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Ten years of deep neck space abscesses

Published online by Cambridge University Press:  29 March 2019

J Buckley ,
A S Harris  and
J Addams-Williams
J Buckley*
Affiliation:
Department of Otolaryngology, Ninewells Hospital, Dundee, Scotland, UK
A S Harris
Affiliation:
Department of Otolaryngology, University Hospital of Wales, Cardiff, UK
J Addams-Williams
Affiliation:
Department of Otolaryngology, Royal Gwent Hospital, Newport, Wales, UK
*
Author for correspondence: Miss J Buckley, Department of Otolaryngology, Ninewells Hospital, James Arrott Dr, Dundee DD2 1SY, Scotland E-mail: Joanna.buckley@doctors.org.uk
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Abstract

Background

The incidence of deep neck space abscesses, which can result in significant morbidity and mortality, is rising. The aetiology is thought to be dental. However, this study suggests a reduction in tonsillectomies may be associated with the rise.

Method

In a retrospective cohort study, patients were identified by a clinical code within one hospital over 10 years. Evidence of preceding infection source, management, lifestyle risks, comorbidities and demographics were extracted.

Results

Fifty-two patients were included: 23 (44 per cent) had concurrent or recent tonsillitis; 11 (21 per cent) had poor dental hygiene; 22 (42 per cent) were smokers; and 9 (17 per cent) had diabetes. The incidence of deep neck space abscess cases increased from 1 in 2006, to 15 in 2015 (correlation value 0.9; p = 0.00019).

Conclusion

The incidence of deep neck space abscess cases is increasing. Risk factors include tonsillitis, smoking and dental infection. This paper adds to the growing evidence that deep neck space abscesses are increasingly related to tonsillitis, and questions whether the threshold for tonsillectomy has been raised too high.

Keywords

TonsillitisRetropharyngeal AbscessTonsillectomyNeckAbscessPeritonsillar Abscess
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 4 , April 2019 , pp. 324 - 328
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Miss J Buckley takes responsibility for the integrity of the content of the paper

References

1Vieira, F, Allen, SM, Stocks, RM, Thompson, JW. Deep neck infection. Otolaryngol Clin North Am 2008;41:459–83Google Scholar
2Lau, AS, Upile, NS, Wilkie, MD, Leong, SC, Swift, AC. The rising rate of admissions for tonsillitis and neck space abscesses in England, 1991–2011. Ann R Coll Surg Engl 2014;96:307–10Google Scholar
3Parhiscar, A, Har-El, G. Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol 2001;110:1051–4Google Scholar
4Procedures of low clinical effectiveness. In: http://www.barnetccg.nhs.uk/Downloads/Publications/Policies/NCL-CCGs-Procedures-of-limited-clinical-effectiveness-policy-2015-16-2016-17.pdf [19 August 2017]Google Scholar
5Yap, D, Harris, AS, Clarke, J. Serious tonsil infections versus tonsillectomy rates in Wales: a 15-year analysis. Ann R Coll Surg Engl 2017;99:31–6Google Scholar
6Bird, JH, Biggs, TC, King, EV. Controversies in the management of acute tonsillitis: an evidence-based review. Clin Otolaryngol 2014;39:368–74Google Scholar
7Does my project require review by a Research Ethics Committee? In: http://www.hra.nhs.uk/documents/2013/09/does-my-project-require-rec-review.pdf [24 January 2018]Google Scholar
8Lee, YQ, Kanagalingam, J. Deep neck abscesses: the Singapore experience. Eur Arch Otorhinolaryngol 2011;268:609–14Google Scholar
9Kataria, G, Saxena, A, Bhagat, S, Singh, B, Kaur, M, Kaur, G. Deep neck space infections: a study of 76 cases. Iran J Otorhinolaryngol 2015;27:293–9Google Scholar
10Biron, VL, Kurien, G, Dziegielewski, P, Barber, B, Seikaly, H. Surgical vs ultrasound-guided drainage of deep neck space abscesses: a randomized controlled trial: surgical vs ultrasound drainage. J Otolaryngol Head Neck Surg 2013;42:18Google Scholar
11Bakir, S, Tanriverdi, MH, Gün, R, Yorgancilar, AE, Yildirim, M, Tekbaş, G et al. Deep neck space infections: a retrospective review of 173 cases. Am J Otolaryngol 2012;33:56–63Google Scholar
12Srivanitchapoom, C, Sittitrai, P, Pattarasakulchai, T, Tananuvat, R. Deep neck infection in Northern Thailand. Eur Arch Otorhinolaryngol 2012;269:241–6Google Scholar
13Brito, TP, Hazboun, IM, Fernandes, FL, Bento, LR, Zappelini, CEM, Chone, CT et al. Deep neck abscesses: study of 101 cases. Braz J Otorhinolaryngol 2017;83:341–8Google Scholar
14Huang, CM, Huang, FL, Chien, YL, Chen, PY. Deep neck infections in children. J Microbiol Immunol Infect 2017;50:627–33Google Scholar
15Wong, DK, Brown, C, Mills, N, Spielmann, P, Neeff, M. To drain or not to drain – management of pediatric deep neck abscesses: a case–control study. Int J Pediatr Otorhinolaryngol 2012;76:1810–13Google Scholar
16Carbone, PN, Capra, GG, Brigger, MT. Antibiotic therapy for pediatric deep neck abscesses: a systematic review. Int J Pediatr Otorhinolaryngol 2012;76:1647–53Google Scholar
17Baldassari, CM, Howell, R, Amorn, M, Budacki, R, Choi, S, Pena, M. Complications in pediatric deep neck space abscesses. Otolaryngol Head Neck Surg 2011;144:592–5Google Scholar
18Stop smoking Wales. Stop Smoking Wales Annual Report 2011–12. In: http://www.stopsmokingwales.com/sitesplus/documents/1006/StopSmokingWalesAnnualReport2011-12FINAL120713.pdf [5 December 2017]Google Scholar
19Diabetes in Wales - Diabetes UK. In: https://www.diabetes.org.uk/In_Your_Area/Wales/Diabetes-in-Wales [5 December 2017]Google Scholar
20Delamaire, M, Maugendre, D, Moreno, M, Le Goff, MC, Allannic, H, Genetet, B. Impaired leucocyte functions in diabetic patients. Diabet Med 1997;14:29–34Google Scholar
21Hostetter, MK. Handicaps to host defense. Effects of hyperglycemia on C3 and Candida albicans. Diabetes 1990;39:271–5Google Scholar