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Deep neck abscesses – changing trends

Published online by Cambridge University Press:  29 June 2007

Dharambir S. Sethi  and
Ralph E. Stanley
Dharambir S. Sethi*
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore.
Ralph E. Stanley
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore.
*
Dharambir S. Sethi, F.R.C.S. (Ed), Department of Otolaryngology, Singapore General Hospital, Outram Road, Singapore 0316. Fax: (65) 226-2079
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Abstract

A retrospective review was conducted of 64 patients with deep neck abscesses. Based on clinical and operative findings, these abscesses were categorized as retropharyngeal abscess (29 patients), parapharyngeal abscess (10 patients), Ludwig's angina (19 patients), or necrotizing cervical fasciitis (six patients). Regional trauma from an ingested foreign body was the cause for 59 per cent of the patients with a retropharyngeal abscess. In 90 per cent of subjects with Ludwig's angina, an odontogenic cause was established; however, in the majority of cases of parapharyngeal abscess (80 per cent) and necrotizing fasciitis of the neck (85 per cent), aetiology was unknown.

Fifty-five patients (86 per cent) required open neck drainage. In the remaining nine (14 per cent) endoscopic drainage of the abscess was possible. Eight patients (12 per cent) needed a tracheotomy for airway control. The overall mortality was eight per cent despite aggressive anti-microbial therapy and early surgical intervention. Thirty-four cultures grew aerobic organisms. Seventy-six per cent of these were gram-negative microorganisms. The bacteriological pattern of deep neck abscesses is changing and may be responsible for the considerable mortality rate with which the abscesses are still associated despite anti-microbial therapy.

Keywords

NeckAbscessSurgeryForeign bodies
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 2 , February 1994 , pp. 138 - 143
Copyright
Copyright © JLO (1984) Limited 1994

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