Deep-neck space abscesses.

Abstract

OBJECTIVE: Despite a reduction in the incidence, deep-neck space infections are still seen today with definite potential for significant morbidity and even mortality. DESIGN: The authors present their experience in the management of 16 patients with 19 deep-neck space abscesses. The distribution of the abscesses were: 5 Ludwig's angina, 4 parapharyngeal abscesses, 3 retropharyngeal abscesses, 3 in the sub-mandibular triangle, 3 in the deep anterior triangle, and 1 in the deep posterior triangle. RESULTS: The source of infection was odontogenic in six patients, pharyngeal in three, otogenic in one, and could not be identified in the other six patients. Most cases presented with pain and neck swelling. Plain x-ray films, computed tomography, ultrasonography, and magnetic resonance imaging were the main diagnostic procedures. Positive culture was obtained in only nine cases (56.2%). No predominant single organism was identified. Antimicrobial therapy and surgical drainage were the mainstay of treatment. Two cases were complicated by internal jugular-vein thrombophlebitis. All the patients survived without major residual sequelae. CONCLUSIONS: The etiology, presentation, and management of deep-neck space infections are briefly reviewed.