Deep Neck Space Infections: Current Trends and Intricacies of Management?

Bhardwaj, Rohit; Makkar, Saurabh; Gupta, Ankur; Khandelwal, Kirti; Nathan, Karthika; Basu, Chirayata; Palaniyappan, Gowtham

doi:10.1007/s12070-020-02174-4

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…Empirically, a combination of ceftriaxone and metronidazole was given to these patients. The administration was continued until 14 days since the culture results showed that the bacteria are sensitive to ceftriaxone and metronidazole [17] , [19] , [20] .…”

Section: Discussionmentioning

confidence: 99%

The application of honey in wound care of raw surface at spontaneous rupture submandibular abscess that extends to submental and right neck: A case report

Saputri

Massie

Gatera

et al. 2022

International Journal of Surgery Case Reports

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Introduction Honey has been reported to accelerate wound healing. The use of honey in wound care mostly uses medicated (Manuka) honey. There are still few who report using Nusantara honey, local honey from Indonesia, as a wound dressing. We report wound care using Nusantara honey in patients with a remarkably open wound due to a ruptured submandibular abscess extending to the submental and right neck. Presentation of case A 67 years old male patient came with a ruptured submandibular abscess that extends to the submental and right neck. On the right submandibular region, an ulcer extends to submental with a size of 10 × 4 × 3 cm, hyperemic, edema around the wound, fluctuating, with pus and tenderness. The isolated bacteria were Staphylococcus aureus . The patient received combination antibiotic therapy, blood sugar management, necrotomy debridement, tooth extraction, and wound care using Nusantara honey on the sixth day after surgery. An improvement was seen on the 10th day after necrotomy. Discussion The use of honey for wound care is based on thousands of years of history. Honey can accelerate wound healing and show different effects depending on the phase of wound healing. In addition, honey also has antibacterial properties. Conclusion Applying Nusantara honey to treat raw surfaces can help speed up wound healing and provide cost-efficiency. There were no allergic reactions or secondary bacterial infections after using honey in this patient.

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Section: Discussionmentioning

confidence: 99%

The application of honey in wound care of raw surface at spontaneous rupture submandibular abscess that extends to submental and right neck: A case report

Saputri

Massie

Gatera

et al. 2022

International Journal of Surgery Case Reports

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“…The therapeutic management of these collections includes, on many occasions, surgical or percutaneous drainage together with appropriate and early antibiotic treatment ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Application of 3D technology for the design of a guidewire for deep cervicofacial collections percutaneous management

López-Martínez,

Pampín-Martínez,

García-López-Chicharro

et al. 2024

J Clin Exp Dent

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Background This study aims to present a case of deep cervicofacial abscesses and demonstrate the efficacy of CT-guided drainage with a custom-designed puncture guide in a challenging anatomical location. The use of this type of guide is an innovative technique since CAD-CAM technology has not been used for this type of application until now. Material and Methods A 76-year-old man with persistent facial swelling and trismus underwent surgical drainage initially, but symptoms persisted. A CT-guided transcutaneous approach was planned using a custom-designed positioning guide created with “in-house” 3D technology. The guide was fabricated using Surgical Guide resin, and the patient underwent successful CT-guided drainage. Results The intervention facilitated precise drainage without damaging critical anatomical structures. The patient exhibited prompt clinical improvement, shortened hospitalization, and favorable aesthetic outcomes. Conclusions CT-guided drainage, particularly when combined with a custom puncture guide, offers a less invasive alternative for challenging cervicofacial abscesses. This approach proves valuable in reducing procedure duration, minimizing soft tissue trauma, and enhancing preoperative planning, making it especially beneficial for patients with high anesthetic risk or complex anatomical considerations. Key words: Cervical abscess, 3D technology, drainage guide, percutaneous puncture.

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“…If the primary cause of orofacial infections in the mandible spaces is not promptly eliminated, swelling into the cervical multilayered deep fascia can occur, leading to infection in the deep neck space [ 8 ]. The severity of these infections can be decreased via surgical clearance and antibiotics, but if the infection spreads, it can obstruct the airway, leading to morbidity and, in rare cases, mortality [ 8 , 9 , 10 , 11 ]. Extended orofacial infections are challenging because of the complex anatomy of the head and neck, the vicinity of vital structures, and the risk of the infection spreading to adjacent spaces.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Airway Management of Orofacial Infections Originating in the Mandible

Sakkas

Weiß

Zink

et al. 2023

JPM

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The primary aim of this study was to assess the incidence of a difficult airway and emergency tracheostomy in patients with orofacial infections originating in the mandible, and a secondary aim was to determine the potential predictors of difficult intubation. This retrospective single-center study included all patients who were referred between 2015 and 2022 with an orofacial infection originating in the mandible and who were surgically drained under intubation anesthesia. The incidence of a difficult airway regarding ventilation, laryngoscopy, and intubation was analyzed descriptively. Associations between potential influencing factors and difficult intubation were examined via multivariable analysis. A total of 361 patients (mean age: 47.7 years) were included in the analysis. A difficult airway was present in 121/361 (33.5%) patients. Difficult intubation was most common in patients with infections of the massetericomandibular space (42.6%), followed by infections of the mouth floor (40%) and pterygomandibular space (23.5%). Dyspnea and stridor were not associated with the localization of infection (p = 0.6486/p = 0.4418). Multivariable analysis revealed increased age, restricted mouth opening, higher Mallampati scores, and higher Cormack–Lehane classification grades as significant predictors of difficult intubation. Higher BMI, dysphagia, dyspnea, stridor and a non-palpable mandibular rim did not influence the airway management. Patients with a difficult airway were more likely to be admitted to the ICU after surgery than patients with regular airway were (p = 0.0001). To conclude, the incidence of a difficult airway was high in patients with orofacial infections originating in the mandible. Older age, limited mouth opening, a higher Mallampati score, and a higher Cormack–Lehane grade were reliable predictors of difficult intubation.

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Deep Neck Space Infections: Current Trends and Intricacies of Management?

Cited by 6 publications

References 17 publications

The application of honey in wound care of raw surface at spontaneous rupture submandibular abscess that extends to submental and right neck: A case report

The application of honey in wound care of raw surface at spontaneous rupture submandibular abscess that extends to submental and right neck: A case report

Application of 3D technology for the design of a guidewire for deep cervicofacial collections percutaneous management

Airway Management of Orofacial Infections Originating in the Mandible

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