title: Clinical aspects, diagnosis and treatment of the phlegmons of maxillofacial area and deep neck infections.
abstract: BACKGROUND
  The problem of maxillofacial and neck tissue inflammatory diseases constantly draws attention of otolaryngologists and maxillofacial surgeons in assosiation with steady frequency of pathology. Despite a modern antibiotic therapy, there still exist cases in which an initial delay in diagnosis and treatment may result in a life-threatening situation.
  
  
  METHODS
  We have analyzed a clinical picture of 219 patients aged from 5 up to 91 years. The patients have been distributed according to the spread of purulent process and the laboratory research data into the following groups.
  
  
  CONCLUSIONS
  In inoculations from a wound during the primary surgical treatment in 67.6% of patients 1 microorganism has been revealed, in 7.9%--2 microorganisms, in 5%--3 and more microorganisms, in 19.4% of patients microorganisms have not been revealed. The most frequent cultures extracted from wound contents, were staphylococci and streptococci (61.2%). The presence of mixed (aerobic and anaerobic) microflora in the inflammation center has been marked recently. We have analyzed 64 MRI and X-CT at suspicion on diffusion of purulent process in deep neck cellular space. In 52 patients the process was localized within the limits of neck spaces and in 12 patients--the pyoinflammatory process extended on mediastinum though the clinical suspicion on mediastinitis was only in 10 patients.
  
  
  CONCLUSIONS
  The treatment of maxillofacial and neck pyoinflammatory diseases and their complications remains a complex and difficult problem. Alongside with clinical methods of diagnosis of maxillofacial and neck pyoinflammatory diseases it is necessary to use accessory methods such as X-CT and MRI which clinical-diagnostic efficiency is very high. An antimicrobial therapy plays a significant role in the treatment of maxillofacial phlegmons. Antimicrobial regiments have been recommended and should cover the polymicrobial etiology.
authors.affiliation: Department of Otolaryngology and Stomatology, Grodno State Medical University, Belarus.
authors.forename: Liudmila
authors.initials: L
authors.lastname: Krautsevich
authors.forename: Oleg
authors.initials: O
authors.lastname: Khorow
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008279:Magnetic Resonance Imaging; D015523:Maxillary Sinusitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D008480:Mediastinitis / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010612:Pharyngitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents