대한기관식도과학회지 (Korean Journal of Bronchoesophagology)
- 제17권1호
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- Pages.46-49
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- 2011
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- 1226-0916(pISSN)
경부 괴사성 근막염의 임상적 고찰
Clinical Analysis of Cervical Necrotizing Fasciitis
- Park, Byung Kuhn (Department of Otolaryngology, Head & Neck surgery, College of Medicine, Konyang University) ;
- Lee, Do-Joon (Department of Otorhinolaryngology, College of Medicine, Dankook University) ;
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Lee, Sang Joon
(Department of Otorhinolaryngology, College of Medicine, Dankook University)
- 투고 : 2011.06.06
- 심사 : 2011.06.24
- 발행 : 2011.06.30
초록
Background and Objectives Cervical necrotizing fasciitis is a fulminant disease associated with necrosis of connective tissue, spread along the fascial plane, and high mortality. We analyzed the clinical characteristics and treatment outcome of this rare fatal disease. Materials and Methods We retrospectively reviewed the medical records of 19 patients treated for cervical necrotizing fasciitis from January 1999 to January 2009. Mean age was 53.7 years. Results The most common predisposing illness was tonsillitis (36.8%), followed by odontogenic infection (15.7%). Diabetes mellitus was most common underlying disease. Liver cirrhosis and chronic renal failure were found in 2 patients each. All patients were treated with combination of parenteral antibiotics and wide surgical debridement by transcervical and/or thoracotomy approach. Multiple surgical debridements were performed in 7 patients. Tracheotomy was performed in most of the patients (88.8%). Period of total hospitalization and Intensive care unit was 23 days and 10.1 days. Two patients died of disease and overall survival rate was 89.4%. Conclusion Early surgical management and care in intensive care unit are essential for cervical necrotizing fasciitis. Possible complications such as respiratory failure, mediastinitis or sepsis should be carefully evaluated.