Plaza Mayor G, Martínez-San Millán J, Martínez-Vidal A
Department of Otolaryngology, Fundación Hospital Alcorcón, Madrid, Spain.
Head Neck. 2001 Feb;23(2):126-33. doi: 10.1002/1097-0347(200102)23:2<126::aid-hed1007>3.0.co;2-n.
A 31-patient prospective series on deep neck infections, managed at Hospital Ramón y Cajal in Madrid, Spain, is presented.
A prospective study was conducted from January 1994 to December 1997, including all parapharyngeal or retropharyngeal infections. Clinical and radiologic findings and length of stay in the hospital were registered. Medical treatment was instituted with broad-spectrum antibiotics, and surgery was reserved for those patients not responding to medical treatment.
Twenty-four patients (77.42%) had parapharyngeal, 3 (9.68%) retropharyngeal and 4 (12.90%) mixed infections. On the basis of clinical and CT findings, 19 cases (61.29%) were considered abscesses and 12 (38.71%) cellulitis. Medical treatment was successful in all but 3 cases (90.32%), with no major complications. All the patients were discharged from the hospital within 20 days after admission (mean, 8.09 days).
Despite the wide use of antibiotics, deep neck space infections are commonly seen. Although most reports are based on surgical treatment followed by antibiotics, medical treatment could be as successful as open surgical drainage in most cases.
本文介绍了西班牙马德里拉蒙·卡哈尔医院对31例颈部深部感染患者进行的前瞻性研究系列。
1994年1月至1997年12月进行了一项前瞻性研究，纳入所有咽旁或咽后感染患者。记录临床和影像学检查结果以及住院时间。采用广谱抗生素进行药物治疗，对药物治疗无反应的患者则进行手术治疗。
24例（77.42%）为咽旁感染，3例（9.68%）为咽后感染，4例（12.90%）为混合感染。根据临床和CT检查结果，19例（61.29%）被诊断为脓肿，12例（38.71%）为蜂窝织炎。除3例（90.32%）外，所有患者药物治疗均成功，无严重并发症。所有患者入院后20天内出院（平均8.09天）。
尽管抗生素广泛应用，但颈部深部间隙感染仍很常见。虽然大多数报道基于手术治疗后使用抗生素，但在大多数情况下，药物治疗与开放手术引流一样成功。
