Priyamvada Shaili, Motwani Gul
Department of Otorhinolaryngology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):912-917. doi: 10.1007/s12070-019-01583-4. Epub 2019 Jan 21.
Deep neck space infections (DNSI) are serious diseases that involve several spaces in the neck. These are commonly seen in low socioeconomic group with poor oral hygiene, and nutritional disorders. These are bacterial infections originating from the upper aerodigestive tract. The incidence of this disease was relatively high before the advent of antibiotics. Treatment of DNSI includes antibiotic therapy, airway management and surgical intervention. Management of DNSI is traditionally based on prompt surgical drainage of the abscess followed by antibiotics or nonsurgical treatment using appropriate antibiotics in the case of cellulitis. This study was conducted to investigate the age and gender, clinical symptoms, site involved, etiology, co-morbidities, bacteriology, complications and outcomes in the patients of DNSI. A prospective study of deep neck space infections was conducted during the period July 2017 to July 2018 on the patients who attended the outpatient department and were admitted as inpatient in Safdarjung hospital, New Delhi. 40 Cases with DNSI all ages and both genders were included in the study. Patients who didn't require surgical intervention to drain pus were excluded. All parameters including age, gender, co-morbidities, presentation, site, bacteriology, complications, and investigations were studied. Due to advent of antibiotics, deep neck space infections are in decreasing trend. The common age group found to be affected is in 2nd and 3rd decade in our study. Out of all deep neck space infections, submandibular space infections were common (37.5%) followed by peritonsillar infections (12.5%). Infection of deep neck space remains fairly common and challenging disease for clinicians. Prompt recognition and treatment of DNSI are essential for an improved prognosis. Odontogenic and tonsillopharyngitis are the commonest cause. Key elements for improved results are the prompt recognition and early intervention. Special attention is required to high-risk groups such as diabetics, the elderly and patients with underlying systemic diseases as the condition may progress to life-threatening complications.
颈部深部间隙感染(DNSI)是累及颈部多个间隙的严重疾病。这些感染常见于社会经济地位低下、口腔卫生差和营养失调的人群。它们是源自上呼吸道消化道的细菌感染。在抗生素出现之前,这种疾病的发病率相对较高。DNSI的治疗包括抗生素治疗、气道管理和手术干预。传统上,DNSI的治疗是在脓肿形成后立即进行手术引流,随后使用抗生素;对于蜂窝织炎,则使用适当的抗生素进行非手术治疗。本研究旨在调查DNSI患者的年龄和性别、临床症状、受累部位、病因、合并症、细菌学、并发症及预后。2017年7月至2018年7月期间,对新德里萨夫达容医院门诊就诊并住院的患者进行了一项关于颈部深部间隙感染的前瞻性研究。该研究纳入了40例各年龄、性别的DNSI患者。不需要手术干预引流脓液的患者被排除在外。研究了所有参数,包括年龄、性别、合并症、临床表现、部位、细菌学、并发症和检查结果。由于抗生素的出现,颈部深部间隙感染呈下降趋势。在我们的研究中,发现受影响的常见年龄组为第二和第三个十年。在所有颈部深部间隙感染中,颌下间隙感染最为常见(37.5%),其次是扁桃体周围感染(12.5%)。颈部深部间隙感染对临床医生来说仍然是相当常见且具有挑战性的疾病。及时识别和治疗DNSI对于改善预后至关重要。牙源性和扁桃体咽炎是最常见的病因。改善治疗效果的关键因素是及时识别和早期干预。对于糖尿病患者、老年人和患有潜在系统性疾病的患者等高风险人群需要特别关注,因为病情可能进展为危及生命的并发症。