Oral and Maxillofacial Surgery Phd Program University of São Paulo, Ribeirão Preto School of Dentistry CEP: 14040-904. Café Ave, 11, West Side, Ribeirão Preto- SP, Brazil
Med Oral Patol Oral Cir Bucal. 2023 Jan 1;28(1):e56-e64. doi: 10.4317/medoral.25583.
Point-of-care-ultrasound can be applied to preview a difficult airway, detect the presence of fluid collection, and soft-tissue edema, and guide the drainage location, although is rarely used. The purpose of this study is to validate a protocol for the assessment of these clinical features on patients with severe odontogenic infections.
This was a single-group prospective cohort study (n=20) including patients with the diagnosis of deep-neck propagation of odontogenic infection. A transcervical linear high-frequency probe transducer (13-6 MHz) was used to scan the structures of the upper airway and the infectious collections. The drainage was guided by ultrasound and the patients were daily evaluated, according to the protocol. The data were extracted and the airway volume, midline deviation, and other important data such as length of hospital stay, dysphagia, voice alteration, raised floor of the mouth, dyspnea, and neck swelling were registered.
The ultrasound examination was correlated with multiple clinical findings, such as dyslalia (p=0,069), dysphagia (p=0,028), dyspnea (p=0,001), among others. This protocol has an advantage as it can be used at bedside evaluation, allowing the assessment of severe and unstable patients, and predicting the increase of the hospitalization time (p=0,019).
This protocol is reliable for the assessment of the upper airway, even in an emergency, predicting not only the severity of the clinical features but aids in the determination of the length of the hospitalization time.
床旁超声可用于预测困难气道、检测积液和软组织水肿的存在，并指导引流位置，尽管其应用较少。本研究旨在验证一种评估严重牙源性感染患者这些临床特征的方案。
这是一项单组前瞻性队列研究（n=20），包括诊断为深颈部牙源性感染扩散的患者。使用经颈线性高频探头（13-6 MHz）扫描上气道和感染性积液的结构。根据方案，超声引导引流，并对患者进行每日评估。提取数据，并登记气道容积、中线偏移和其他重要数据，如住院时间、吞咽困难、声音改变、口底抬高、呼吸困难和颈部肿胀。
超声检查与多种临床发现相关，如发音困难（p=0.069）、吞咽困难（p=0.028）、呼吸困难（p=0.001）等。该方案具有优势，因为它可以在床边评估中使用，允许评估严重和不稳定的患者，并预测住院时间的延长（p=0.019）。
该方案可可靠地评估上气道，即使在紧急情况下，不仅能预测临床特征的严重程度，还能辅助确定住院时间。
