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Category: Volume 06 Issue 03 March 2018
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Title: Clinical Presentation of Neck Space Abscess and its Management in a Rural Based Tertiary Care Centre

Authors: Ashis Kumar Ghosh, Jayanta Saha, Srimanti Kundu, Sujoy Panchadhyayee

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i3.105

Abstract

Objective: The aim of this study is to evaluate patients of neck abscess in respect to its common presentation, predisposing factors, co-morbidity, frequently involved area and treatment modality needed.  

Study Design: It’s a prospective study done between January 2016 to December 2017 at Burdwan Medical College and Hospital, Burdwan.

Materials and Method: 46 patients with clinical diagnosis of neck abscess are included in our study during January 2016 to December 2017. Details of all patients are recorded and all of them are assessed for demographic profile, clinical presentation, presence of any co-morbidity, probable source of infection, abscess location, treatment procedures during hospital stay.

Result: among 46 patients 22 were male and rest 24 were female, mean age of our sample is 22.98 with SD 15.414. Patients mostly complain about neck pain (76%) and swallowing difficulty (67%). 8.7% patients have diabetes mellitus as co-morbidity. The source of infection is unknown in most of the cases, but dental caries and oro-pharyngeal infection (28.3% each) were found as source of infection in a significant number of patients. Abscess formation was found mostly in submandibular space (28.3%) followed by para-pharyngeal space (26.1%). 80% patients needed incision and drainage along with iv antibiotics whether 20% patients responded well to conservative treatment. One patient with compromised upper airway, underwent tracheostomy as a life saving procedure.

Conclusion: Patients of all age group may be presented with neck space infection. Patients with co-morbidities present with more severe form of neck space infection. In many cases of neck space infection, source of infection may present in nearby areas. As patient with neck space infection can progress to life threatening conditions, prompt medical as well as surgical treatment is very important.

References

  1. Suphi B, Ilker BA, Erhan D, Sureyya HK, Ibrahim C . Neck abscess : 79 cases. North Clin Istanbul 2015;2(3):222–226.
  2. Ricard S, Jean-Pierre J.Benign Neck Disease.Stell & Maran’s Textbook of Head and Neck Surgery and Oncoligy, 5th edition, page 228-230.
  3. Brito TP, Hazboun IM, Fernandes FL, Bento LR, Zappelini CEM, Chone CT, Crespo AN. Deep neck abscesses: study of 101 cases. Braz J Otorhinolaryngol. 2017;83(3):341-348.
  4. Panduranga Kamath, Ashok BS, Mahesh CH , Suja S. Presentation and management of deep neck space abscess. Indian J Otolaryngol Head Neck Surg. 2003 Oct; 55(4): 270–275.
  5. Seyyed JM, Rostam P, Mehdi N, Milad B, Seyyed MHS, Freshtey  Treatment and Prognosis of Deep Neck Infections.  Indian J Otolaryngol Head Neck Surg. 2015 Mar; 67(Suppl 1): 134–137.
  6. Sethi DS, Stanley RE. Deep neck abscesses: Challenging trends. J Laryngol Otol. 1994;108:138–43.
  7. Eftekharian A, Roozbahany NA, Vaezeafshar R, Narimani N. Deep neck infections: a retrospective review of 112 cases. Eur Arch Otorhinolaryngol. 2009;266:273-7.
  8. Parhiscar A, Harel G. Deep neck abscess: A retrospective review of 210 cases. Ann Otolo Rhinol Laryngol. 2001;110 (11):1051–54.
  9. Bakir S, Tanriverdi MH, Gun R, Yorgancilar AE, Yildirim M, Tekbas G, et al. Deep neck space infections: A retrospective review of 173 cases. Am J Otolaryngol. 2012;33(1):56–63.
  10. Atishkumar BG, Vijayalaxmi A, Pallavi K. Deep neck space infection - A retrospective study of 270 cases at tertiary care center. world Journal of Otorhino-laryngology Head and Neck Surgery (2016) 2, 208-213.
  11. Sakagushi M, Sato S, Ishiyama T, Katsuno S, Tagushi K. Char- acterization and management of deep neck infection. J Oral Maxillofac Surg. 1997;26:131-4.
  12. Lee JK, Kim HD, Lim SC. Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J. 2007;48:55-62.
  13. Coelho MS, Ramos G, Prestes LC, Soccol A, Oliveira MSB, Lobo P. Deep neck infections - classification in levels of severity. Int Arch Otorhinolaryngol. 2009;13:184-8.
  14. Sennes LU, Imamura R, Júnior FVA, Frizzarini R, Tsuji DH. Infec ̧cões dos espa ̧cos cervicais: estudo prospective de 57 casos. Rev Bras Otorrinolaringol. 2002;68:388-93
  15. Mumtaz RM, Arain AA, Suhail A, Rajput SA, Mohammad A, Nabeel H. Deep neck space infections: retrospective review of 46 patients. J Cranio Max Dis. 2014;3:21e25.
  16. Har-El G, Aroesty JH, Shaha A, Lucente FE. Changing trends in deep neck abscess: a retrospective study of 110 patients. Oral Surg Med. 1994;77:446-450.

Corresponding Author

Jayanta Saha