[Diagnostic and therapeutic concepts of canine fossa abscess. Evaluation of a multicenter study of 55 German-speaking departments of oromaxillofacial surgery].
A possible complication of fossa canina infections is reactive thrombosis of the vena angularis, which can lead to cavernous sinus phlebothrombosis. According to the literature there are different opinions about the treatment protocol of fossa canina abscesses. Therefore a multicentre study was undertaken in which 55 departments of oral surgery were interviewed using a standardized questionnaire about their procedures. The basis of diagnosis consists of clinical examination (100%), antibiogram (77.1%) and radiography (97.1%). A total of 28.6% use additional imaging procedures. Sonography is used by 20.0% and is found to be helpful in the diagnosis of vena angularis thrombosis. The painful palpation of the medial angle of the eye is of major diagnostic importance (100%) although anatomic variations of the vena angularis have to be considered. Extraoral incisions are not used in most cases (25.7% in exceptional cases) as well as ligations of the vena angularis in case of thrombosis (8.6% in exceptional cases). There is an agreement in the use of antibiotics (elective administration in 14.3%, obligatory administration in 85.7%); 77.1% don't use heparin to treat thrombosis of the vena angularis. In heparin therapy risks such as bleeding complications and thrombocytopenia have to be considered.
Merten
H A
HA
Abteilung für Kieferchirurgie, Zentrum Zahn-, Mund- und Kieferheilkunde, Universität Göttingen.
Schmidt
C
C
Wiese
K G
KG
Hönig
J F
JF
D020226:Cavernous Sinus Thrombosis / Q000175:diagnosis / Q000601:surgery; D003481:Cuspid; D003952:Diagnostic Imaging; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D010482:Periapical Abscess / Q000175:diagnosis* / Q000601:surgery; D010508:Periodontal Abscess / Q000175:diagnosis* / Q000601:surgery; D011379:Prognosis
D006493:Heparin