Prabhu Supreet Ratnakar, Nirmalkumar Enosh Steward
Department of Otorhinolaryngology, Dr. N D Desai Faculty of Medical Science and Research, Nadiad, Gujarat, India.
External Faculty, Department of Otorhinolaryngology, Knowledge Institute of Physiotherapy, Anand, Gujarat, India.
Ann Maxillofac Surg. 2019 Jan-Jun;9(1):118-123. doi: 10.4103/ams.ams_251_18.
The aim of this study was to provide insight about all the common fascial space infections of the neck, their presentation, their etiology, complaints, length of stay, and the treatment given.
It was conducted in a tertiary center in Nadiad, Gujarat, India. A total of 1034 patients were treated for fascial space infections of the neck in the hospital from 2001 to 2017. There were 63.24% male and 36.75% female with age ranging from 21 days to 96 years having the mean age of 31.4 years.
Odontogenic infection with poor oral hygiene as a cause was found in most (78.43%) of the abscesses. Diabetes was the most common comorbid condition found in 98 (9.47%) patients along with HIV found in ten (0.96%) patients. Pain (99.41%), fever (86.07%), swelling (86.94%), and dysphagia/odynophagia (67.21%) were the most common presenting symptoms. Ludwig's angina and submandibular abscess were found to be the most common deep head-and-neck space infection making up for 52% cases. The most common group of microorganisms isolated were . (19.82%) and (18.66%).
Treatment was given in the form of incision and drainage of the abscesses (83.69%) and systemic antibiotics (100%). The most common space infection among the deep neck infections is the submandibular space infection (52%). If the etiological factor was not removed which mostly was carious teeth, high chances of recurrence were found (27.27%). Four patients required tracheostomy, and there was one mortality in the entire series.
本研究旨在深入了解颈部所有常见的筋膜间隙感染，包括其表现、病因、症状、住院时间及所接受的治疗。
研究在印度古吉拉特邦纳迪德的一家三级中心开展。2001年至2017年期间，该医院共治疗了1034例颈部筋膜间隙感染患者。男性占63.24%，女性占36.75%，年龄范围为21天至96岁，平均年龄为31.4岁。
大多数（78.43%）脓肿是由口腔卫生不良导致的牙源性感染引起。糖尿病是最常见的合并症，98例（9.47%）患者患有糖尿病，10例（0.96%）患者合并感染HIV。疼痛（99.41%）、发热（86.07%）、肿胀（86.94%）以及吞咽困难/吞咽疼痛（67.21%）是最常见的症状表现。路德维希咽峡炎和下颌下脓肿是最常见的深部头颈部间隙感染，占病例总数的52%。分离出的最常见微生物群是……（19.82%）和……（18.66%）。
治疗方式为脓肿切开引流（83.69%）及全身使用抗生素（100%）。深部颈部感染中最常见的间隙感染是下颌下间隙感染（52%）。如果病因未消除，而病因大多是龋齿，则复发几率很高（27.27%）。4例患者需要气管切开术，整个系列中有1例死亡。
