No CrossRef data available.
Article contents
Deep neck space infections: a UK centre, two-year, retrospective review of 53 cases
Published online by Cambridge University Press: 22 October 2024
Abstract
Objective
This retrospective study comprehensively assesses clinical characteristics, management, outcomes, and complications of deep neck space infections in adults at a UK ear, nose and throat tertiary centre.
Methods
Adult deep neck space infection patients from April 2019 to March 2021 were retrospectively reviewed using health records and picture archiving and communication system data. Demographics, presentation, microbiology, treatment, complications, and outcomes were analysed.
Results
Fifty-three patients (mean age: 53.8 years, M:F ratio 1.5:1) were studied. Deep neck space infections were polymicrobial in 29.4 per cent, with Streptococcus milleri group (64.7 per cent) occurring most frequently. Complications occurred in 20.8 per cent, including mediastinitis (13.2 per cent) and Lemierre's syndrome (7.5 per cent). Mortality was 5.7 per cent. Treatment included intensive care admission (32.1 per cent), tracheostomy (15.1 per cent), medical management alone (39.6 per cent), bedside peritonsillar abscess drainage (18.9 per cent), transcervical drainage (28.3 per cent), transoral drainage (13.2 per cent), and hot tonsillectomy (5.7 per cent). Patient age correlated with length of stay.
Conclusion
The study highlights deep neck space infection complexity, emphasising tailored management, effective antibiotics, and frequency and severity of complications. Comprehensive understanding of deep neck space infections can improve care and outcomes.
- Type
- Main Article
- Information
- Copyright
- Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED
Footnotes
Alexander Charlton takes responsibility for the integrity of the content of the paper
References
Brito, TP, Hazboun, IM, Fernandes, FL, Bento, LR, Zappelini, CEM, Chone, CT et al. Deep neck abscesses: study of 101 cases. Braz J Otorhinolaryngol 2017;83:341–8CrossRefGoogle ScholarPubMed
Huang, TT, Liu, TC, Chen, PR, Tseng, FY, Yeh, TH, Chen, YS. Deep neck infection: analysis of 185 cases. Head Neck 2004;26:854–60CrossRefGoogle ScholarPubMed
Yap, D, Harris, AS, Clarke, J. Serious tonsil infections versus tonsillectomy rates in Wales: a 15-year analysis. Ann R Coll Surg Engl 2017;99:31–6CrossRefGoogle Scholar
Lau, AS, Upile, NS, Wilkie, MD, Leong, SC, Swift, AC. The rising rate of admissions for tonsillitis and neck space abscesses in England, 1991–2011. Ann R Coll Surg Engl 2014;96:307–10CrossRefGoogle ScholarPubMed
Toppi, J, Hughes, J, Phillips, D. Bacterial infections of the oropharynx and deep neck spaces: an investigation of changes in presentation patterns during the COVID-19 pandemic. ANZ J Surg 2021;91:2726–30CrossRefGoogle ScholarPubMed
Celakovsky, P, Kalfert, D, Smatanova, K, Tucek, L, Cermakova, E, Mejzlik, J et al. Bacteriology of deep neck infections: analysis of 634 patients. Aust Dent J 2015;60:212–15CrossRefGoogle ScholarPubMed
Maharaj, S, Ahmed, S, Pillay, P. Deep neck space infections: a case series and review of the literature. Clin Med Insights Ear Nose Throat 2019;12:1179550619871274CrossRefGoogle ScholarPubMed
Boscolo-Rizzo, P, Stellin, M, Muzzi, E, Mantovani, M, Fuson, R, Lupato, V et al. Deep neck infections: a study of 365 cases highlighting recommendations for management and treatment. Eur Arch Otorhinolaryngol 2012;269:1241–9CrossRefGoogle ScholarPubMed
Biron, VL, Kurien, G, Dziegielewski, P, Barber, B, Seikaly, H. Surgical vs ultrasound-guided drainage of deep neck space abscesses: a randomized controlled trial. J Otolaryngol Head Neck Surg 2013;42:18CrossRefGoogle ScholarPubMed
Hurley, RH, Douglas, CM, Montgomery, J, Clark, LJ. The hidden cost of deep neck space infections. Ann R Coll Surg Engl 2018;100:129–34CrossRefGoogle ScholarPubMed
Parhiscar, A, Har-el, G. Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol 2001;110:1051–4CrossRefGoogle ScholarPubMed
Ridder, GJ, Technau-Ihling, K, Sander, A, Boedeker, CC. Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg 2005;133:709–14CrossRefGoogle ScholarPubMed
Velhonoja, J, Lääveri, M, Soukka, T, Irjala, H, Kinnunen, I. Deep neck space infections: an upward trend and changing characteristics. Eur Arch Otorhinolaryngol 2020;277:863–72CrossRefGoogle ScholarPubMed
Almutairi, DM, Alqahtani, RM, Alshareef, N, Alghamdi, YS, Al-Hakami, HA, Algarni, M. Deep neck space infections: a retrospective study of 183 cases at a tertiary hospital. Cureus 2020;12:e6841Google Scholar
Hirai, T, Kimura, S, Mori, N. Head and neck infections caused by Streptococcus milleri group: an analysis of 17 cases. Auris Nasus Larynx 2005;32:55–8CrossRefGoogle ScholarPubMed
Heim, N, Faron, A, Wiedemeyer, V, Reich, R, Martini, M. Microbiology and antibiotic sensitivity of head and neck space infections of odontogenic origin. Differences in inpatient and outpatient management. J Craniomaxillofac Surg 2017;45:1731–5CrossRefGoogle ScholarPubMed
Vieira, F, Allen, SM, Stocks, RMS, Thompson, JW. Deep neck infection. Otolaryngol Clin North Am 2008;41:459–83CrossRefGoogle ScholarPubMed
Thompson, HY, Fulmer, RP, Schnadig, VJ. Metastatic squamous cell carcinoma of the tonsil presenting as multiple cystic neck masses: report of a case with fine needle aspiration findings. Acta Cytol 1994;38:605–7Google ScholarPubMed
Wang, CP, Ko, JY, Lou, PJ. Deep neck infection as the main initial presentation of primary head and neck cancer. J Laryngol Otol 2006;120:305–9CrossRefGoogle Scholar
Kataria, G, Saxena, A, Bhagat, S, Singh, B, Kaur, M, Kaur, G. Deep neck space infections: a study of 76 cases. Iran J Otorhinolaryngol 2015;27:293–9Google ScholarPubMed