Daramola Opeyemi O, Flanagan Carrie E, Maisel Robert H, Odland Rick M
Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Otolaryngol Head Neck Surg. 2009 Jul;141(1):123-30. doi: 10.1016/j.otohns.2009.03.033.
To review our experience with deep neck abscesses and identify unique trends in our patient population.
Case series with chart review.
Evaluation of patients with deep neck space abscesses between 2001 and 2006. Peritonsillar abscess, superficial craniocervical infection, and salivary gland infections were excluded from selection of study population. A total of 106 cases were reviewed.
Dental infections were the most common cause of deep neck abscesses (49.1%). Comorbidities included substance abuse (53.7%), psychiatric illness (10.4%), hypertension (9.4%), head and neck cancer (6.6%), and diabetes mellitus (5.7%). All patients received systemic antibiotics, eight patients required tracheotomy, 85 patients underwent surgical drainage in the operating room, and 11 had bedside drainage. Median and lower quartile of time in hospital was 2 and 3 days, respectively, whereas upper quartile was 4 days (range, 1 to 27 days). Patients with comorbidities or concurrent illness tended to stay longer (P<0.05, Mann-Whitney test). There were six complications and no mortality.
Substance abuse and poor orodental hygiene are important predisposing factors to deep neck abscesses. Appropriate management continues to favor a combination of early surgical drainage and systemic antibiotics.
回顾我们治疗颈部深部脓肿的经验，并确定我们患者群体中的独特趋势。
病例系列研究并进行图表回顾。
对2001年至2006年间患有颈部深部间隙脓肿的患者进行评估。扁桃体周围脓肿、浅表颅颈感染和唾液腺感染被排除在研究人群选择之外。共回顾了106例病例。
牙源性感染是颈部深部脓肿最常见的原因（49.1%）。合并症包括药物滥用（53.7%）、精神疾病（10.4%）、高血压（9.4%）、头颈癌（6.6%）和糖尿病（5.7%）。所有患者均接受了全身抗生素治疗，8例患者需要气管切开术，85例患者在手术室接受了手术引流，11例患者进行了床边引流。住院时间的中位数和下四分位数分别为2天和3天，而上四分位数为4天（范围为1至27天）。患有合并症或并发疾病的患者住院时间往往更长（P<0.05，Mann-Whitney检验）。有6例并发症，无死亡病例。
药物滥用和不良的口腔卫生是颈部深部脓肿的重要易感因素。适当的治疗仍然倾向于早期手术引流和全身抗生素联合使用。
