Shah Naiya, Patel Shital, Rupawala Taher, Makwana Sanjay, Mansuri Saloni, Bhimani Kruna
Department of Oral and Maxillofacial Surgery, Ahmedabad Municipal Corporation Dental College, Bhalakia Mill compound, Opp. Anupam cinema, Khokhra, Ahmedabad, 380008 India.
J Maxillofac Oral Surg. 2022 Dec;21(4):1148-1154. doi: 10.1007/s12663-021-01560-x. Epub 2021 Apr 11.
To explore the efficacy of ultrasonography as an additional diagnostic tool in superficial odontogenic fascial space infections of maxillofacial region and modifying the treatment plan when needed.
Forty patients with superficial fascial space infections underwent a detailed clinical, plain radiological and ultrasonographic examination. Based on the ultrasonographic findings, final diagnosis was made and compared with clinical findings. Patients diagnosed with cellulitis were given medical line of treatment, and those with abscess were subjected to incision and drainage along with standard general supportive care and removal of etiologic agent.
In this study, out of 40 patients (male = 22, female = 18), clinical diagnosis of cellulitis was made in 26 cases (65%) and abscess in 14 (35.0%). On USG examination, cellulitis was present in 21 cases (52.5%), while abscess in 19 (47.5%). Final diagnosis of cellulitis was made in 13 (59.1%) males and 12(66.7%) females, while abscess was confirmed in 9 (40.9%) male and 6 (33.3%) female patients. The results showed that sensitivity of the clinical examination alone was 64% with 33% specificity, and for USG, sensitivity was 84% with specificity of 100%.
The adjuvant role of ultrasonography in the diagnosis and timely management of superficial fascial space infections is promising owing to its accessibility, relative safety, repeatability and cost-effectiveness.
探讨超声检查作为一种辅助诊断工具在颌面部浅表牙源性筋膜间隙感染中的作用,并在必要时调整治疗方案。
40例浅表筋膜间隙感染患者接受了详细的临床、普通放射学及超声检查。根据超声检查结果做出最终诊断,并与临床检查结果进行比较。诊断为蜂窝织炎的患者接受药物治疗,诊断为脓肿的患者在接受标准的一般支持治疗及去除病因的同时,进行切开引流。
本研究中,40例患者(男性22例,女性18例),临床诊断为蜂窝织炎的有26例(65%),脓肿14例(35.0%)。超声检查显示,蜂窝织炎21例(52.5%),脓肿19例(47.5%)。最终诊断为蜂窝织炎的男性13例(59.1%),女性12例(66.7%);确诊为脓肿的男性9例(40.9%),女性6例(33.3%)。结果显示,单纯临床检查的敏感性为64%,特异性为33%;超声检查的敏感性为84%,特异性为100%。
超声检查在浅表筋膜间隙感染的诊断及及时治疗中具有辅助作用,因其具有可及性、相对安全性、可重复性及成本效益,前景广阔。