Clinical Diagnosis And Treatment Of Deep Neck Infection

Objective To explore the clinical features and the diagnosis and treatment of Deep Neck Infection,and guide clinicians to make a better diagnosis and treatment for the disease.Methods Patients diagnosed with Deep Neck Infection by Otolaryngologist in the Union Hospital afflicted of Fujian Medical University were retrospectively reviewed between February 2011 and February 2019 according to their medical information,including age,gender,underlying disease,etiology,clinical manifestations,auxiliary examination,treatment,the outcome of treament and follow-up results,etc.The data was processed using SPSS 20.0 software.Results Of the 37 patients enrolled,27 were male and 10 were female,with an average age of 52.14±16.63 years(range,4 to 84 years)and a median age of 55 years.There were 15 cases of diabetes mellitus,8 cases of hypertension,.One of them had hypertension heart disease,heart function level II,and atrial fibrillation.Pharyngeal infection(17 cases)is the most common cause of Deep Neck Infection,the remaining causes include upper respiratory tract infection in 6 cases,foreign body in 5 cases,unknown cause in 4 cases,odontogenic infection in 3 cases,and congenital piriform sputum secondary infection in 1 case.Pain,difficulty in swallowing,fever,limited mobility,and dyspnea were common symptoms.Parapharyngeal space infection(27 cases)was the most common.The remaining infected spaces were anterior tracheal space(14 cases),perivascular space(11 cases),posterior pharyngeal space(9 cases),submandibular space(7 cases),and periesophageal space(3 cases)and supracondylar space(3 cases).Mediastinum infection occurred in 8 cases.Multiple spaces infection were more common than single space infection.All patients were treated with a broadspectrum,full-course antibiotic,anaerobic infections were treated with anti-anaerobic drugs,and the drainage was performed after the abscess was formed.Non-surgical treatment accounted for 43.24% of the sample(16 cases),surgical treatment accounted for 56.76% of the sample(21 cases),and 8 cases of bacterial culture were positive.All patients were cured or improved after treatment,and there were no deaths.The average hospital stay was 14.1± 10.50 days.The follow-up time ranged from 1 month to 8 years.One patient with recurrence was treated with abscess incision and drainage again,and was further visited in the external hospital and diagnosed as congenital pear-shaped fossa.Multiple spaces infections,complications,white blood cell counts,and tracheotomy were associated with hospital days.Conclusion Deep Neck Infection is one of the most emergency and critical disease of Otorhinolaryngology-Head and Neck Surgery,This study found through retrospective case analysis that pharyngeal infection is the most common cause of Deep Neck Infection.Parapharyngeal space is most likely to be involved.Multiple spaces infection were more common than single space infection.It’s the key to improve curative ratio to use antibiotics appropriately and make a surgical treatment when the abscess forms.The nutritional support and management of airway and prevention of complications play the same important roles in the treatment of Deep Neck Infection.Multiple space infections,complications,white blood cell count and tracheotomy were associated with the hospital days.