condition, remaining a constant challenge for the head and neck surgeon. Contrast-enhanced computed tomography is critical for therapeutic planning, which requires both a surgical approach and antibiotic therapy. Surgical treatment should be performed as soon as possible. In severe cases, the multidisciplinary approach is advisable.

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Section: Discussionsupporting

confidence: 77%

Management of Deep Neck Space Infections: A Large Tertiary Center Experience

Loperfido¹,

Stasolla²,

Giorgione³

et al. 2023

Cureus

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“…9 Other studies have reported a variety of ODS complications associated with the COVID-19 pandemic, which included a series of cases of ODS with invasive fungal mucormycosis and a case of ODS with cavernous sinus involvement and systemic spread with mediastinitis. 10,11 In our cohort, one patient from the COVID group presented with an intracranial abscess requiring an oro-maxillofacial intervention, endoscopic sinus surgery, orbitofrontal craniotomy, and extended antibiotic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…They postulated that the infection spreads through direct routes, such as submucosal or thrombophlebitis, or indirect routes, such as hematogenous spread through the maxillary alveolar marrow or through the facial veins passing through the pterygoid plexus to the orbit, face, brain, or systemically 9 . Other studies have reported a variety of ODS complications associated with the COVID‐19 pandemic, which included a series of cases of ODS with invasive fungal mucormycosis and a case of ODS with cavernous sinus involvement and systemic spread with mediastinitis 10,11 . In our cohort, one patient from the COVID group presented with an intracranial abscess requiring an oro‐maxillofacial intervention, endoscopic sinus surgery, orbitofrontal craniotomy, and extended antibiotic therapy.…”

Section: Discussionmentioning

confidence: 99%

Trends of Odontogenic Sinusitis Incidence During the COVID‐19 Pandemic

Ringel,

Kons,

Holbrook

et al. 2023

The Laryngoscope

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ObjectivesThe COVID‐19 pandemic affected the epidemiology of several diseases. This study aims to compare the incidence of surgically treated odontogenic sinusitis (ODS) before and during the COVID‐19 pandemic and identify unique features.MethodsA retrospective chart review of patients who underwent at least maxillary antrostomy at a tertiary referral center was performed. The patients were divided into two cohorts: “pre‐COVID” (March 2018 to February 2020) and “COVID” (March 2020 to February 2022). Data on demographics, comorbidities, and treatment interventions were collected and analyzed.ResultsOf the 734 patients who underwent maxillary antrostomy, 370 (50.4%) were operated on during the COVID period, with a mean age of 53.1 ± 15.7 years. ODS was found as the etiology of 22 (6%) and 45 (12.2%) of the pre‐COVID and COVID cases, respectively (p = 0.006). Although no difference was found in the incidence of diabetes (p = 0.9) or obesity (p = 0.7) between groups, a trend toward higher incidence of immunosuppression was found in the pre‐COVID patients (18.2% vs. 0%, p = 0.06). A higher incidence of sphenoid sinus involvement (31.8% vs. 8.9%, p < 0.05) was identified in the pre‐COVID group; however, no differences in ethmoid (86.4% vs. 86.7%, p = 0.999) or frontal sinus involvement (54.5% vs. 37.8%, p = 0.3) were found between the groups.ConclusionThere was an increase in the incidence of ODS during the first 2 years of the COVID‐19 pandemic compared to the 2 years prior. Similar clinical characteristics were found in both groups. Future studies focusing on specific etiologies to explain ODS preponderance may help determine optimal treatment and prevention strategies.Level of EvidenceLevel III Laryngoscope, 2023

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“…The types of surgical techniques that are currently available are conventional scalpel surgery and laser surgery. The conventional cold-blade method has all the side effects of classical surgery, such as tissue bleeding with the need for suturing and possible bacterial overinfection of the surgical site [12,13].…”

Section: Introductionmentioning

confidence: 99%

Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review

Inchingolo

Malcangi

Ferrara

et al. 2023

IJERPH

Self Cite

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An abnormal and hypertrophied upper labial frenulum (ULF) can cause diastemas, gingival recession, eruption abnormalities, and the onset of carious and periodontal problems in the upper central incisors, as well as aesthetic and functional disorders of the upper lip. The goal of this investigation is to review the evidence on the surgical techniques that are currently available for treating ULF in order to identify the best approach. PubMed, Scopus, Cochrane Library, and Embase were searched for papers that matched our topic from 13 November 2012 up to 22 November 2022 using the following Boolean keywords: “frenulum” and “surgery*”. A total of eight articles were selected for the purpose of the review. ULF can be surgically treated using either traditional scalpel surgery or laser surgery. The latter is the better option due to its intra- and post-operative benefits for both the patients and the clinicians, in terms of faster healing, fewer side effects and discomfort, and greater patient compliance. However, a higher learning curve is required for this technique, especially to calibrate the appropriate power of the laser. To date, it is not possible to identify which type of laser achieves the best clinical results for the treatment of ULF.

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Cavernous Sinus Involvement and Near Miss Mediastinitis following Mandibular Tooth Infection Treated during the COVID-19 Pandemic: Clinical Diagnosis and Treatment

Cited by 4 publications

References 79 publications

Management of Deep Neck Space Infections: A Large Tertiary Center Experience

Management of Deep Neck Space Infections: A Large Tertiary Center Experience

Trends of Odontogenic Sinusitis Incidence During the COVID‐19 Pandemic

Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review

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