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A Study on Deep Neck Space Infections

Nirmal Kumar J, Sankaranaarayanan G and Greeshma

Aim: To do a cross-sectional analysis of cases of neck space infections as to the symptomatology, causes, investigations, complications and treatment so that our understanding on this improves thereby improving our treatment outcome.

Materials and Methods: A review of 17 treated cases of Deep Neck Space Infection (DNSI) in our department from September 2015 to September 2016 was carried out. A standard proforma was used for data collection and the following variables were recorded including age and gender, symptoms, etiology, co-morbidities (diabetes, HIV), site of infection, bacteriology, growth culture and antibiotic sensitivity, surgical intervention and duration of treatment.

Results: The most common source for Deep Neck Space infection is dental in origin. The most common symptoms were neck swelling and pain, followed by odynophagia. Submandibular space and parapharyngeal space involvement were more common in odontogenic DNSI. Bacteriology reveals Klebsiella species as the most common organism. Mean duration of hospital stay was 14 days with minimum of 8 days and maximum of 33 days.

Conclusions: DNSI is a potentially life threatening condition. The deep location and complexity of this region makes the diagnosis and treatment of these infections challenging. Its presentation maybe masked and bacterial cultures may not be conclusive but it still needs early diagnosis and prompt management whether conservative or surgical. The gold standard imaging modality for the diagnosis of DNSI is computed Tomography. With the advent of better radiological imaging modalities and better effectiveness of antibiotics, we are now able to treat these infections successfully and reduce the rate of complications.