Steroids in Maxillofacial Space Infection: A Retrospective Cohort Study

Abstract

Maxillofacial space infection (MSI) is one of the most common conditions encountered in oral and maxillofacial surgery clinics. Early recognition and proper management of MSI could prevent a life-threatening event. Objectives: To report a series of MSI managed with antibiotics, surgical intervention and exogenous steroids as an adjunct, highlighting functional improvement following steroid administration. Methods: A retrospective cohort study was carried out from December 2013 to September 2016, involving 30 patients (n = 30, 22 males, 8 females) diagnosed with MSI. All patients were initially managed with intravenous empirical antibiotics, analgesics and removal of potential source of infection. A course of 3 doses of IV Dexamethasone 8 mg at an interval of 8 hours was started during the first day of hospital admission. Results: This series reports 30 patients presenting with MSI, who received prompt antibiotics and 3 doses of steroids as in-patients. Significant clinical improvement was noted in the form of amelioration of pain, rapid reduction in edema, and improved trismus, shortening hospital stay to an average of 3.5 days, and omission of surgical intervention in 50% of our cases. No adverse effects or drug reaction was noted. Conclusion: In conclusion, the value of synergistic use of corticosteroids with antibiotics in management of MSI is significant. Despite these promising findings, there is scarce evidence in the literature to fully support the use of corticosteroids in abscess management. The role of corticosteroids in treatment of MSI should be explored further.

Length of hospital stay among oral and maxillofacial patients: a retrospective study

“…The rate of readmission for patients with maxillofacial infection in our center was 1%, which is comparable to the readmission rate of 0.4% reported among maxillofacial infection patients in another study 11 . The short LOS of patients admitted for maxillofacial infections in our study can be attributed to the use of exogenous steroids as an adjunct in indicated cases to alleviate infection-related symptoms and thus shorten hospital stay, as supported by Low et al 12 and Kent et al 13 . However, conflicting studies have reported adverse effects from steroid use in infectious conditions 14 , 15 .…”

Wisdom Tooth Surgery Complications—Local Anaesthesia versus General Anaesthesia

“…On the day of surgery, patient was orally intubated, sedated and scrubbed. IV Dexamethasone 8 mg and antibiotics were served as pre-operative medication for GA procedure given by anaesthesist after intubation [14].…”

Application of corticosteroids in dentistry

“…In maxillofacial surgery, corticosteroids are indispensable in the postoperative period for most surgical interventions, as well as more severe infections, because they make the postoperative period easier for the patient and reduce the time spent in hospital 38 .…”

“…U maksilofacijalnoj hirurgiji, KS su nezaobilazni u postoperativnom periodu kod većine hirurških intrevencija, kao i težih infekcija, jer olakšavaju postoperativni period pacijentu, a sa njihovom primenom smanjuje se i broj dana provedenih u bolnici 38 .…”