title: Surgical vs ultrasound-guided drainage of deep neck space abscesses: a randomized controlled trial: surgical vs ultrasound drainage.
abstract: BACKGROUND
  Deep neck space abscesses (DNAs) are relatively common otolaryngology-head and neck surgery emergencies and can result in significant morbidity with potential mortality. Traditionally, surgical incision and drainage (I&D) with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound-guided drainage (USD) is a less invasive and effective alternative in select cases.
  
  
  OBJECTIVE
  To compare I&D vs USD of well-defined DNAs, using a randomized controlled clinical trial design. The primary outcome measure was effectiveness (length of hospital stay (LOHS) and safety), and the secondary outcome measure was overall cost to the healthcare system.
  
  
  METHODS
  Patients presenting to the University of Alberta Emergency Department with a well-defined deep neck space abscess were recruited in the study. Patients were randomized to surgical or US-guided drainage, placed on intravenous antibiotics and admitted with airway precautions. Following drainage with either intervention, abscess collections were cultured and drains were left in place until discharge.
  
  
  RESULTS
  Seventeen patients were recruited in the study. We found a significant difference in mean LOHS between patients who underwent USD (3.1 days) vs I&D (5.2 days). We identified significant cost savings associated with USD with a 41% cost reduction in comparison to I&D.
  
  
  CONCLUSIONS
  USD drainage of deep neck space abscesses in a certain patient population is effective, safe, and results in a significant cost savings to the healthcare system.
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, 1E4,34 WMC, 8440 112 Street, T6G 2B7, Edmonton, Alberta, Canada. hadi.seikaly@albertahealthservices.ca.
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Biron
authors.forename: George
authors.initials: G
authors.lastname: Kurien
authors.forename: Peter
authors.initials: P
authors.lastname: Dziegielewski
authors.forename: Brittany
authors.initials: B
authors.lastname: Barber
authors.forename: Hadi
authors.initials: H
authors.lastname: Seikaly
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery*; D000328:Adult; D017046:Cost Savings; D004322:Drainage / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009333:Neck; D025321:Surgery, Computer-Assisted / Q000191:economics / Q000379:methods; D014463:Ultrasonography