Deep neck space infections, arising usually from tonsils and lymph nodes in children and dental source and salivary glands in adults can be life threatening. It is therefore important to recognise the variables which indicate immediate intervention to prevent fatalities. In this retrospective study of 586 adult patients, the authors present univariate and multivariate analysis of factors associated with life threatening conditions such as mediastinitis, sepsis, dyspnoea, pneumonia, internal jugular vein involvement and death which were observed in 60 of these 586 patients. Patients with pharyngeal swelling, dyspnoea, disturbance of neck movements and dysphonia were more likely to have life threatening complications. Co-morbidities, such as heart disease, pulmonary disease, hepatopathy, haematological diseases and renal failure added to the risks but in this study diabetes was not a significant predictive factor. The anatomical sites considered most dangerous to spread of infection were retropharyngeal space involvement and space around the great vessels. A spectrum of organisms is presented and fungal infection is considered to be most serious. The study provides a good refresher on this dangerous condition which usually presents as an emergency.
Predicting life-threatening complications in deep neck space infections
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