Deep Neck Infection: Current Practice

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  • 深頚部感染症の臨床
  • シンケイブ カンセンショウ ノ リンショウ

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Deep neck infection (DNI) is a serious and potentially life-threatening infection that spreads in the spaces surrounded by the cervical fasciae. It is divided into 3 stages, lymphadenitis, cellulitis and abscess, which can substantially be differentiated by contrast-enhanced computed tomography (CECT). CECT is also useful in evaluating the extension of DNI, which gives efficient information on determining treatment. The successful management of DNI depends on an understanding of the anatomy of the neck fascial planes and spaces, antibiotic therapy, and potential complications. The mainstays of treatment of DNI are antibacterial therapy and surgical drainage. Cellulitis and lymphadenitis can be treated with IV antibiotic therapy alone. In contrast, abscesses are mandated with surgical drainage, because it has been reported that only 10 to 25% of abscesses may be successfully treated with antibiotics alone. There are many types of surgical approaches. Irrespective of type of approaches, the surgical incision must be large enough to amply expose the entire abscess cavity. Percutaneous needle aspiration as a substitute for surgical incision and drainage is recommended for experts who have full experience of the latter procedure.

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