Odontogenic Head and Neck Region Infections Requiring Hospitalization: An 18-Month Retrospective Analysis

Abstract

The aim of this study was to comprehensively review our experience with odontogenic infections in the head and neck region requiring treatment at a national referral center. We retrospectively reviewed 85 patients treated at the Chair and Clinic of Maxillofacial Surgery of the University Hospital in Wrocław between January 2018 and June 2019. We excluded patients with nonondontogenic infections or other than purulent clinical forms of dentivitis in the head and neck region. Several demographic, clinicopathological, and treatment variables were assessed. The majority of patients were men who were referred for inpatient treatment by a dentist or family doctor, presented to the Hospital Emergency Ward (SOR) by themselves, or transported to the SOR by paramedics SOR from their home or another hospital. All patients were treated in accordance with the current guidelines for head and neck region odontogenic infections. An incision was made and the abscess was drained. The odontogenic cause was removed followed by the collection of tissue for microbiological examination. The course of infection was monitored by means of laboratory parameters such as leukocyte counts and c-reactive protein levels. Odontogenic infections in the head and neck region are a persistent and common problem. Rapid, accurate diagnosis and treatment minimizes the risk of life-threatening complications, shortens the hospitalization period, and lowers treatment costs.

Haematological and Biochemical Variations in Cervico-Facial Cellulitis of Dental Origin in the City of Ouagadougou (Burkina Faso)

“…Socio-demographic characteristics Cervicofacial cellulitis affects patients of all ages, but predominates in young subjects, which was noted in our study [6]. The male predominance found in the literature, Zawiślak [4] in Poland, Bissa [13] in Togo and Benzarti [14] in Tunisia, is also noted in our results. This could be explained by the neglect of oral hygiene measures by men but also by the high consumption of tobacco and alcohol, which are incriminating factors in cellulitis [15].…”

“…Cervicofacial cellulitis is responsible for a major disturbance of the biological homeostasis of the host individual, resulting in a rich and varied clinical and topographical symptomatology [4] [5] [6] [7] [8]. The biological disorders induced by cellulitis must be associated with those caused by comorbidities that may interact with it and be responsible for the appearance of severe forms [9].…”

Medical Infrared Thermography in Odontogenic Facial Cellulitis as a Clinical Decision Support Tool. A Technical Note

“…Facial cellulitis is a common infection of head and neck fascial spaces mainly attributable to dentoalveolar origin, such as dental infections, postoperative infections, periodontal disease or inflammation of the pericoronal tissues [9,10]. Decisions on whether to hospitalize patients in order to treat acute odontogenic facial cellulitis (AOFC) usually rely on the severity of the infection [6,9]. Three aspects largely determine the severity and spread of infectious process: (i) the warning clinical signs (high fever > 38.5 • C, weakness, dyspnea, dysphagia, severe trismus, edema of eyelids, impaired vision, etc.…”

“…Moreover, since prompt treatment of severe odontogenic infections promotes shorter hospital stays with fewer complications [6,40,41], MIT could become a tool for clinical decision support for physicians regarding the need of cervico-thoracic CT scans. Biological evaluations using blood analyses of the C-reactive proteins and numbers of white blood cells, which are predictive factors of severe complications of facial cellulitis, could also be requested [5,10,[42][43][44].…”

“…Despite IV antibiotic therapy and surgical management, odontogenic infections may promptly spread to deep spaces of the head and neck. Serious complications can then arise and be life-threatening, such as critical airway obstructions, downward mediastinitis, cavernous sinus thrombosis or septic shock [5][6][7][8]. Inpatient mortality was estimated to be between 0.01% to 0.2%, associated with advanced age of the patient, the presence of comorbid factors such as diabetes, and delayed surgical treatment [1,4,8].…”