A Clinical study on Deep Neck Space Infections

INTRODUCTION: Deep neck space infections (DNSI) are serious diseases that involve several spaces in the neck. The common primary sources of DNSI are dental infections, Pharyngotonsillar infections and salivary gland infections, and foreign bodies. With widespread use of antibiotics, the prevalence of DNSI has been reduced. Common complications of DNSI include airway obstruction, jugular vein thrombosis, and sepsis. Treatment principally comprises airway management, antibiotic therapy, and surgical intervention. This study was conducted to investigate the age and sex distribution of patients, symptoms, clinical presentation sites involved, bacteriology, and management and complications of DNSI. AIM OF THE STUDY: 1. To study distribution pattern of different types of deep neck space infection. 2. To study distribution within sexes and various age groups. 3. To study Etiology, Clinical presentation and Bacteriology of deep neck space infections. 4. To analyse various types of Investigations and Treatment for early and effective management. 5. To analyse the outcome of the disease. MATERIALS AND METHODS: This prospective study was performed from September 2018 to October 2019, in the Department of Otorhinolaryngology, Thanjavur Medical College , Thanjavur , Tamilnadu and included 50 patients with DNSI. Patients of all age groups and gender were included. All parameters including age, gender, comorbidities, presentation, site, bacteriology, complications, and required interventions were studied. RESULTS: In our study, the majority of patients were in the 21–50-year age group. Males accounted for 42% of the sample and females for 58%, with a Male : Female ratio of 1 : 1.38. Most of the patients were from a rural background. Diabetes and anemia was found as a co-morbid condition. The most common etiological factor was tonsillar and pharyngeal infection followed by odontogenic infection (27.63%). The most common presentation was Peritonsillar abscess (58%), followed by Parapharyngeal abscess (16%), Ludwig’s angina (12%). And in 50% of cases, Streptococcus and Staphylococcus were found in the culture. Surgical intervention was carried out in 74% cases. Emergency tracheotomy was required in 2 % cases. CONCLUSION: DNSI can be life-threatening in diabetic patients, the immunocompromised, and elderly patients, and special attention should therefore be given to these groups. Early diagnosis and treatment is essential to prevent complications. All patients must be treated initially with intravenous antibiotics, with treatment subsequently updated based on a culture and sensitivity report. Due to poor oral hygiene, lack of nutrition, smoking and chewing of beetle nut and tobacco, odontogenic infections are the most common cause of DNSI. Thus, DNSI could be prevented by making the population aware of dental and oral hygiene and offering regular check-ups for dental infections. As an Otolaryngologist the clinical evaluation of the Deep neck space infections constrained mainly towards early identification of impending airway compromise and planning treatment strateg