BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of...BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of serious mortality and morbidity.METHODS This study was carried out with the participation of 188 patients who were treated at Mersin University Department of Otorhinolaryngology and Head and Neck Surgery at January 1,2024.When the patient files were retrospectively examined,16 of 188 patients(8.5%)were included in the study because they were observed to have necrotizing fasciitis and/or intrathoracic complications.RESULTS There were a total of 16 patients in this study,9 males(56.25%)and 7 females(43.75%).All patients were adults(>18 years)and the mean age was 50.37 years±15.37 years.Female patients had a mean age of 40.42 years±13.38 years,whereas for male patients was 58.11 years±12.44 years.CONCLUSION Patients with necrotizing fasciitis and/or intrathoracic complications require more complicated and serious surgeries,intensive care unit monitoring,and mechanical ventilator support.Higher rates of morbidity and mortality should be expected in Bal KK et al.Deep neck infections mortal complications WJCC https://www.wjgnet.com 6384 October 26,2024 Volume 12 Issue 30 these patients who are hospitalized for longer periods of time.展开更多
Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patie...Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patients with DNA will be identified. Methods: We retrospectively studied 29 patients who presented to the department of otolaryngology with deep neck abscesses between April 2011 and April 2015. These 29 patients were managed with CPD after antibiotic therapy or needle aspiration failed. Data on patient demographics, location of infection, existing comorbidity, duration of hospitalization, treatment received, and complications were reviewed. Results: The average age of 29 patients, including 18 men and 11 women, was 56 years old. Abscess was found in parapharyngeal space (n = 16), submandibular space (n = 7), retropharyngeal space (n = 5) and pretracheal space (n = 1). The maximum transverse diameter of abscess ranged from 4.8 cm to 8.0 cm (mean 6.03 cm). Positive cultures were found in 24 cases and the most common pathogen found was Streptococcus viridans. Average hospital stay was 6.7 days. Deep neck abscesses were completely removed without residual in all patients. No one had complications and no one died during and after CPD. Conclusion: CPD is a safe and highly effective procedure for treating patients with deep neck abscesses who do not respond to antibiotics therapy. This technique can also provide reliable evidence on pathogens responsible for deep neck abscesses and help otolaryngologists choose effective treatment to achieve better clinical success rate. We recommend that most deep neck abscesses should be managed initially by CPD before resorting to open surgery.展开更多
Objectives:To compare the effectiveness of vacuum-assisted closure(VAC)against traditional drainage technique,using a retrospective case-control study design,in terms of managing deep neck infections(DNIs).Methods:Pat...Objectives:To compare the effectiveness of vacuum-assisted closure(VAC)against traditional drainage technique,using a retrospective case-control study design,in terms of managing deep neck infections(DNIs).Methods:Patients presenting to Peking Union Medical College Hospital diagnosed with DNIs were recruited in this study.We analyzed the clinical characteristics of DNI patients and divided them into(a)VAC placement group(26 cases)and(b)traditional drainage group(57 cases)according to whether VAC was placed.The differences in length of stay(LOS),wound healing time,and debridement frequency were compared between the two groups.Results:Eighty-three patients had multiple-space infections,i.e.infection at two or more sites.The debridement frequency of the VAC group was significantly lower than that of the traditional drainage group(p=0.001).The wound healing time of the traditional drainage group and VAC group was 38 days(a range of 13-98 days)and 40 days(a range of 11-106 days),respectively;the average LOS was 15 days(a range of 2-68 days)and 16 days(a range of 4-35 days),respectively;and the debridement frequencies were one time(a range of 0-3 times)and zero times(a range of 0-2 times),respectively.The two groups did not differ significantly in wound healing time and hospitalization duration(p=0.319 and 0.937).Conclusions:VAC treatment of DNIs has significant advantages in reducing the frequency of debridement and patient suffering,but it does not show significant advantages in wound healing.Randomized trials are still needed to demonstrate its efficacy.展开更多
Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectiv...Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectively, study conducted in the Department of Ear, Nose and Throat, Dr. Shankarrao Chavan Govern-ment Medical College, Nanded, Maharashtra, India, from March 2013 to March 2016. Results:Analysis showed that males are most likely to have deep neck space infections (DNSI). Odontogenic and tonsillar causes were the more frequent ones. Staphylococcus aureus and Streptococcus species were the microorganisms more commonly isolated. Conclusion:DNSI remains a common and challenging disease for otorhinolaryngologists, and should be treated on emergency basis. In developing countries, lack of adequate nutrition, poor oral hygiene, tobacco chewing, smoking and beetle nut chewing has led to an increased prevalence of dental and periodontal diseases. In present study, Odontogenic infections were the most common etiological factor for DNSI.展开更多
Objective:Deep neck infections(DNI)are responsible for significant morbidity in children and healthcare expenditures.Few studies exist specifically addressing the clinical and epidemiologic characterization and manage...Objective:Deep neck infections(DNI)are responsible for significant morbidity in children and healthcare expenditures.Few studies exist specifically addressing the clinical and epidemiologic characterization and management of DNI's in the pediatric population.Our goal was to analyse the demographic characteristics,clinical presentation,diagnostic and therapeutic approaches of peritonsillar and DNI in pediatric patients.Methods:The medical records of patients,aged up to 18 years,admitted for peritonsillar and DNI at our department,from 2011 to 2016,were retrospectively reviewed and compared with the literature available.Ninety-eight patients were enrolled.Results:The mean age was higher in patients with peritonsillar abscess and lower in patients with retropharyngeal and parapharyngeal infections.Admissions have significantly increased from 2011.There was a seasonal variation for DNI incidence,with a peak incidence in Summer and Spring.All patients included were treated as inpatient and received empirical intravenous antibiotic therapy and steroids regardless of drainage procedures.Incision and drainage was performed in 72 patients.The hospital length of stay was higher among patients with retropharyngeal abscess and in the group with complications.Only 2 patients developed complications during hospital stay.The most common microbiological pattern was monomicrobial and the most commonly isolated pathogens were Streptococcus Pyogenes,Streptococcus Mitisand anaerobic bacteria.Conclusions:Surgical incision and drainage followed by intravenous antibiotic and steroids proved to be successfull with low morbidity related to surgical approach.However,in selected cases,medical therapy may be an alternative to surgical management in uncomplicated infections.展开更多
Hyperthermia-induced decline in cognitive performance is a moderate complication that poses challenges to the maintenance of safety. Although the underlying mechanism can be attributed to the disruption of brain netwo...Hyperthermia-induced decline in cognitive performance is a moderate complication that poses challenges to the maintenance of safety. Although the underlying mechanism can be attributed to the disruption of brain networks, the propensity remains unclear. This study aimed to test the hypothesis that the extent of the alterations in cognitive performance is governed by the activity of deep brain structures, including monoaminergic neural systems. A decline in cognitive performance during mild hyperthermia and the beneficial effects of neck cooling were demonstrated using the Continuous Performance Test as a battery of cognitive tasks. Aspects of cognitive performance were characterized using the deep-brain activity (DBA) index as a neural activity parameter and the State-Trait Anxiety Inventory to assess the extent of alterations in cognitive performance as an individual measure. It was found that a higher average DBA index during tasks is essential for high cognitive performance in the heat. This beneficial effect of DBA is governed by the upper brainstem. This DBA benefit is more significant for individuals with higher average DBA indices at rest in a normal environment. Individual differences in cognitive performance in the heat are governed by differences in DBA. In addition, the beneficial effect of DBA on cognitive performance in heat only applies under conditions including neck cooling. This limited neck-cooling effect is attributed to anti-homeostatic thermoregulatory responses to cognitive tasks regulated by DBA.展开更多
Objective To retrospect therapeutic effects of iliac flap with deep iliac circumflex vessel with canulate compression bone screws internal fixation on femoral neck fracture of young people. Method 34 cases of femoral ...Objective To retrospect therapeutic effects of iliac flap with deep iliac circumflex vessel with canulate compression bone screws internal fixation on femoral neck fracture of young people. Method 34 cases of femoral neck fracture had been treated with pedicle bone flap with deep iliac circumflex artery and canulate bone screws internal fixation. Result By follow up for 1 to 1.5 years, 32 cases were healing by first intention, and patients obtained satisfactory joint function. Conclusion Femoral neck fracture can be treated by transplanting pedicle bone flap with deep iliac circumflex vessel and canulate bone screws internal fixation.展开更多
文摘BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of serious mortality and morbidity.METHODS This study was carried out with the participation of 188 patients who were treated at Mersin University Department of Otorhinolaryngology and Head and Neck Surgery at January 1,2024.When the patient files were retrospectively examined,16 of 188 patients(8.5%)were included in the study because they were observed to have necrotizing fasciitis and/or intrathoracic complications.RESULTS There were a total of 16 patients in this study,9 males(56.25%)and 7 females(43.75%).All patients were adults(>18 years)and the mean age was 50.37 years±15.37 years.Female patients had a mean age of 40.42 years±13.38 years,whereas for male patients was 58.11 years±12.44 years.CONCLUSION Patients with necrotizing fasciitis and/or intrathoracic complications require more complicated and serious surgeries,intensive care unit monitoring,and mechanical ventilator support.Higher rates of morbidity and mortality should be expected in Bal KK et al.Deep neck infections mortal complications WJCC https://www.wjgnet.com 6384 October 26,2024 Volume 12 Issue 30 these patients who are hospitalized for longer periods of time.
文摘Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patients with DNA will be identified. Methods: We retrospectively studied 29 patients who presented to the department of otolaryngology with deep neck abscesses between April 2011 and April 2015. These 29 patients were managed with CPD after antibiotic therapy or needle aspiration failed. Data on patient demographics, location of infection, existing comorbidity, duration of hospitalization, treatment received, and complications were reviewed. Results: The average age of 29 patients, including 18 men and 11 women, was 56 years old. Abscess was found in parapharyngeal space (n = 16), submandibular space (n = 7), retropharyngeal space (n = 5) and pretracheal space (n = 1). The maximum transverse diameter of abscess ranged from 4.8 cm to 8.0 cm (mean 6.03 cm). Positive cultures were found in 24 cases and the most common pathogen found was Streptococcus viridans. Average hospital stay was 6.7 days. Deep neck abscesses were completely removed without residual in all patients. No one had complications and no one died during and after CPD. Conclusion: CPD is a safe and highly effective procedure for treating patients with deep neck abscesses who do not respond to antibiotics therapy. This technique can also provide reliable evidence on pathogens responsible for deep neck abscesses and help otolaryngologists choose effective treatment to achieve better clinical success rate. We recommend that most deep neck abscesses should be managed initially by CPD before resorting to open surgery.
基金Natural Science Foundation of Beijing Municipality(Grant/Award Number:7192171)Peking Union Medical Foundation,Pumch Healthcare Quality and Safety Incubation Program(Grant/Award Number:XHZJ2411)。
文摘Objectives:To compare the effectiveness of vacuum-assisted closure(VAC)against traditional drainage technique,using a retrospective case-control study design,in terms of managing deep neck infections(DNIs).Methods:Patients presenting to Peking Union Medical College Hospital diagnosed with DNIs were recruited in this study.We analyzed the clinical characteristics of DNI patients and divided them into(a)VAC placement group(26 cases)and(b)traditional drainage group(57 cases)according to whether VAC was placed.The differences in length of stay(LOS),wound healing time,and debridement frequency were compared between the two groups.Results:Eighty-three patients had multiple-space infections,i.e.infection at two or more sites.The debridement frequency of the VAC group was significantly lower than that of the traditional drainage group(p=0.001).The wound healing time of the traditional drainage group and VAC group was 38 days(a range of 13-98 days)and 40 days(a range of 11-106 days),respectively;the average LOS was 15 days(a range of 2-68 days)and 16 days(a range of 4-35 days),respectively;and the debridement frequencies were one time(a range of 0-3 times)and zero times(a range of 0-2 times),respectively.The two groups did not differ significantly in wound healing time and hospitalization duration(p=0.319 and 0.937).Conclusions:VAC treatment of DNIs has significant advantages in reducing the frequency of debridement and patient suffering,but it does not show significant advantages in wound healing.Randomized trials are still needed to demonstrate its efficacy.
文摘Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectively, study conducted in the Department of Ear, Nose and Throat, Dr. Shankarrao Chavan Govern-ment Medical College, Nanded, Maharashtra, India, from March 2013 to March 2016. Results:Analysis showed that males are most likely to have deep neck space infections (DNSI). Odontogenic and tonsillar causes were the more frequent ones. Staphylococcus aureus and Streptococcus species were the microorganisms more commonly isolated. Conclusion:DNSI remains a common and challenging disease for otorhinolaryngologists, and should be treated on emergency basis. In developing countries, lack of adequate nutrition, poor oral hygiene, tobacco chewing, smoking and beetle nut chewing has led to an increased prevalence of dental and periodontal diseases. In present study, Odontogenic infections were the most common etiological factor for DNSI.
文摘Objective:Deep neck infections(DNI)are responsible for significant morbidity in children and healthcare expenditures.Few studies exist specifically addressing the clinical and epidemiologic characterization and management of DNI's in the pediatric population.Our goal was to analyse the demographic characteristics,clinical presentation,diagnostic and therapeutic approaches of peritonsillar and DNI in pediatric patients.Methods:The medical records of patients,aged up to 18 years,admitted for peritonsillar and DNI at our department,from 2011 to 2016,were retrospectively reviewed and compared with the literature available.Ninety-eight patients were enrolled.Results:The mean age was higher in patients with peritonsillar abscess and lower in patients with retropharyngeal and parapharyngeal infections.Admissions have significantly increased from 2011.There was a seasonal variation for DNI incidence,with a peak incidence in Summer and Spring.All patients included were treated as inpatient and received empirical intravenous antibiotic therapy and steroids regardless of drainage procedures.Incision and drainage was performed in 72 patients.The hospital length of stay was higher among patients with retropharyngeal abscess and in the group with complications.Only 2 patients developed complications during hospital stay.The most common microbiological pattern was monomicrobial and the most commonly isolated pathogens were Streptococcus Pyogenes,Streptococcus Mitisand anaerobic bacteria.Conclusions:Surgical incision and drainage followed by intravenous antibiotic and steroids proved to be successfull with low morbidity related to surgical approach.However,in selected cases,medical therapy may be an alternative to surgical management in uncomplicated infections.
文摘Hyperthermia-induced decline in cognitive performance is a moderate complication that poses challenges to the maintenance of safety. Although the underlying mechanism can be attributed to the disruption of brain networks, the propensity remains unclear. This study aimed to test the hypothesis that the extent of the alterations in cognitive performance is governed by the activity of deep brain structures, including monoaminergic neural systems. A decline in cognitive performance during mild hyperthermia and the beneficial effects of neck cooling were demonstrated using the Continuous Performance Test as a battery of cognitive tasks. Aspects of cognitive performance were characterized using the deep-brain activity (DBA) index as a neural activity parameter and the State-Trait Anxiety Inventory to assess the extent of alterations in cognitive performance as an individual measure. It was found that a higher average DBA index during tasks is essential for high cognitive performance in the heat. This beneficial effect of DBA is governed by the upper brainstem. This DBA benefit is more significant for individuals with higher average DBA indices at rest in a normal environment. Individual differences in cognitive performance in the heat are governed by differences in DBA. In addition, the beneficial effect of DBA on cognitive performance in heat only applies under conditions including neck cooling. This limited neck-cooling effect is attributed to anti-homeostatic thermoregulatory responses to cognitive tasks regulated by DBA.
文摘Objective To retrospect therapeutic effects of iliac flap with deep iliac circumflex vessel with canulate compression bone screws internal fixation on femoral neck fracture of young people. Method 34 cases of femoral neck fracture had been treated with pedicle bone flap with deep iliac circumflex artery and canulate bone screws internal fixation. Result By follow up for 1 to 1.5 years, 32 cases were healing by first intention, and patients obtained satisfactory joint function. Conclusion Femoral neck fracture can be treated by transplanting pedicle bone flap with deep iliac circumflex vessel and canulate bone screws internal fixation.
