الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 84 |  |  |
| | | from | 84 | | |
Abstract
Deep neck infections are continued to be seen despite of the widespread use of antibiotics for infection of head and neck.
The aim of the study is to create a protocol for diagnosis & management of DNIs cases.
This study included 107 cases which attended the ORL Department, Alexandria University Hospital. Both sex and all age group were included in the study.
The records of retrospective group were reviewed .prospective group admitted in the ORL Department, lab and radiological investigation were done to reach final diagnosis.
Diabetes mellitus was the most commonly associated systemic diseases ten cases. Malignancy was associated in 2 cases, The most common cause was dental infection, occurring in 35 cases. Forteen cases (13.7%) had deep neck infections due to underlying congenital causes. Foreign body impaction was associated with deep neck infections in 9 cases. Three patient had TB deep neck infections.
Neck pain (72%), odynophagia (56%), dysphagia (52%) and dysphonia (19.6%) were the most common symptoms.
Suppuration was detected in 80 cases (74.8% ) while cellulites was detected in 27 cases.
Multiple space infection was found in 40.2% of cases. Both Ludwig’s angina and retropharyngeal abscess were the most common types of deep neck infections in our series both occurring in 12.1% and 11.2% of cases
All cases proved clinically and radiologically to be cellulitis (27 cases) were treated by medical treatment in the form of intravenous wide spectrum antibiotic. 17 cases were completely resolved and discharged from the hospital in a period from 2-5 days while 10 cases were not improved by conservative treatment. Surgical drainage was done in all cases with clinical and radiological evidence of suppuration at presentation (90 cases).
Ventilation during general anesthesia was achieved in 68 cases using endotracheal intubation while in 20 cases tracheostomy was done. Tracheostomy was indicated commonly in cases with multiple space infection (12.5% 0f cases) and ludwig’s angina (3.4% 0f cases).
Cases presented with infected congenital cysts was managed by complete excision of the cyst under umbrella of wide spectrum antibiotic. The management policy for cases with deep neck infection due to the presence of congnital pyriform sinus was treating the acute attack conservatively and surgery was done after complete recovery from acute attack.
Complications of deep neck infections were diagnosed in 31 patients. The most common complication encountered in this study was airway obstruction (19.6% of cases).
The hospital stay ranged from (2 – 20) days. Seventy three percent of cases stayed in hospital less than 10 days.