Most frequent etiology of DNI were dental infection 70,6% (n=139), acute phlegmonous laryngitis 14,7% (n=29), chronic decompensated tonsillitis

Materials and methods AA retrospective study using 263 patient’s records with DNI who were hospitalized in Pauls Stradins Clinical University Hospital’s department of Otorhinolaryngology and Centre of Dentistry and Facial Surgery in the period from January 1st 2012 to December 31st 2014. The inclusion diagnosis was phlegmon and/or abscess of the deep spaces in adult patients. Statistical analysis was conducted using SPSS 22.0 soware, significance level was set at maximum of 5% (p<0,05). Descriptive StStatistics, Binary Logistic Regression and Mann-Whitney tests were used.

Aim TTo analyse patients’ records from Pauls Stradins Clinical University Hospital, who were hospitalized due to DNI. Reveal any possible association between demographic parameters, etiology, DNI localization, complications, comorbidities, treatment and bacterial culture.

Introduction DeepDeep neck infection (DNI) occurs in the spaces between muscles and organs in the floor of the mouth and neck. In 21st century odontogenic origin is the most common etiology in adult population. Complex anatomy of this region plays a major role in the development of the complications as well as surgical approach. [James M.Christian, Adam C.Goddard, M.Boyd Gillespie, Cummings Otolaryngology, Elsevier, 2015]

Conclusions Deep neck infection (DNI) tends to affect both genders equally, usually in middle age. The most frequent etiology is dental infection which corresponds to the world data. DespiDespite antibacterial and surgical treatment complications occurs in approx. 11%, mostly as airway obstruction.If the DNI has developed, surgical incision and drainage combined with aggressive antibacterial therapy is the treatment of choice.

In <3% of cases there were different localization of DNI: neck abscess, perimandibular abscess, abscess of sulcus mylohyoideus, sublingual abscess, retromaxillar abscess, paralaryngeal abscess, neck cyst abscess. There were 20,9% (n=55) of patients who had 2 localizations of DNI.

There were complications in 11,4% (n=30). 6,1% (n=16) were transferred to intensive care unit (ICU). Median stay in ICU was 18 days (IQR 7,5 – 22,75). One lethal case.

Antibacterial treatment was prescribed for all patients, mostly 2 medications. Most frequent were metronidazole 79,5% (n=209), cefazoline 40,7%, ceriaxone 26,2% (n=69), ampiciline 24,3% (n=64), amoxicilline/clavulanic acid 19,8% (n=52).

Complications were more common in patients with positive culture of Methicillin sensitive coagulase negative Staphylococcus (OR=7.567 p=0.002) and Methicillin sensitive S.aureus (OR=5.067 p=0.032).Complications and neck phlegmon were more uncommon in smokers than non-smokers (OR=0.380 p=0.025; OR = 0.542 p=0.028).

PhlPhlegmon of mouth floor was more common in patients with dental infection (OR=10.096 p<0.001) and it was also increased in patients with phlegmon of the face and cheek (OR=18.58 p=0.012).

CompliComplications and neck phlegmon were more common in patients with chronic decompensated tonsillitis (OR=4.978 p=0.007; OR=6.654 p=0.002) and acute phlegmonous laryngitis (OR=15.643 p<0.001; OR=30.333 p<0.001).

CompliComplications and neck phlegmon were more common in ≥60 years old patients compared to younger patients (OR=7.367 p=0.002; OR=3.429 p=0.001).

Complications were more common in patients with parapharygitis (OR=15.571 p=0.024).

Most frequent primary operations were incision and drainage 96,3% (n=237), tooth extraction 22,8% (n=56), tonsillectomy 8,9% (n=22).

DEEP NECK INFECTION: REVIEW OF 263 CASES

Authors: Alise Adoviča1, Linda Veidere1, Marks Ronis1Scientific research supervisor: MD Gunta Sumeraga1,2

1Rīga Stradiņš University, Latvia2Pauls Stradins Clinical University Hospital, Latvia