Deep Neck Infection

Deep Neck Infection – General Information

This is a severe problem and that is the reason why, for centuries, surgeons and physicians have tried to find an appropriate treatment. The most important aspect related to this problem is the deep location and the complexity of the infection. In these conditions, Deep Neck Infections present a high rate of mortality and morbidity. In the past, these kind of infections lead to a large number of complications; nowadays, these complications are reduced, as doctors have access to modern technology: sophisticated diagnostic tools, modern antibiotics, modern hematology and microbiology.
Deep Neck Infection is such severe and it represents such a challenging condition because of a number of reasons:

• The complex anatomy of the neck spaces: this aspect can make the localization of the infection quite difficult.
• The deep location of the infection: the infection usually develops under a superficial unaffected tissue, so it is usually impossible to visualize.
• Access to the infection: in order to reach the real problem, the surgeon who performs the intervention must cross the superficial tissue above the infection. In this situation, the structure of this tissue is at a high risk.
• Proximity: during the intervention, some internal problems can appear such as: thrombosis, neural dysfunction, osteomyelitis or vascular erosion.
• Communication: the neck spaces are known to communicate with each other. This way, the infection which affects one space is expected to spread to other spaces as well.    

The reports show that Deep Neck Infection does not affect a large number of people.

Deep Neck Infection – Symptoms

Deep Neck Infection – Treatment

If you present one or more of the symptoms and signs listed above, you should immediately visit a doctor and obtain a sure diagnosis. The doctor will probably try to determine your medical history and the most probable things he will be interested about are the following: recent dental procedures, respiratory difficulties, pain, infections of the respiratory system, oral cavity trauma, rate of onset, the evolution of the symptoms and their duration. In addition, the doctor should perform a physical examination in order to detect the area in which the infection is located, the spaces of the neck which are involved and any other complications and compromises which can appear. He should also examine your neck, your head and the dentition. For this last examination, you can also consult a dentist and then communicate the results to your doctor.

After the doctor determines the localization, the severity and the stage in which the Deep Neck Infection is, he must choose the best way of treating the problems. The most common ways of treatment are discussed below.

Airway: this kind of therapy is performed in the case of all the patients. This way, the doctor has permanently data about the evolution of the disease and he can react in emergent situations.  The intubation is however extremely difficult even for an experienced doctor; because of the swollen tissues of the neck, he can not visualize the vocal cords and he can cause further swollen and other complications.  There are also some other factors which can cause problems during the intubation: tracheal deviation, trismus, compression of the external airway or spine rigidity. In order to perform a safe intubation in the case of patients who suffer from Deep Neck Infection, the doctor should choose a local anesthesia.

Cultures: if the doctor chooses an antimicrobial therapy, he should firstly obtain cultures of abscess fluid, blood and neck tissue.

Volume and metabolic resuscitation: these procedures should also be performed in the case of all the patients who suffer from Deep Neck Infection. This way, the doctor can identify the metabolic problems.

Intravenous antibiotics: before the cultures are analyzed, the doctor should choose parenteral antibiotics, as these are suitable for any organism. After the cultures are examined, the doctor will choose the type of antibiotics which best suits his patient’s condition. The antibiotics have to be administrated for at least two days.

Surgical therapy: the first stage of this way of treating patients with Deep Neck Infection consists of incision and drainage. The doctor should firstly establish a safe airway in order to reach the abscess. The drainage should then be performed without affecting the tissues which surround the abscess.  

Needle aspiration: this method is used in the case of patients who present small abscesses which are also easy to reach. This intervention may need to be accompanied by ultrasound guidance.

Further actions in the case of patients who suffer from Deep Neck Infection consist of monitoring the medical condition after the treatment. This measure is important in order to eliminate the possibility of an abscess to reaccumulate.