Lack of association of CT findings and surgical drainage in pediatric neck abscesses.
OBJECTIVE
To evaluate the relationship between neck abscess characteristics on computerized tomography (CT) scan and surgical drainage in pediatric patients.


METHODS
Retrospective data warehouse review identified 43 children younger than 19 years admitted to a tertiary care pediatric hospital during the first quarters of 2000 through 2003 who underwent CT imaging for suspicion of head and neck abscesses involving the neck; face; and peritonsillar, retropharyngeal, and parapharyngeal spaces. A total of 45 scans were graded by a radiologist blinded to management. Thickness of the prevertebral soft tissue; location, dimensions, and degree of enhancement of the abscess; patient age; steroid and preadmission antibiotic use; and surgical intervention were recorded.


RESULTS
Surgical drainage was performed in 32 of 43 patients (74%). We found no significant correlation between prevertebral soft tissue thickness, abscess dimensions or enhancement on CT scan, and surgical drainage. There was no significant association between surgical drainage and patient age, administration of steroids, or preadmission antibiotic use.


CONCLUSIONS
Neck abscess appearance on CT scan did not predict surgical drainage, although prevertebral soft tissue thickness and abscess dimensions may be important features. Abscess enhancement, patient age, and the use of steroids and prehospitalization antibiotics were not found to correlate with surgical drainage.
Malloy
Kelly M
KM
Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Christenson
Thomas
T
Meyer
James S
JS
Tai
Steven
S
Deutsch
Ellen S
ES
Barth
Patrick C
PC
O'Reilly
Robert C
RC
D000038:Abscess / Q000000981:diagnostic imaging* / Q000628:therapy; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents