Ear Nose and Throat Unit, AORN Cardarelli Hospital, Napoli, Italy.
Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy.
Rev Recent Clin Trials. 2022;17(1):46-52. doi: 10.2174/1574887116666210910153033.
Deep Neck Infections (DNIs) spread along fascial planes and involve neck spaces. Recently, their incidence has decreased due to the introduction of antibiotics; nevertheless, complications related to DNIs are often life-threatening.
The purpose of this article is focused on the identification of predisposing factors of these complications, as well as on the development of a reliable therapeutic algorithm.
Sixty patients with DNIs were enrolled from 2006 to 2019 for a retrospective study. The exclusion criteria for the present study were cellulitis, small abscesses responding to empiric or specific antibiotic therapy, or involvement of only one deep neck space. During the analysis, the following parameters of interest have been evaluated: gender, age, site of origin, pathways of spread, comorbidities, clinical features, bacteriology data, type of surgical approach required, complications, duration of hospitalization and mortality rate. On admission, microbial swab analysis was performed.
Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), iron deficiency anemia and the involvement of multiple spaces have been associated with a significantly higher risk of developing complications. Most of our patients had polymicrobial infections. All patients underwent surgical drainage. The complication rate had occurred in 56.6% of patients, while death in 18.3%.
DNIs represent a medical and surgical emergency with potentially serious complications; thus, avoidance of diagnostic delay is mandatory. Our preliminary data suggest the importance of evaluating the extent of infections because the involvement of multiple spaces requires timely surgery due to the higher risk of complications and mortality.
深部颈部感染（DNI）沿着筋膜平面扩散，并累及颈部间隙。由于抗生素的引入，其发病率最近有所下降；然而，与 DNI 相关的并发症通常是危及生命的。
本文的目的是确定这些并发症的易患因素，并制定可靠的治疗方案。
对 2006 年至 2019 年期间的 60 例 DNI 患者进行回顾性研究。本研究的排除标准为蜂窝织炎、对经验性或特定抗生素治疗有反应的小脓肿、或仅累及一个深部颈部间隙。在分析过程中，评估了以下感兴趣的参数：性别、年龄、起源部位、传播途径、合并症、临床特征、细菌学数据、所需的手术方法、并发症、住院时间和死亡率。入院时进行微生物拭子分析。
糖尿病（DM）、慢性阻塞性肺疾病（COPD）、缺铁性贫血和多个间隙受累与发生并发症的风险显著增加相关。我们的大多数患者存在混合感染。所有患者均接受手术引流。并发症发生率为 56.6%，死亡率为 18.3%。
DNI 是一种具有潜在严重并发症的医疗和外科急症；因此，必须避免诊断延误。我们的初步数据表明评估感染范围的重要性，因为多个间隙受累需要及时手术，因为并发症和死亡率的风险更高。
