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A Perspective of Clinical Behaviour and Management of Deep Neck Space Infections (DNSI): The Clinical Conundrum

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

The diagnosis and management of deep neck space infections remain a challenging task for otolaryngologists. A retrospective observational analysis of 137 cases of deep neck infections at a tertiary care centre was reviewed. We present 137 treated cases of DNSIs in a retrospective 5 years clinical study conducted in the department of otolaryngology at a tertiary care center from January 2012 to December 2016. Demographic information, Socio-economic data, etiopathogenesis, clinical presentation, spaces involved, diagnosis, and treatment strategies, associated morbidities, course and complications were analysed and compared with past experiences. Odontogenic and salivary gland infections causes were the most common source of DNIs. Major complication observed was skin defect. In this study, submandibular space infection was found to be the most common space involved in DNSI. Pain (100%) was the most common clinical complaint followed by neck swelling (65.69%). Staphylococcus aureus (38 cases) was the most common micro-organism isolated. Surgical intervention was the main modality of treatment and there was one mortality. DNSIs are fairly common challenging and potentially lethal entities which can lead to severe complications in a very short time, should there be delay in its prompt diagnosis and management. Computerized Tomography Scan (CT scan) with contrast is the investigation of choice in diagnosing DNSIs. Assessment of airway control must take precedence.

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Acknowledgement

The authors wish to thank Dr Anthony W Chow for giving permission to quote one pictorial demonstration of deep neck spaces from one of his articles.

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Authors and Affiliations

  1. Department of ENT, Shri Guru Ram Rai Institute of Medical Sciences, Dehradun, Uttarakhand, India

    Apoorva Kumar Pandey, Tripti Maithani, Arvind Varma & V. P. Singh

  2. Department of ENT, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India

    Chetan Bansal

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  1. Apoorva Kumar Pandey
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  2. Chetan Bansal
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  3. Tripti Maithani
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  4. Arvind Varma
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  5. V. P. Singh
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Correspondence to Chetan Bansal.

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There are no financial interests the authors may have in companies or other entities that have an interest in the information in the Contribution (e.g., grants, advisory boards, employment, consultancies, contracts, honoraria, royalties, expert testimony, partnerships, or stock ownership in medically related fields). The authors have no financial interest.

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Pandey, A.K., Bansal, C., Maithani, T. et al. A Perspective of Clinical Behaviour and Management of Deep Neck Space Infections (DNSI): The Clinical Conundrum. Indian J Otolaryngol Head Neck Surg 71 (Suppl 1), 594–604 (2019). https://doi.org/10.1007/s12070-018-1423-3

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  • DOI: https://doi.org/10.1007/s12070-018-1423-3

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