Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

THE SUPERFICIAL AND DEEP SPREADING PATHWAYS OF INFECTION OF THE MAXILLOFACEAL AND NECK AREA: REPORTS OF 2 CASES

두경부 감염의 천층 및 심층부로의 확산 경로: 증례 보고

  • Lee, Jung-Gyo (Department of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School) ;
  • Choi, Byung-Jun (Department of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School) ;
  • Kim, Yeo-Gap (Department of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School) ;
  • Lee, Baek-Soo (Department of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School) ;
  • Kwon, Yong-Dae (Department of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School) ;
  • Kim, Young-Ran (Department of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School)
  • 이정교 (경희대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 최병준 (경희대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김여갑 (경희대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 이백수 (경희대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 권용대 (경희대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김영란 (경희대학교 치의학전문대학원 구강악안면외과학교실)
  • Received : 2009.07.16
  • Accepted : 2010.01.13
  • Published : 2010.01.29
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Abstract

The spreading pathways which is the cause of infection on head and neck area are submandibular space, masticatory space, parapharyngeal space, retropharyngeal space, carotid sheath and mediastinum, etc. If spread to parapharyngeal area involving airway, such infection can be life-threatening by airway obstruction, or can cause vascular injury followed by hemorrhage, nerve injuries. Also, if spread to superficially, necrotizing fasciitis and many complications may occur including gangrene of skin. The key to successful treatment of infection on head and neck area is recognition of spreading pathways, early diagnosis and following therapeutic management. Our department present two cases, one is infection progressed superficially to suprasternal space, another is spreading deep according to parapharyngeal space, subclavian space and carotid sheath followed by airway obstruction, and obtained significant results with surgical incision and drainage, administration of selected antibiotics, continuous post-operative treatment. We report these 2 cases with literatures review.

Keywords

References

  1. SH Kim, JH Lee : The retrospective study of intrafascial infection from odontogenic infection in oral and maxillofacial region. J Kor Maxillofac Plast Reconstr Surg 29 : 42, 2007.
  2. Rega AJ, Aziz SR, Ziccardi VB : Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. J Oral Maxillofac Surg 64 : 1377, 2006. https://doi.org/10.1016/j.joms.2006.05.023
  3. Whitesides L, Cotto-Cumba C, Myers RA : Cervical necrotizing fasciitis of odontogenic origin: a case report and review of 12 cases. J Oral Maxillofac Surg 58 : 144, 2000. https://doi.org/10.1016/S0278-2391(00)90327-6
  4. Bahu SJ, Shibuya TY, Meleca RJ et al : Craniocervical necrotizing fasciitis: an 11-year experience. Otolaryngol Head Neck Surg 125 : 245, 2001. https://doi.org/10.1067/mhn.2001.118182
  5. Sakaguchi M, Sato S, Ishiyama T et al : Characterization and management of deep neck infections. Int J Oral Maxillofac Surg 26 : 131, 1997.
  6. Obiechina AE, Arotiba JT, Fasola AO : Necrotizing fasciitis of odontogenic origin in Ibadan, Nigeria. Br J Oral Maxillofac Surg 39 : 122, 2001. https://doi.org/10.1054/bjom.2000.0585
  7. Agarwal AK, Sethi A, Sethi D et al : Role of socioeconomic factors in deep neck abscess: A prospective study of 120 patients. Br J Oral Maxillofac Surg 45 : 553, 2007. https://doi.org/10.1016/j.bjoms.2007.01.001
  8. Meher R, Jain A, Sabharwal A et al : Deep neck abscess: a prospective study of 54 cases. J Laryngol Otol 119 : 299, 2005.
  9. Brook I : Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. J Oral Maxillofac Surg 62 : 1545, 2004. https://doi.org/10.1016/j.joms.2003.12.043
  10. Stalfors J, Adielsson A, Ebenfelt A et al : Deep neck space infections remain a surgical challenge. A study of 72 patients. Acta Otolaryngol 124 : 1191, 2004. https://doi.org/10.1080/00016480410017864
  11. Ariji Y, Gotoh M, Kimura Y et al : Odontogenic infection pathway to the submandibular space: imaging assessment. Int J Oral Maxillofac Surg 31 : 165, 2002. https://doi.org/10.1054/ijom.2001.0190
  12. Zeitoun IM. Dhanarajani PJ : Cervical cellulitis and mediastinitis caused by odontogenic infections: report of two cases and review of literature. J Oral Maxillofac Surg 53 : 203, 1995. https://doi.org/10.1016/0278-2391(95)90404-2
  13. Sl Jeong, BC Cho, YC Lee et al : A case report of fetal mediastinal abscess secondary to odontogenic infection. J Kor Oral Maxillofac Surg 24 : 118, 1998.
  14. Wong TY : A nationwide survey of deaths from oral and maxillofacial infections: the Taiwanese experience. J Oral Maxillofac Surg 57 : 1297, 1999. https://doi.org/10.1016/S0278-2391(99)90863-7
  15. SY Kim, BS Lee, TG Kwon et al : Management of cervicofacial necrotizing fasciitis. J Kor Maxillofac Plast Reconstr Surg 25 : 344, 2003.
  16. McCurdy JA Jr., MacInnis EL, Hays LL : Fatal mediastinitis after a dental infection. J Oral Surg 35 : 726, 1977.
  17. Owens BM, Schuman NJ : Ludwig's angina. Gen Dent 42 : 84, 1994.
  18. WK Seo, W Lee, HO Han et al : Necrotizing fasciitis of head and neck area: 4 cases reports. J Kor Oral Maxillofac Surg 32 : 580, 2006.