Deep neck infection: analysis of 80 cases.
Deep neck infections are serious diseases that involve several spaces in the neck. The most dreadful complication is descending necrotizing fasciitis, which needs early diagnosis and aggressive treatment.


OBJECTIVE
To analyze 80 treated cases of deep neck infection and propose a schematic guideline for managing this disease.


METHODS
The authors present a retrospective analysis of 80 treated cases of deep neck infection, from June 1997 to June 2003.


RESULTS
Odontogenic and tonsilar causes were the more frequent ones. Submandibular and parapharyngeal spaces were the most frequent location of deep neck infection. Staphylococcus aureus and Streptococcus sp were the microorganisms more commonly isolated.


CONCLUSIONS
Airway control should be priority in managing deep neck infections and if the patient has to be submitted to surgery special care should be taken at the moment of intubation - when curare must never be used. CT scan is the gold-standard imaging evaluation for the diagnosis of deep neck infection. Morbi-mortality is high when associated with septic shock and mediastinitis. Our mortality rate was 11.2% and only one, in five patients with mediastinitis, survived.
Head & Neck Surgery Discipline, São Paulo Santa Casa, Brazil.
Alexandre Babá
AB
Suehara
Antonio José
AJ
Gonçalves
Fernando Antonio Maria Claret
FA
Alcadipani
Norberto Kodi
NK
Kavabata
Marcelo Benedito
MB
Menezes
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001424:Bacterial Infections / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D009333:Neck; D010614:Pharynx; D035422:Pleural Cavity; D012141:Respiratory Tract Infections / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric