Deep Neck Space Abscess – A Case Report

Abstract

Deep neck spaces are regions of loose connective tissue present between three layers of deep cervical fascia, namely, superficial, middle, and deep layers. The investing layer is the superficial layer, the pre-tracheal layer is the intermediate layer, and the prevertebral layer is the deep layer. Deep neck space infection (DNI) is defined as an infection in the potential spaces and actual fascial planes of the neck. Spread of infection occurs along communicating fascial boundaries. These deep neck spaces may be further classified into 3 anatomic groups, relative to the hyoid bone: Those located above the level of the hyoid, those that involve the entire length of the neck, those located below the level of hyoid. The patterns of infection may include abscess formation, cellulitis, and necrotizing fasciitis. Antibiotics and surgical drainage form the mainstay of treatment. There are some spaces in the neck present between these layers of deep cervical fascia. These deep neck spaces are filled with loose connective tissue. Deep neck space infection involves the spaces and fascial planes of the neck. Spread of infection occurs along communicating fascial boundaries after overcoming the natural resistance of the fascial planes. With relation to the hyoid bone, these deep neck spaces are further classified as follows: 1. Spaces above the level of the hyoid bone (peritonsillar, submandibular, parapharyngeal, masticator, buccal, and parotid spaces). 2. Spaces that involve the entire length of the neck (retropharyngeal, prevertebral, and carotid spaces). 3. Spaces located below the level of hyoid bone (anterior visceral or pre - tracheal space). Infection may present either as abscess, cellulitis, or necrotizing fasciitis. The mainstay of the management are antibiotics and surgical drainage.