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European Archives of Oto-Rhino-Laryngology

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Open Access 01-03-2020 | Necrotizing Fasciitis | Head and Neck

Deep neck space infections: an upward trend and changing characteristics

Authors: Jarno Velhonoja, Meira Lääveri, Tero Soukka, Heikki Irjala, Ilpo Kinnunen

Published in: European Archives of Oto-Rhino-Laryngology | Issue 3/2020

Abstract

Purpose

This study reviews our experience with deep neck space infections (DNIs) requiring surgical intervention, including cervical necrotizing fasciitis. The aim of the study was to identify predisposing and aggravating factors of the disease and recognize the possible factors that can lead to life-threatening complications and slow down the healing process.

Methods

We compare the results to previous data from 1985 to 2005 to find possible alterations and changing trends. The characteristics of four lethal cases are described. This retrospective analysis includes patient data from 2004 to 2015 in tertiary referral hospital and in total, 277 patients were found.

Results

Surgical drainage through a neck opening ± intraoral incision was made in 215 (77.6%) patients, an intraoral incision was only made in 62 patients (22.4%). ICU care was needed in 66 (23.8%) cases. Odontogenic etiology (44.8%) was the most common origin. The most common comorbidity was a psychiatric disorder and/or dementia and occurred in 55 (19.9%) patients. Patients with underlying illnesses were more likely to be admitted to the ICU (p = 0.020), required a longer ICU stay (p = 0.004) and repeated surgery (p = 0.009). Gas formation seemed to be predictive of a more severe course of infection. Early extraction of the odontogenic foci was related to a lower length of stay (LOS) (p = 0.039).

Conclusion

The annual numbers have risen from 14 to 24 cases per year when compared to previous data. DNIs remain a cause of lethal complications; the mortality was 1.4% and overall complications occurred in 61 (22.0%) patients.

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Title: Deep neck space infections: an upward trend and changing characteristics
Authors: Jarno Velhonoja
Meira Lääveri
Tero Soukka
Heikki Irjala
Ilpo Kinnunen
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Necrotizing Fasciitis
Streptococci
Mediastinitis
Mediastinitis
Published in: European Archives of Oto-Rhino-Laryngology / Issue 3/2020
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05742-9

At a glance: The STEP trials

Springer Medicine

Deep neck space infections: an upward trend and changing characteristics

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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