Case Western Reserve University School of Medicine.
Division of Pediatric Plastic and Reconstructive Surgery, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH.
J Craniofac Surg. 2024;35(1):e92-e94. doi: 10.1097/SCS.0000000000009892. Epub 2023 Nov 16.
Cervical necrotizing fasciitis (CNF) is a rare condition in the United States, with very few cases reported as a sequela of mandibular fracture. The authors describe the case of a 40-year-old man with poor oral health and no significant past medical history who developed CNF following delayed treatment of an open mandibular fracture, leading to life-threatening septic shock, thrombophlebitis of the internal jugular vein, and septic emboli to the lungs. Successful management of this patient was accomplished by serial surgical debridement, the administration of broad-spectrum antibiotics, and hemodynamic support. Eventual reconstruction was performed with external fixation of the mandible fracture and split-thickness skin grafting for the left neck and chest wound. The authors recommend early treatment of open mandibular fractures for immunocompromised patients or patients with poor oral hygiene to avoid the rare but potentially fatal complication of CNF and highlight external fixation as a useful technique in select cases of complex mandibular fractures.
颈部坏死性筋膜炎（CNF）在美国较为罕见，仅有少数病例报道为下颌骨骨折的后遗症。作者描述了一例 40 岁男性病例，该患者口腔健康状况不佳，无明显既往病史，因开放性下颌骨骨折延迟治疗而发生 CNF，导致危及生命的感染性休克、颈内静脉血栓性静脉炎和脓毒性栓子到肺部。通过连续的外科清创术、给予广谱抗生素和血流动力学支持，成功地对该患者进行了治疗。最终通过外部固定下颌骨骨折和对左侧颈部和胸部伤口进行分层皮片移植来进行重建。作者建议对免疫功能低下的患者或口腔卫生状况不佳的患者进行早期治疗开放性下颌骨骨折，以避免 CNF 这种罕见但可能致命的并发症，并强调在某些复杂的下颌骨骨折病例中，外部固定是一种有用的技术。
