The Treatment for Advanced Deep Neck Infection. Bibliographical Investigation.

Abstract

Advanced deep neck infection (ADNI) can spread into spaces and cause death rapidly. In 1990 we reported a case of ADNI secondary to tonsillitis, with general deterioration due to duodenal perforation and liver cirrhosis. Since then there have been also many case reports on ADNI, and which some patients have died.To determine the rational treatment of ADNI, 55 cases were collected from the literature in Japan and were analyzed statistically.It was conclusions that the most important point is the prevention of the spread of infection, especially downward into the mediastinum. Drainage by a vertical incision is useful, and effective antibiotics must be administered such as clindamycin, lincomycin, cefmetazole, sulbenicillin or imipenem/cilastacin. Special care is needed in the treatment of elderly patients and those with diabetes other diseases in which immunity is reduced.