Matoušek Petr, Čábalová Lenka, Formánková Debora, Staníková Lucia, Čelakovský Petr, Mejzlík Jan, Chrobok Viktor, Komínek Pavel
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Czech Republic.
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Czech Republic.
Otolaryngol Pol. 2021 Oct 28;76(2):42-45. doi: 10.5604/01.3001.0015.3431.
<b>Aim:</b> The aim of this study was to compare the odontogenic and tonsillar origins of deep neck infection (DNI) as a negative prognostic factor for developing complications. </br></br> <b>Methods:</b> This was a retrospective study of 544 patients with tonsillar and odontogenic origins of DNI treated between 2006 and 2015 at 6 ENT Departments and Departments of Oral and Maxillofacial Surgery. Complications from DNI (descending mediastinitis, sepsis, thrombosis of the internal jugular vein, pneumonia, and pleuritis) were evaluated in both groups and compared. Associated comorbidities (cardiovascular involvement, hepatopathy, diabetes mellitus respiratory involvement, gastroduodenal involvement) were reviewed. </br></br> <b>Results:</b> Five hundred and forty-four patients were analyzed; 350/544 males (64.3%) and 19/544 females (35.7%). There were 505/544 cases (92.8%) with an odontogenic origin and 39/544 cases (7.2%) with a tonsillar origin of DNI. Complications occurred more frequently in the group with tonsillar origin of DNI (P < 0.001). There was no difference in diabetes mellitus between the two groups. </br></br> <b>Conclusions:</b> Currently, the tonsillar origin of DNI occurs much less frequently; nevertheless, it carries a much higher risk of developing complications than cases with an odontogenic origin. We recommend that these potentially high-risk patients with a tonsillar origin of deep neck infections should be more closely monitored.
目的:本研究旨在比较深部颈部感染(DNI)的牙源性和扁桃体源性作为发生并发症的负面预后因素。
方法:这是一项对2006年至2015年间在6个耳鼻喉科及口腔颌面外科接受治疗的544例牙源性和扁桃体源性DNI患者的回顾性研究。对两组患者的DNI并发症(下行性纵隔炎、败血症、颈内静脉血栓形成、肺炎和胸膜炎)进行评估并比较。回顾相关合并症(心血管受累、肝病、糖尿病、呼吸受累、胃十二指肠受累)。
结果:分析了544例患者;男性350/544例(64.3%),女性19/544例(35.7%)。DNI牙源性起源505/544例(92.8%),扁桃体源性起源39/544例(7.2%)。DNI扁桃体源性起源组并发症发生率更高(P<0.001)。两组糖尿病患病率无差异。
结论:目前,DNI的扁桃体源性起源发生频率低得多;然而,与牙源性起源病例相比,其发生并发症的风险要高得多。我们建议对这些潜在高危的深部颈部感染扁桃体源性起源患者应进行更密切的监测。