Criteria for admission of odontogenic infections at high risk of deep neck space infection.
OBJECTIVE
Many patients with odontogenic infections are hospitalised because of the risk of deep neck space infection. The objective of this study was to identify risk factors allowing more reliable selection of patients requiring hospitalisation for both specialists and emergency physicians.


METHODS
This retrospective study was based on a cohort of 97 patients hospitalised for odontogenic infection in the Department of Otorhinolaryngology and Head and Neck Surgery of Centre hospitalier Sud Francilien, Île-de-France, from January 2008 to June 2012.


RESULTS
The majority of patients presented with dental abscess (66 patients; 68%). Nineteen patients (20%) presented with deep neck space infection. The frequency of deep neck space infection was significantly higher in patients with mandibular odontogenic infection (16/55 patients (29%) than in those with maxillary odontogenic infection (3/42 (7%); P ≤ 0.009). The incidence of deep neck space infection was significantly higher in patients with dental abscess (17/66, (26%) than in those without dental abscess (2/31 (6%); P ≤ 0.03).


CONCLUSIONS
In addition to the well-known classical criteria (fever, neck swelling, dyspnoea, dysphagia, trismus, leukocytosis, elevated C reactive protein (CRP)), the criteria for admission for odontogenic infection should include mandibular odontogenic infection and/or the presence of dental abscess.
Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France. Electronic address: notaibi@alfaisal.edu.
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Alotaibi
Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France.
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Cloutier
Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France.
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Khaldoun
Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France.
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Bois
Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France.
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Chirat
Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France.
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Salvan
D000038:Abscess / Q000209:etiology* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000150:complications* / Q000628:therapy; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004322:Drainage; D004417:Dyspnea / Q000209:etiology / Q000628:therapy; D004487:Edema / Q000209:etiology / Q000628:therapy; D005260:Female; D005334:Fever / Q000209:etiology / Q000628:therapy; D005491:Focal Infection, Dental / Q000150:complications* / Q000628:therapy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008206:Lymphatic Diseases / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009333:Neck; D010343:Patient Admission; D018579:Patient Selection; D012135:Respiratory Sounds / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014076:Tooth Diseases / Q000150:complications* / Q000628:therapy; D014313:Trismus / Q000209:etiology / Q000628:therapy; D055815:Young Adult
D000900:Anti-Bacterial Agents
Criteria for admission; Deep neck space infection; Dental abscess; Odontogenic infection