State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
BMC Infect Dis. 2022 Jun 22;22(1):566. doi: 10.1186/s12879-022-07545-6.
Cervicofacial space infections are potentially life-threatening, which require accurate diagnosis, early incision, and adequate drainage. The utilization of computed tomography (CT) in cervicofacial space infections has significantly increased for its advantages in the evaluation of abscesses, its availability, and low cost. However, the clinical value of preoperative CT imaging in cervicofacial space infections remains controversial for its poor specificity, radiation exposure, potential complications, and extra cost. We, therefore, investigated whether CT examination should be used as a routine examination in the treatment of patients with cervicofacial space infections.
A retrospective study of all patients affected by cervicofacial space infections that received incision and drainage surgery from Jan 2016 to Dec 2020 was performed at West China Hospital of Stomatology at Sichuan University. Patients were divided into two groups: the group with preoperative CT and without preoperative CT. Outcomes, including reoperation rate, missed diagnosis rate, days of symptom relief, length of stay, duration of surgery, and total cost of hospitalization, were analyzed.
Out of n = 153 patients, 108 patients underwent surgery with preoperative CT and 45 patients without preoperative CT. The reoperation rate in the preoperative CT group (6/108, 5.6%) was significantly lower (P = 0.00) than that in the group without preoperative CT (10/45, 22.2%). Significant reduction of missed diagnosis rate (P = 0.00), days of symptom relief (P = 0.01), length of stay(P = 0.03), and duration of surgery (P = 0.01) were detected in the preoperative CT group. The results demonstrated that the utilization of preoperative CT can reduce the missed diagnosis rate and repeated surgery complications.
We recommend preoperative CT as a routine examination in cervicofacial space infections.
颈面部间隙感染具有潜在的致命性，需要准确诊断、早期切开引流。计算机断层扫描（CT）在颈面部间隙感染中的应用因其在评估脓肿方面的优势、可用性和低成本而显著增加。然而，术前 CT 成像在颈面部间隙感染中的临床价值存在争议，因为其特异性差、辐射暴露、潜在并发症和额外费用。因此，我们研究了 CT 检查是否应该作为颈面部间隙感染患者治疗的常规检查。
回顾性分析了 2016 年 1 月至 2020 年 12 月在四川大学华西口腔医院接受切开引流术的颈面部间隙感染患者。患者分为两组：术前 CT 组和无术前 CT 组。分析了包括再手术率、漏诊率、症状缓解天数、住院时间、手术时间和住院总费用在内的结局。
共纳入 153 例患者，其中 108 例行术前 CT 检查，45 例未行术前 CT 检查。术前 CT 组（6/108，5.6%）的再手术率明显低于无术前 CT 组（10/45，22.2%）（P=0.00）。术前 CT 组的漏诊率（P=0.00）、症状缓解天数（P=0.01）、住院时间（P=0.03）和手术时间（P=0.01）显著降低。结果表明，术前 CT 可降低漏诊率和重复手术并发症。
我们建议将术前 CT 作为颈面部间隙感染的常规检查。
