Please enter verification code
Confirm
A Review of Deep Neck Space Infections: Perspective from a Sub-Saharan African Center
Journal of Surgery
Volume 8, Issue 6, December 2020, Pages: 197-203
Received: Oct. 19, 2020; Accepted: Oct. 28, 2020; Published: Nov. 27, 2020
Views 98      Downloads 32
Authors
Moses Ikechukwu Ajaero, Departments of ENT and Surgery, Federal Medical Centre, Owerri, Nigeria
Samuel Uchechukwu Nduagu, Departments of ENT and Surgery, Federal Medical Centre, Owerri, Nigeria
Chidiebere Peter Echieh, Departments of ENT and Surgery, Federal Medical Centre, Owerri, Nigeria; Department of Surgery, University of Calabar Teaching Hospital, University of Calabar, Calabar, Nigeria
Raphael Arinze Onyekwelu, Departments of ENT and Surgery, Federal Medical Centre, Owerri, Nigeria
Article Tools
Follow on us
Abstract
Deep neck space infections (DNSI) are inflammation often with abscess collection within potential fascial spaces in the head and neck region. The incidence of DNSIs is relatively higher in populations of low socioeconomic status This study aimed at analyzing the pattern of presentation and management of DNSIs seen at our facility over 10 years. Data were extracted from patients’ case notes and medical records. A total of 72 patients (47 males and 25 females) were studied with a Male to Female ratio of 1.88:1. The patients’ ages ranged from 4years to 80 years with mean age of 46.2±21.3 years. the commonest presenting complaints were pain (95.8%), dysphagia (81.9%) and odynophagia (70.8%). The mean duration of complaints prior to presentation was 10.9±4.1days. Majority of the DNSIs were of odontogenic origin (56.9%) and diabetes mellitus (26.4%) was the most commonly encountered co-morbid condition. Submandibular and sublingual infections were the most common (40.3%) followed by peritonsillar space infections (23.6%) and retropharyngeal and prevertebral space infections (16.7%). S. aureus (15.3%) was the most commonly isolated organism among the rest with the infection being polymicrobial in 33.3% of the patients. The commonest complications were septicaemia (18.1%), necrotizing fasciitis (12.4%) and mediastinitis (2.8%). In Sub-Saharan Africa, DNSIs can affect all age groups; appear to have more morbidity in people with low socioeconomic class and co-morbidities. They can be managed with a combination of incision and drainage and intravenous antibiotics. Attention to oro-dental hygiene may help reduce the incidence of DNSI as majority are found to be linked with odontogenic and pharyngo-tonsillar conditions.
Keywords
Deep Neck Space, Infection, Sub-Saharan Africa
To cite this article
Moses Ikechukwu Ajaero, Samuel Uchechukwu Nduagu, Chidiebere Peter Echieh, Raphael Arinze Onyekwelu, A Review of Deep Neck Space Infections: Perspective from a Sub-Saharan African Center, Journal of Surgery. Vol. 8, No. 6, 2020, pp. 197-203. doi: 10.11648/j.js.20200806.15
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Almuqamam M, Gonzalez FJ, Kondamudi NP. Deep Neck Infections. In: Statpearls. Treasure Island (Florida): Statpearls publishing. 2020. PMID: 30020634.
[2]
Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterization of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003; 24 (2): 111-117.
[3]
Boscolo RP, Stellin M, Muzzi E. Deep neck space infections: a study of 365 cases highlighting recommendations for management and treatment. Eur Arch Otorhinolaryngol. 2012; 269: 1241-1249.
[4]
Hasegawa J, Hidaka H, Tateda M. An analysis of clinical risk factors of deep neck infections. Auris Nasus Larynx. 2011; 38: 101-107.
[5]
Weed HG, Forest LA. Deep Neck Infection. In: Cummings CW, Flint PW, Harker LA. Eds. Otolaryngology: Head and Neck Surgery. 4th ed. Philadelphia, PA: Elsevier/Mosby; 2005: 2515-2524.
[6]
Ugboko V, Ndukwe K, Oginni F. Ludwig’s angina: an analysis of sixteen cases in a sub-Saharan Nigerian tertiary facility. Afr J Oral Health. 2005; 2 (1): 16-23.
[7]
Okoje VN, Ambeke OO, Gbolahan OO. Ludwig’s angina: an analysis of cases at the University College Hospital, Ibadan. Ann Ib Postgrad Med. 2018; 16 (1): 61-68.
[8]
Kataria G, Saxena A, Bhagat S, Singh B, Kaur M, Kaur G. Deep Neck Space Infections: a study of 76 cases. Iran J Otorhinolaryngol. 2015; 27 (81): 293-299.
[9]
Afolabi OA, Abdullahi A, Labaran AS, Sanni R, Muasa E, Ahmad BM. Peritonsillar abscess in Northern Nigeria: a 7-year review. Malays J Med Sci. 2014; 21 (6): 14-18.
[10]
Almutairi D, Alqahtani R, Aishareef N, Alghamdi YS, Al-Hakami HA, Algarni M. Deep neck Space Infections: a retrospective study of 183 cases at a tertiary hospital. Cureus. 2020; 12 (3): 22-29.
[11]
Afolabi OA, Fadare JO, Oyewole EO, Ogah SA. Fishbone foreign body presenting with an acute fulminating retropharyngeal abscess in a resource-challenging centre: a case report. J Med Case Rep. 2011; 5: 165.
[12]
Wang WP, Wang MC, Lin HC, Lee KS, Chou P. Tonsillectomy and the risk for deep neck space infection – A Nationwide cohort study. PLoS One. 2015; 10 (4): e0117535.
[13]
Yilmaz S, Bas B, Ozden B, Selcuk U, Kurnaz S. Deep neck infection after third molar extraction. J Istanb Univ Fac Dent. 2015; 49 (2): 41-45.
[14]
Agbara R, Obiadazie AC, Ediagbini S, Ernest I. A fatal case of empyema thoracis: the price for underestimating odontogenic infections. Oral Maxill Surg Cases. 2016; 2 (2): 22-26.
[15]
Osunde OD, Akhiwu BI, Efunkoya AA, Adebola AR, Iyogun CA, Arotiba JT. Management of fascial space infections in a Nigerian teaching hospital: a 4-year review. Nig Med J. 2012; 53 (1): 12-15.
[16]
Kokong D, Adoga AA, Akhiwu IB, Agbara R, Mugu J, Embu H, Ramyil VM. Deep neck space infections: scope, dangers and predictors of outcome in an emerging economy. Int J Clin Exp Otolaryngol. 2017: 3: 56-62.
[17]
Braimah RO, Taiwo AO, Ibikunle AA. Ludwig’s angina: analysis of 28 cases seen and managed in Sokoto, Northwest Nigeria. Saud Surg J. 2016; 4 (1): 77-83.
[18]
Velhonoja J, Laaveri M, Kinnunen I. Deep neck space infection: an upward trend and changing characteristics. Eur Arch Otorhinolaryngol. 2020; 277: 863-872.
[19]
Nasir SB, Shuaibu IY, Labaran AL, Inusa A. Management of deep neck space infections in a tertiary centre in Northwest Nigeria. Nig J Surg. 2019; 25 (2): 183-187.
[20]
Adegbiji WA, Olajide GT, Adebayo AA. Clinical profile and management of peritonsillar abscesses in a sub-Saharan Africa. Int J Innov Res Med Sci. 2020; 5 (1): 05-09.
[21]
Ibrahim OR, Lugga AS, Suleiman BM, Yohanna J. Deep neck space infection (retropharyngeal abscess) with upper airway obstruction in a 7 day old neonate. J Clin Neonatol. 2019; 8 (2): 128-130.
[22]
Avci S. Traumatic deep neck space infections due to pulling a tooth with pliers. Acta Biomed. 2018. 89 (3): 406-407.
[23]
Yang CS, Zhang LJ, Sun ZH, Yang L, Shi FD. Acute prevertebral abscess secondary to intradiscal oxygen-ozone chemonucleolysis for treatment of a cervical disc herniation. J Int Med Res. 2018; 46 (6): 2461-2465.
[24]
Cho SY, Woo JH, Kim YJ, Chun EH, Han JI, Kim DY, Baik HJ et al. Airway management in patients with deep neck infections: a retrospective analysis. Medicine (Baltimore). 2016; 95 (27): e4124.
[25]
Motahari SJ, Poormoosa R, Nikkhah M, Bahari M, Shirazy SMH, Khayarinejad F. Treatment and prognosis of deep neck infections. Indian J Otolaryngol Head Neck Surg. 2015; 67 (1) suppl: 134-137.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186