Gupta Manisha, Singh Virendra
Dept. of Oral and Maxillofacial Surgery, Postgraduate Institute of Medical Sciences, Haryana Ghaziabad, India ; Dept. of Oral and Maxillofacial Surgery, ITS Dental College and Hospital, Delhi-Merrut Road, Ghaziabad, India.
J Maxillofac Oral Surg. 2010 Mar;9(1):35-7. doi: 10.1007/s12663-010-0011-1. Epub 2010 Jun 4.
The purpose of this study was to retrospectively evaluate a series of patients with space infection.
In this study 256 patients with space infection over a period of two years were treated with intravenous antibiotic and prompt incision and drainage followed by culture and sensitivity tests in some cases. Data collection included demographic, anatomic treatment and complication information.
The sample consisted of 256 patients with a mean age of 28 years. 7 patients were immunocompromised and 20 female patients were pregnant out of 84 female patients who were included in the study. Caries followed by implant failure were identified to be the most frequent cause for space infection. Trismus and dysphagia were present in over 70% of the cases. The vestibular masticator, perimandibular (submandibular, submental and/or sublingual) and parapharyngeal, submaxillary spaces were involved. Abscess was found in 76% of the cases. All the patients were drained under local anesthesia or conscious sedation except one patient who was drained under GA. Three deaths occurred.
This study indicated that prompt incision and drainage along with intravenous antibiotic under local anesthesia or conscious sedation was the mainstay of treatment of severe space infection. Patients were relieved of their signs and symptoms by third day, however trismus may persist for 5-7 days.
本研究旨在回顾性评估一系列颌面部间隙感染患者。
本研究中，对256例在两年时间内发生颌面部间隙感染的患者采用静脉输注抗生素治疗，并及时进行切开引流，部分病例随后进行了培养和药敏试验。数据收集包括人口统计学、解剖学、治疗及并发症信息。
样本包括256例患者，平均年龄28岁。在纳入研究的84例女性患者中，7例免疫功能低下，20例为孕妇。龋齿继以种植失败被确定为间隙感染最常见的原因。超过70%的病例存在牙关紧闭和吞咽困难。感染累及咀嚼肌前缘、颌周（下颌下、颏下和/或舌下）及咽旁、颌下间隙。76%的病例发现脓肿。除1例在全身麻醉下进行引流外，所有患者均在局部麻醉或清醒镇静下进行引流。发生3例死亡。
本研究表明，在局部麻醉或清醒镇静下及时进行切开引流并静脉输注抗生素是严重颌面部间隙感染治疗的主要方法。患者在第三天症状体征缓解，但牙关紧闭可能持续5 - 7天。
