Clinical aspects, diagnosis and treatment of the phlegmons of maxillofacial area and deep neck infections
Journal Title: Otolaryngologia Polska - Year 2008, Vol 62, Issue 5
Abstract
Introduction. The problem of maxillofacial and neck tissue infl ammatory diseases constantly draws attention of otolaryngologists and maxillofacial surgeons in assosiation with steady frequency of pathology. Despite a modern antibiotic therapy, there still exist cases in which an initial delay in diagnosis and treatment may result in a life-threatening situation. Material and methods. We have analyzed a clinical picture of 219 patients aged from 5 up to 91 years. The patients have been distributed according to the spread of purulent process and the laboratory research data into the following groups. Results. and discussion. In inoculations from a wound during the primary surgical treatment in 67.6% of patients 1 microorganism has been revealed, in 7.9% – 2 microorganisms, in 5% – 3 and more microorganisms, in 19.4% of patients microorganisms have not been revealed. The most frequent cultures extracted from wound contents, were staphylococci and streptococci (61.2%). The presence of mixed (aerobic and anaerobic) microfl ora in the inflammation center has been marked recently. We have analyzed 64 MRI and X-CT at suspicion on diffusion of purulent process in deep neck cellular space. In 52 patients the process was localized within the limits of neck spaces and in 12 patients – the pyoinfl ammatory process extended on mediastinum though the clinical suspicion on mediastinitis was only in 10 patients. Conclusions. The treatment of maxillofacial and neck pyoinfl ammatory diseases and their complications remains a complex and diffi cult problem. Alongside with clinical methods of diagnosis of maxillofacial and neck pyoinfl ammatory diseases it is necessary to use accessory methods such as X-CT and MRI which clinical-diagnostic effi ciency is very high. An antimicrobial therapy plays a signifi cant role in the treatment of maxillofacial phlegmons. Antimicrobial regiments have been recommended and should cover the polymicrobial etiology.
Authors and Affiliations
Liudmila Krautsevich, Oleg Khorow
Keywords
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