Deep neck infection with dental origin: analysis of 85 consecutive cases (2000-2006).
CONCLUSIONS
Diagnostic work-up should include contrast-enhanced computed tomography (CT) and mandible orthopantogram. When a dental origin of deep neck infection is suspected, the intravenous antibiotic regimen has to be active against gram-positive bacteria, both aerobes and anaerobes. Surgical exploration and drainage may be mandatory at presentation, or in cases not responding to medical therapy within the first 24 h.


OBJECTIVE
Deep neck infections are still associated with significant morbidity and mortality rates when complications occur. Despite worldwide improvement in dental care and oral hygiene, a significant prevalence of deep neck infections caused by dental infections has been described recently (> 40%).


METHODS
We analysed retrospectively 85 cases of deep neck infection with dental origin out of 206 consecutive cases of deep neck infection diagnosed in our institution between 2000 and 2006.


RESULTS
The most frequent dental source was a periapical infection of the first mandibular molar, followed by second and third molar, respectively. Submandibular space infection involvement was diagnosed in 73 of 85 patients (85.9%), masticatory space infection in 28 (32.9%); in 56 patients (65.9%) the infection involved more than one space. Twenty-four patients (28.2%) were treated only with intravenous antibiotic therapy; 61 patients (71.8%) required both medical and surgical procedures.
Marioni
Gino
G
Department of Medical and Surgical Specialties, Section of Otolaryngology, University of Padova, Padova, Italy. gino.marioni@unipd.it
Rinaldi
Roberto
R
Staffieri
Claudia
C
Marchese-Ragona
Rosario
R
Saia
Giorgia
G
Stramare
Roberto
R
Bertolin
Andy
A
Dal Borgo
Roberto
R
Ragno
Fabrizio
F
Staffieri
Alberto
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003131:Combined Modality Therapy; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010482:Periapical Abscess / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D010485:Periapical Periodontitis / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D011862:Radiography, Panoramic; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014076:Tooth Diseases / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D014463:Ultrasonography
D000900:Anti-Bacterial Agents