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Rasteniene R, Simenaite G, Brukiene V. Maxillofacial infections in lithuanian hospitalised children and adolescents: a 17-years retrospective study. Eur Arch Paediatr Dent 2023; 24:603-611. [PMID: 37452905 DOI: 10.1007/s40368-023-00824-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To analyse the epidemiology, treatment, and microbiological findings of hospitalised Lithuanian children and adolescents admitted due to maxillofacial infections over a 17-years period. METHODS 428 medical records of paediatric (under the age of 18) patients hospitalised at Vilnius University Hospital from 2003 to 2019 due to a maxillofacial infection were reviewed. The data concerning patient sociodemographic characteristics, aspects related to a hospital stay, treatment modalities, microbiological findings, and sensitivity to antibiotics, were collected and analysed. RESULTS The most prevalent condition was odontogenic maxillofacial space infection (28.7%), followed by lymphadenitis (21.7%). The mean (sd) age was 10.86 (4.8) years and the male-to-female ratio was 1.37:1. The majority of patients (83.4%) underwent surgical treatment. The mean (sd) hospital stay was 5.49 (2.9) days. The longest hospital stay was observed in the case of odontogenic maxillofacial space infections. A longer period of hospitalisation was generally associated with the presence of anaerobes and their resistance to antibiotics as well as multiple space involvement in deep neck space infections and a permanent causative tooth in odontogenic cases. The most commonly isolated microbiological species was Staphylococcus aureus spp. CONCLUSION The most common origin of maxillofacial infection was odontogenic among investigated Lithuanian children and adolescents. In the majority of cases, a penicillin group antibiotic was prescribed. Streptococci were the predominant bacteria in the cases of odontogenic infection, while Staphylococci were the most prevalent among non-odontogenic cases. Nearly 40.0% of isolated microorganisms were resistant to penicillin. High resistance to metronidazole was identified among anaerobic bacteria.
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Affiliation(s)
- R Rasteniene
- Faculty of Medicine, Institute of Odontology, University of Vilnius, Žalgirio Str. 117, 08217, Vilnius, Lithuania.
| | - G Simenaite
- Faculty of Medicine, Institute of Odontology, University of Vilnius, Žalgirio Str. 117, 08217, Vilnius, Lithuania
| | - V Brukiene
- Faculty of Medicine, Institute of Odontology, University of Vilnius, Žalgirio Str. 117, 08217, Vilnius, Lithuania
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2
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Shareef M, Ghosn Y, Khdhir M, El Annan T, Alam R, Hourani R. Critical infections in the head and neck: A pictorial review of acute presentations and complications. Neuroradiol J 2022:19714009211059122. [PMID: 35188822 DOI: 10.1177/19714009211059122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Non-traumatic head and neck emergencies include several disease processes such as infectious, inflammatory, and malignant. Infections are among the most common pathological processes that affect the head and neck, and are particularly important due to their acute, severe, and potentially life-threatening nature. Radiologists need to be well acquainted with these entities because any delay or misdiagnosis can lead to significant morbidity and mortality. Having a general understanding of such diseases is crucial, their prevalence, clinical presentation, common causative pathogens, route of spread, potential complications, and multimodality radiological appearance. Furthermore, understanding the relevant anatomy of the region, including the various fascial planes and spaces, is essential for radiologists for accurate image interpretation and assessment of potential complications. Our aim is to review the most common severe infections affecting the head and neck as well as other rare but potentially life-threatening infections. We will also describe their imaging features while focusing on the anatomy of the regions involved and describing their potential complications and treatment options.
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Affiliation(s)
| | - Youssef Ghosn
- Department of Diagnostic Radiology, 66984American University of Beirut, Lebanon
| | - Mihran Khdhir
- Department of Diagnostic Radiology, 66984American University of Beirut, Lebanon
| | - Tamara El Annan
- Department of Diagnostic Radiology, 66984American University of Beirut, Lebanon
| | - Raquelle Alam
- Department of Diagnostic Radiology, 66984American University of Beirut, Lebanon
| | - Roula Hourani
- Department of Diagnostic Radiology, 66984American University of Beirut, Lebanon
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3
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Silva CM, Paixão J, Tavares PN, Baptista JP. Life-threatening complications of Ludwig's angina: a series of cases in a developed country. BMJ Case Rep 2021; 14:e240429. [PMID: 33906886 PMCID: PMC8076936 DOI: 10.1136/bcr-2020-240429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2021] [Indexed: 11/03/2022] Open
Abstract
Ludwig's angina is a deep neck space infection defined as a rapidly progressive bilateral cellulitis of the submandibular space. In spite of being an uncommon entity in developed countries and the reduction of mortality and morbidity due to modern era of antibiotics, improved imaging and airway management, it is still an important and potentially life-threatening condition. The authors present 3 cases of Ludwig's angina that occurred in a developed country, and that required admission in intensive care unit and extensive surgical and medical treatment.
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Affiliation(s)
- Catarina Mendes Silva
- Serviço de Medicina Intensiva, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Joana Paixão
- Serviço de Medicina Interna, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | | | - João Pedro Baptista
- Serviço de Medicina Intensiva, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
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4
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Chi JM, Hagiwara M. Update on MRI for Oral Cavity. Top Magn Reson Imaging 2021; 30:85-96. [PMID: 33828060 DOI: 10.1097/rmr.0000000000000278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Magnetic resonance imaging (MRI) is the imaging modality of choice to evaluate the complex anatomy and pathology of the oral cavity. In this article, an overview of MRI findings of common benign lesions in the oral cavity including congenital, vascular, and inflammatory/infectious lesions will be reviewed. In addition, MRI findings of common benign and malignant oral cavity tumors will be presented.
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Affiliation(s)
- Joan M Chi
- Department of Radiology, NYU Langone Health, New York, NY
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5
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Kamalian S, Avery L, Lev MH, Schaefer PW, Curtin HD, Kamalian S. Nontraumatic Head and Neck Emergencies. Radiographics 2020; 39:1808-1823. [PMID: 31589568 DOI: 10.1148/rg.2019190159] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Head and neck imaging is an intimidating subject for many radiologists because of the complex anatomy and potentially serious consequences of delayed or improper diagnosis of the diverse abnormalities involving this region. The purpose of this article is to help radiologists to understand the intricate anatomy of the head and neck and to review the imaging appearances of a variety of nontraumatic head and neck conditions that bring patients to the emergency department, including acute infectious and inflammatory diseases and acute complications of head and neck neoplasms. These conditions are presented in five sections on the basis of their primary location of involvement: the oral cavity and pharynx, neck, sinonasal tract, orbits, and ears. Important anatomic landmarks are reviewed briefly in each related section.Online supplemental material is available for this article.©RSNA, 2019.
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Affiliation(s)
- Shervin Kamalian
- From the Department of Radiology, Division of Emergency Radiology, Massachusetts General Hospital, 55 Fruit St, Blake SB Rm 0029A, Boston, MA 02114 (Shervin Kamalian, L.A., M.H.L., P.W.S., Shahmir Kamalian); and Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston, Mass (H.D.C.)
| | - Laura Avery
- From the Department of Radiology, Division of Emergency Radiology, Massachusetts General Hospital, 55 Fruit St, Blake SB Rm 0029A, Boston, MA 02114 (Shervin Kamalian, L.A., M.H.L., P.W.S., Shahmir Kamalian); and Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston, Mass (H.D.C.)
| | - Michael H Lev
- From the Department of Radiology, Division of Emergency Radiology, Massachusetts General Hospital, 55 Fruit St, Blake SB Rm 0029A, Boston, MA 02114 (Shervin Kamalian, L.A., M.H.L., P.W.S., Shahmir Kamalian); and Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston, Mass (H.D.C.)
| | - Pamela W Schaefer
- From the Department of Radiology, Division of Emergency Radiology, Massachusetts General Hospital, 55 Fruit St, Blake SB Rm 0029A, Boston, MA 02114 (Shervin Kamalian, L.A., M.H.L., P.W.S., Shahmir Kamalian); and Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston, Mass (H.D.C.)
| | - Hugh D Curtin
- From the Department of Radiology, Division of Emergency Radiology, Massachusetts General Hospital, 55 Fruit St, Blake SB Rm 0029A, Boston, MA 02114 (Shervin Kamalian, L.A., M.H.L., P.W.S., Shahmir Kamalian); and Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston, Mass (H.D.C.)
| | - Shahmir Kamalian
- From the Department of Radiology, Division of Emergency Radiology, Massachusetts General Hospital, 55 Fruit St, Blake SB Rm 0029A, Boston, MA 02114 (Shervin Kamalian, L.A., M.H.L., P.W.S., Shahmir Kamalian); and Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston, Mass (H.D.C.)
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6
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Jizzini MN, Shah M, Yeung SCJ. Extramedullary Plasmacytoma Involving the Trachea: A Case Report and Literature Review. J Emerg Med 2019; 57:e65-e67. [PMID: 31266689 DOI: 10.1016/j.jemermed.2019.05.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/28/2019] [Accepted: 05/06/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Extramedullary plasmacytoma is an uncommon type of plasma cell neoplasm that occurs outside of the bone marrow. Very rarely, extramedullary plasmacytomas can involve the trachea, causing significant respiratory distress. CASE REPORT We describe a patient with a history of multiple myeloma who presented with voice hoarseness and dyspnea and was found to have airway obstruction due to an extramedullary plasmacytoma near the larynx. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: It is important to investigate the possibility of upper airway obstruction in cancer patients presenting with hoarseness and dyspnea to prevent incorrect management, which can lead to fatal results. In particular, wheezing and dyspnea in patients with a history of asthma may not always be due to asthma exacerbation. Computed tomography scans and emergency laryngoscopy have been shown to be useful in aiding with correct diagnosis of upper airway obstruction, ensuring appropriate treatment.
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Affiliation(s)
- Mazen Nizar Jizzini
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mohsin Shah
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sai-Ching Jim Yeung
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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7
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Varghese L, Mathews SS, Antony Jude Prakash J, Rupa V. Deep head and neck infections: outcome following empirical therapy with early generation antibiotics. Trop Doct 2018; 48:179-182. [PMID: 29759037 DOI: 10.1177/0049475518774472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In order to study the bacteriological profile, antibiotic sensitivity and outcome following empirical therapy with early generation antibiotics in patients with deep head and neck infection, a retrospective review of 42 patients admitted for drainage and intravenous antibiotic therapy was performed. Ludwig's angina was the commonest infection, with the most common organisms isolated being Group F ß-haemolytic (15%) and non-haemolytic (12.5%) streptococcus. All streptococci and anaerobic gram-positive cocci were susceptible to penicillin. S. aureus isolates were oxacillin-sensitive and enterococcus isolates were ampicillin-sensitive. All 42 patients received empirical therapy with either intravenous penicillin or its derivatives. In only three patients was a change of antibiotic required based on culture and sensitivity results. Early generation antibiotics appear ideal as empirical therapy for deep head and neck infection.
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Affiliation(s)
- Lalee Varghese
- 1 Associate Professor, Department of Otorhinolaryngology, Christian Medical College, Vellore
| | - Suma Susan Mathews
- 2 Professor, Department of Otorhinolaryngology, Christian Medical College, Vellore
| | | | - V Rupa
- 4 Professor, Department of Otorhinolaryngology, Christian Medical College, Vellore
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8
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Greenstein A, Witherspoon R, Leinkram D, Malandreni M. An unusual case of a brain abscess arising from an odontogenic infection. Aust Dent J 2018; 60:532-5. [PMID: 25484130 DOI: 10.1111/adj.12266] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2014] [Indexed: 11/30/2022]
Abstract
A brain abscess that originates from an odontogenic infection, although rare, can at times be difficult to diagnose, especially in the context of pain and trismus. We report a rare case of odontogenic infection as a result of an infected maxillary third molar, causing an infratemporal and temporalis collection, resulting in a brain abscess with concurrent cerebritis. This is a clinical case review documenting an uncommon but potentially fatal complication.
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Affiliation(s)
- A Greenstein
- Oral and Maxillofacial Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - R Witherspoon
- Oral and Maxillofacial Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - D Leinkram
- Oral and Maxillofacial Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - M Malandreni
- Oral and Maxillofacial Surgery, Poole Hospital, Poole, United Kingdom
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9
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Derinkuyu BE, Boyunağa Ö, Polat M, Damar Ç, Tapısız Aktaş A, Alımlı AG, Öztunalı Ç, Kara SS, Uçar M, Tezer H. Association between deep neck space abscesses and internal carotid artery narrowing in pediatric patients. Turk J Med Sci 2017; 47:1842-1847. [PMID: 29306247 DOI: 10.3906/sag-1707-165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim: Our aim was to interpret the effects of deep neck space abscesses on the adjacent carotid artery according to abscess location, as well as to determine narrowing by calculating the mean stenosis ratios.Materials and methods: Neck computed tomography scans and clinical data of 45 children with neck abscesses were evaluated retrospectively for abscess location and internal carotid artery narrowing. The lumen areas of the carotid arteries were measured from standard levels, and stenosis ratios were calculated with two different techniques. The mean stenosis ratios of each group according to abscess location were then compared with the control group.Results: Among the 45 abscesses included in the study, 51.1% (n = 23/45) were located in the peritonsillar region, 37.8% (n = 17/45) were located in the parapharyngeal-lateral retropharyngeal space, and 11.1% (n = 5/45) were in the midline retropharyngeal space. We found a statistically significant difference between the mean stenosis ratios of the ipsilateral side of the parapharyngeal-lateral retropharyngeal abscesses and the control group (P < 0.01).Conclusion: The children with parapharyngeal-lateral retropharyngeal abscesses all had narrowing in the adjacent carotid lumen to some degree. Although most of the patients had no clinical symptoms, radiologists have to be aware of this arterial complication to prevent further progress and fatal complications.
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10
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Lipschitz N, Yakirevitch A, Sagiv D, Migirov L, Talmi YP, Wolf M, Alon EE. Nasal vestibulitis: etiology, risk factors, and clinical characteristics: A retrospective study of 118 cases. Diagn Microbiol Infect Dis 2017; 89:131-134. [PMID: 28780999 DOI: 10.1016/j.diagmicrobio.2017.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/07/2017] [Accepted: 06/12/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nasal vestibulitis (NV) is a common infection; however, scant data is available in the literature as it pertains to NV. We aim to describe the clinical characteristics of NV in respect to its potential complications. METHODS A retrospective chart review of 118 NV cases admitted to a tertiary medical center between 2008 and 2015. RESULTS Identified risk factors for NV included nasal hair plucking (n=15, 14.41%), nose blowing (n=10, 9.32%), nose picking (n=9, 8.47%) and nose piercing (n=5, 3.39%). Twelve patients (10.17%) were diabetic, and 3 patients were immunosuppressed. Mid-facial cellulitis was observed in the majority of patients (78.81%), and abscess of the nasal vestibule was observed in almost half (48.30%). Cultures were taken from 33.33% of patients demonstrated MSSA as the most common isolate (81.25%). No complications were observed. CONCLUSION Even in complicated cases of NV requiring admission, the risk of major complications is extremely low.
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Affiliation(s)
- Noga Lipschitz
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel.
| | - Arkadi Yakirevitch
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Doron Sagiv
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Lela Migirov
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoav P Talmi
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Wolf
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran E Alon
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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11
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Brea Álvarez B, Esteban García L, Tuñón Gómez M, Cepeda Ibarra Y. Nontraumatic head and neck injuries: A clinical approach. Part 2. RADIOLOGIA 2017. [DOI: 10.1016/j.rxeng.2017.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Brea Álvarez B, Esteban García L, Tuñón Gómez M, Cepeda Ibarra Y. Nontraumatic head and neck injuries: a clinical approach. Part 2. RADIOLOGIA 2017; 59:182-195. [PMID: 28408041 DOI: 10.1016/j.rx.2017.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 02/02/2017] [Accepted: 02/16/2017] [Indexed: 12/01/2022]
Abstract
Nontraumatic emergencies of the head and neck represent a challenge in the field of neuroradiology for two reasons. As explained in the first part of this update, these entities affect an area where the thorax joins the cranial cavity and can thus compromise both structures; second, they are uncommon, so they are not well known. Maintaining the same approach as in the first part, focusing on the clinical presentations in the emergency department rather than on the anatomic regions affected, we will study the entities that present with two patterns: those that present with a combination of cervical numbness, dysphagia, and dyspnea and those that present with acute sensory deficits. In the latter group, we will specifically focus on visual deficits, because this is the most common symptom that calls for urgent imaging studies.
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Affiliation(s)
- B Brea Álvarez
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España.
| | - L Esteban García
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - M Tuñón Gómez
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - Y Cepeda Ibarra
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
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13
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Linderup MW, Bregendahl S, Helleberg M, Schytte S, Pikelis A, Nørholt SE. Deep head and neck infection causing pathological fracture of the mandibular condyle. BJR Case Rep 2017; 3:20160093. [PMID: 30363265 PMCID: PMC6159235 DOI: 10.1259/bjrcr.20160093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/18/2016] [Accepted: 11/23/2016] [Indexed: 11/20/2022] Open
Abstract
We report an unusual case of a 46-year-old male with a severe deep head and neck infection after extraction of two mandibular molars that led to a potentially life-threatening condition and caused pathological fracture of the mandibular condyle. This is the first published spontaneous pathological fracture of the mandibular condyle caused by an infection spread from a lower molar tooth. Based on CT scan we discuss the pathways of infection of odontogenic origin and the reflections of treatment. This case report illustrates an unusual presentation of a spontaneous pathological condylar fracture caused by a severe life-threatening infection after tooth extraction. It details the examination and management of the patient and reflections about the treatment.
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Affiliation(s)
- Mette Werner Linderup
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Sidse Bregendahl
- Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Malene Helleberg
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Sten Schytte
- Department of Otolaryngology, Aarhus University Hospital, Aarhus, Denmark
| | - Arunas Pikelis
- Department of Otolaryngology, Aarhus University Hospital, Aarhus, Denmark
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,Section of Maxillofacial Surgery and Oral Pathology, Aarhus School of Dentistry, Aarhus University, Aarhus, Denmark
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14
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Pont E, Mazón M. Indications and Radiological Findings of Acute Otitis Media and Its Complications. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017. [DOI: 10.1016/j.otoeng.2017.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Brea Álvarez B, Tuñón Gómez M, Esteban García L, García Hidalgo C, Ruiz Peralbo R. Nontraumatic head and neck emergencies: A clinical approach. Part 1: Cervicofacial swelling, dysphagia, and dyspnea. RADIOLOGIA 2016. [DOI: 10.1016/j.rxeng.2016.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Nontraumatic head and neck emergencies: a clinical approach. Part 1: cervicofacial swelling, dysphagia, and dyspnea. RADIOLOGIA 2016; 58:329-42. [PMID: 27520826 DOI: 10.1016/j.rx.2016.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 06/27/2016] [Accepted: 06/29/2016] [Indexed: 11/23/2022]
Abstract
Nontraumatic emergencies of the head and neck represent a challenge in the field of neuroradiology for two reasons: first, they affect an area where the thorax joins the cranial cavity and can thus compromise both structures; second, they are uncommon, so they are not well known. Various publications focus on nontraumatic emergencies of the head and neck from the viewpoints of anatomic location or of particular diseases. However, these are not the most helpful viewpoints for dealing with patients in the emergency department, who present with particular signs and symptoms. We propose an analysis starting from the four most common clinical presentations of patients who come to the emergency department for nontraumatic head and neck emergencies: cervical swelling, dysphagia, dyspnea, and loss of vision. Starting from these entities, we develop an approach to the radiologic management and diagnosis of these patients.
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17
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Chalifoux JR, Vachha B, Moonis G. Imaging of Head and Neck Infections: Diagnostic Considerations, Potential Mimics, and Clinical Management. Semin Roentgenol 2016; 52:10-16. [PMID: 28434498 DOI: 10.1053/j.ro.2016.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Behroze Vachha
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Gul Moonis
- Columbia University Medical Center, New York, NY.
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18
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Horn DDSG, Silveira ODS, Azevedo CDDBE, Pires LR, Morais CMF, Seraidarian PI, Manzi FR. Hipoplasia condilar de provável origem otológica. REVISTA CEFAC 2016. [DOI: 10.1590/1982-0216201618320215] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO: A articulação temporomandibular é uma das mais complexas do corpo humano sendo o processo condilar responsável pela expressão do crescimento mandibular. A hipoplasia condilar é caracterizada por uma formação defeituosa do processo condilar. A otite média aguda é um processo inflamatório, desencadeada a partir de infecções das fossas nasais, cavidades paranasais e rinofaringe, propagadas por meio da tuba auditiva. No caso apresentado, a paciente apresentava assimetria facial desde o primeiro ano de vida, além de recorrentes casos de otite justamente nos estágios iniciais do fechamento da sutura temporotimpânica e do forame de Huschke o que facilitaria a disseminação dessa infecção otológica o que comprometeria o desenvolvimento do côndilo resultando na hipoplasia identificada, somente do lado direito. Assim, os profissionais que atuam na região da articulação temporomandibular e ouvido devem ter o conhecimento da existência e das implicações clínicas do forame de Huschke para um diagnóstico precoce e evitar o desenvolvimento das assimetrias faciais nos casos em que esta apresenta associação com sinais clínicos de infecção das áreas afetadas, restabelecendo função, estética e o estado psicológico do paciente.
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Pont E, Mazón M. Indications and radiological findings of acute otitis media and its complications. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2016; 68:29-37. [PMID: 27241558 DOI: 10.1016/j.otorri.2016.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/12/2016] [Accepted: 02/24/2016] [Indexed: 11/19/2022]
Abstract
Most cases of acute otitis media resolve with antibiotics and imaging is not required. When treatment fails or a complication is suspected, imaging plays a crucial role. Since the introduction of antibiotic treatment, the complication rate has decreased dramatically. Nevertheless, given the critical clinical relevance of complications, the importance of early diagnosis is vital. Our objective was to review the clinical and radiological features of acute otitis media and its complications. They were classified based on their location, as intratemporal or intracranial. Imaging makes it possible to diagnose the complications of acute otitis media and to institute appropriate treatment. Computed tomography is the initial technique of choice and, in most cases, the ultimate. Magnetic resonance is useful for evaluating the inner ear and when accurate evaluation of disease extent or better characterization of intracranial complications is required.
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Affiliation(s)
- Elena Pont
- Servicio de Otorrinolaringología, Hospital General de Onteniente, Valencia, España.
| | - Miguel Mazón
- Sección de Neurorradiología y Radiología de cabeza-cuello, Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, España
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Abstract
The teeth are unique in that they provide a direct pathway for spread of infection into surrounding osseous and soft tissue structures. Periodontal disease is the most common cause of tooth loss worldwide, referring to infection of the supporting structures of the tooth, principally the gingiva, periodontal ligament, cementum, and alveolar bone. Periapical disease refers to an infectious or inflammatory process centered at the root apex of the tooth, usually occurring when deep caries infect the pulp chamber and root canals. We review the pathogenesis, clinical features, and radiographic findings (emphasis on computed tomography) in periodontal and periapical disease.
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Affiliation(s)
- Vahe M Zohrabian
- Department of Radiology, Yale School of Medicine, New Haven, CT.
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Pahwa S, Sharma S, Das CJ, Dhamija E, Agrawal S. Intraorbital Cystic Lesions: An Imaging Spectrum. Curr Probl Diagn Radiol 2015; 44:437-48. [DOI: 10.1067/j.cpradiol.2015.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 03/13/2015] [Accepted: 03/13/2015] [Indexed: 11/22/2022]
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Lopes Oliveira MJ, Semedo CMP, Quintela MJG, Fragata IMR, Coelho CCG, Valejo Coelho PJ. Pseudoaneurysm of the facial artery territory in an odontogenic infection setting. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0216-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Potential airway compromise secondary to impacted Wharton's duct calculus: a noteworthy phenomenon. The Journal of Laryngology & Otology 2015; 129:721-4. [DOI: 10.1017/s0022215115001449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectives:This case report describes a patient who suffered an acute, severe complication of unilateral submandibular sialolithiasis, the disease process and management of these patients.Case report:A 70-year-old woman was under investigation for a recurrent, painful right submandibular swelling and subsequently presented with an acute exacerbation. She exhibited symptoms of acute submandibular sialadenitis, and also reported breathing difficulty and a change in voice quality. Computed tomography imaging showed that this was caused by a submandibular gland duct sialolith, with inflammation extending to the ipsilateral supraglottis. She was treated medically and the stone was removed when the inflammation had stabilised.Conclusion:This case highlights the need to thoroughly assess patients with neck swellings, especially when symptoms are atypical, to avoid life-threatening complications.
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Wang YP, Wang MC, Lin HC, Chou P. The impact of prior tonsillitis and treatment modality on the recurrence of peritonsillar abscess: a nationwide cohort study. PLoS One 2014; 9:e109887. [PMID: 25291179 PMCID: PMC4188615 DOI: 10.1371/journal.pone.0109887] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 09/03/2014] [Indexed: 11/19/2022] Open
Abstract
Background Studies suggest an increased risk of peritonsillar abscess (PTA) recurrence in patients with prior tonsillitis. However, this association is inconsistent and could be confounded by different treatment modalities. This study aimed to assess the risk of recurrence among PTA patients with different degrees of prior tonsillitis and treatment modalities, and the role of tonsillectomy in current practice. Methods All in-patients with peritonsillar abscess between January 2001 and December 2009 were identified in a nationwide, retrospective cohort study. Recurrence was defined as the first occurrence of PTA ≧30 days from the initial PTA. Factors independently associated with recurrence were analyzed using Cox proportional hazard model after adjusting for demographic and clinical data. Results There were 28,837 patients, with a 5.15% recurrence rate and 4.74 years of follow-up. The recurrence rates were significantly higher among subjects with more than five prior tonsillitis or 1–4 prior tonsillitis compared to those without prior tonsillitis (adjusted hazard ratio, 2.82 [95% confidence interval, 2.39–3.33] and 1.59 [95% CI: 1.38–1.82]). The adjusted HR in patients treated with needle aspiration was 1.08 compared to those treated with incision & drainage (95% CI: 0.85–1.38). After age stratification, the adjusted HRs of more than five prior tonsillitis increased to 2.92 and 3.50 in patients aged ≦18 and 19–29 years respectively. The adjusted HR ofneedle aspiration only increased in patients ≦18 years old (aHR: 1.98 [95% CI: 0.99–3.97]). The overall tonsillectomy rate was 1.48% during our study period. Conclusions The risk of PTA recurrence increases with higher degrees of prior tonsillitis in all age groups and management by needle aspiration only in the pediatric population. Patients younger than 30 years old with PTA and more than five prior tonsillitis have the greatest risk of recurrence.
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Affiliation(s)
- Ying-Piao Wang
- Department of Otolaryngology, Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology and School of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Mao-Che Wang
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Otolaryngology, Head and Neck Surgery, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hung-Ching Lin
- Department of Otolaryngology, Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology and School of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Pesus Chou
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Oh JS, Kim SG, You JS, Min HG, Kim JW, Kim ES, Kim CM, Lim KS. Deep Neck Space Infection Caused by Keratocystic Odontogenic Tumor. Maxillofac Plast Reconstr Surg 2014; 36:73-7. [PMID: 27489814 PMCID: PMC4281907 DOI: 10.14402/jkamprs.2014.36.2.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 08/20/2013] [Accepted: 01/14/2014] [Indexed: 11/17/2022] Open
Abstract
Keratocystic odontogenic tumor (KCOT) is a benign cystic intraosseous tumor of odontogenic origin. An infection of a KCOT is not common because KCOT is a benign developmental neoplasm. Moreover, a severe deep neck space infection with compromised airway caused by infected KCOT is rare. This report presents a 60-year-old male patient with a severe deep neck space infection related to an infected KCOT due to cortical bone perforation and rupture of the exudate. Treatment of the deep neck space infection and KCOT are reported.
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Affiliation(s)
- Ji-Su Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University
| | - Su-Gwan Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University
| | - Jae-Seek You
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University
| | - Hong-Gi Min
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University
| | - Ji-Won Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University
| | - Eun-Sik Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University
| | - Cheol-Man Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University
| | - Kyung-Seop Lim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University
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Giannitto C, Esposito AA, Casiraghi E, Biondetti PR. Epidemiological profile of non-traumatic emergencies of the neck in CT imaging: our experience. Radiol Med 2014; 119:784-9. [PMID: 24553784 DOI: 10.1007/s11547-014-0389-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 10/28/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE This study was undertaken to collect information on the incidence and distribution of acute, non-traumatic conditions of the neck at our emergency radiology department and to review the literature about this topic. MATERIALS AND METHODS We retrospectively reviewed 143 consecutive patients who underwent neck computed tomography (CT) for non-traumatic emergencies between 1 December 2008 and 31 December 2012. For each of the conditions identified, we defined the overall incidence, the incidence based on the site, gender, average age and age range. RESULTS Computed tomography examination was positive in 125 out of 143 patients (87.4%), 74 men and 51 women, with an average age of 51.1 years, aged between 10 and 90 years. We found 79 inflammatory/infectious conditions (63.2% of positive cases, 55.2% of total cases), 46 men and 33 women, with an average age of 47 years. Computed tomography revealed 26 newly found tumours (20.8/18.2%), 19 men and 7 women, with an average age of 68.5 years, aged between 49 and 97 years. In 20 cases, 9 men and 11 women, with an average age of 57.3 years, aged between 21 and 90 years, we diagnosed other acute conditions: six cases of foreign body ingestion (4.8/4.2%), five benign swellings (4/3.5%), five cases of vascular disorders (4/3.5%), and four cases of oedema of the larynx (3.2/2.8 %). CONCLUSIONS Our study of emergency CT of non-traumatic conditions of the neck fundamentally revealed infectious/inflammatory diseases and newly found neoplasms.
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Kwon SK, Kim HB, Song JJ, Cho CG, Park SW, Choi JS, Ryu J, Oh SH, Lee JH. Vocal fold augmentation with injectable polycaprolactone microspheres/pluronic F127 hydrogel: long-term in vivo study for the treatment of glottal insufficiency. PLoS One 2014; 9:e85512. [PMID: 24465582 PMCID: PMC3899012 DOI: 10.1371/journal.pone.0085512] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 11/27/2013] [Indexed: 11/18/2022] Open
Abstract
There is increasing demand for reconstruction of glottal insufficiency. Several injection materials have been examined for this purpose, but all had limitations, such as poor long-term durability, migration from the injection site, inflammation, granuloma formation, and interference with vocal fold vibration due to viscoelastic mismatch. Here, we developed a novel injection material, consisting of polycaprolactone (PCL) microspheres, which exhibits better viscoelasticity than conventional materials, and Pluronic F127 carrier, which decreases the migration of the injection materials. The material was injected into rabbits with glottal insufficiency and compared with the FDA-approved injection material, calcium hydroxylapatite (CaHA). Endoscopic and histological examinations indicated that PCL/Pluronic F127 remained at the injection site with no inflammatory response or granuloma formation, whereas CaHA leaked out and migrated from the injection site. Therefore, vocal fold augmentation was almost completely retained during the 12-month follow-up period in this study. Moreover, induced phonation and high-speed recording of vocal fold vibration showed decreased vocal fold gap area in the PCL/Pluronic F127 group. Our newly developed injection material, PCL/Pluronic F127, permits efficient augmentation of paralyzed vocal fold without complications, a concept that can be applied clinically, as demonstrated by the successful long-term follow-up.
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Affiliation(s)
- Seong Keun Kwon
- Department of Otorhinolaryngology, Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
- Cancer Research Institute, Seoul, Republic of Korea
- Seoul National University Medical Research Center, Seoul, Republic of Korea
- * E-mail:
| | - Hee-Bok Kim
- Department of Otorhinolaryngology, Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Jae-Jun Song
- Department of Otorhinolaryngology, Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Chang Gun Cho
- Department of Otorhinolaryngology, Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Seok-Won Park
- Department of Otorhinolaryngology, Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Jong-Sun Choi
- Department of Pathology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Junsun Ryu
- Head and Neck Oncology Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Se Heang Oh
- Department of Nanobiomedical Science & WCU Research Center, Dankook University, Cheonan, Republic of Korea
| | - Jin Ho Lee
- Department of Advanced Materials, Hannam University, Yuseong Gu, Daejeon, Republic of Korea
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Abstract
This article outlines infections in the submandibular, lateral pharyngeal, retropharyngeal, danger, and prevertebral spaces, in conjunction with infections of the sinuses and mediastinum. By understanding the anatomy and pathophysiology, the reader will gain insight into the rationale for various therapeutic options.
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Affiliation(s)
- Denise Jaworsky
- Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, British Columbia V5Z 1M9, Canada
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Abstract
Emergency physicians should be comfortable treating most dental and related infections. In this article, we outline recommended techniques to perform a dental examination, explore common pathologies, recommend pain and antibiotic management strategies and review common pitfalls. How to avoid overprescribing opioid analgesics is discussed in depth, along with recent studies to support this strategy.
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Affiliation(s)
- Alan Hodgdon
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 500, Pittsburgh, PA 15213, USA.
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Falcon-Chevere JL, Giraldez L, Rivera-Rivera JO, Suero-Salvador T. Critical ENT skills and procedures in the emergency department. Emerg Med Clin North Am 2013. [PMID: 23200328 DOI: 10.1016/j.emc.2012.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Injuries and illness to the ears, nose, and throat are frequently seen in the emergency department. The emergency medicine physician must be proficient in recognizing these injuries and their associated complications and be able to provide appropriate management. This article discusses the most common otorrhinolaringologic procedures in which emergency physicians must be proficient for rapid intervention to preserve function and avoid complications. A description of each procedure is discussed, as well as the indications, contraindications, equipment, technique and potential complications.
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Affiliation(s)
- Jorge L Falcon-Chevere
- Department of Emergency Medicine, University of Puerto Rico School of Medicine, 65th Inf. Station, San Juan, PR 00929, USA.
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Maroldi R, Farina D, Ravanelli M, Lombardi D, Nicolai P. Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR 2013; 33:432-42. [PMID: 22964409 DOI: 10.1053/j.sult.2012.06.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Deep neck space infection may lead to severe and potentially life-threatening complications, such as airway obstruction, mediastinitis, septic embolization, dural sinus thrombosis, and intracranial abscess. The clinical presentation is widely variable, and often early symptoms do not reflect the disease severity. The complication risk depends on the extent and anatomical site: diseases that transgress fascial boundaries and spread along vertically oriented spaces (parapharyngeal, retropharyngeal, and paravertebral space) have a higher risk of complications and require a more aggressive treatment compared with those confined within a nonvertically oriented space (peritonsillar, sublingual, submandibular, parotid, and masticator space). Imaging has 5 crucial roles: (1) confirm the suspected clinical diagnosis, (2) define the precise extent of the disease, (3) identify complications, (4) distinguish between drainable abscesses and cellulitis, and (5) monitor deep neck space infection progression. Ultrasonography is the gold standard to differentiate abscesses from cellulitis, for the diagnosis of lymphadenitis. and to identify internal jugular thrombophlebitis in the infrahyoid neck. However, field-of-view limitation and poor anatomical information confine the use of ultrasonography to the evaluation of superficial lesions and to image-guided aspiration or drainage. Computed tomography (CT) combines fast image acquisition and precise anatomical information without field-of-view limitations. For these reasons, it is the most reliable technique for the evaluation of deep and multicompartment lesions and for the identification of mediastinal and intracranial complications. Contrast agent administration enhances the capability to differentiate fluid collections from cellulitis and allows the detection of vascular complications. Magnetic resonance imaging is more time-consuming than CT, limiting its use to selected indications. It is the technique of choice for assessing the epidural space involvement in pre- and paravertebral space infections and complements CT in the evaluation of the infections reaching the skull base.
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Affiliation(s)
- Roberto Maroldi
- Department of Radiology, University of Brescia, Brescia, Italy.
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Scheinfeld MH, Shifteh K, Avery LL, Dym H, Dym RJ. Teeth: What Radiologists Should Know. Radiographics 2012; 32:1927-44. [DOI: 10.1148/rg.327125717] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Microbiota associated with infections of the jaws. Int J Dent 2012; 2012:369751. [PMID: 22829824 PMCID: PMC3399405 DOI: 10.1155/2012/369751] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 05/09/2012] [Accepted: 05/18/2012] [Indexed: 01/28/2023] Open
Abstract
The microbial infections involving the craniofacial skeleton, particularly maxilla and mandible, have direct relationship with the dental biofilm, with predominance of obligate anaerobes. In some patients, these infections may spread to bone marrow or facial soft tissues, producing severe and life-threatening septic conditions. In such cases, local treatment associated with systemic antimicrobials should be used in order to eradicate the sources of contamination. This paper discuss the possibility of spread of these infections and their clinical implications for dentistry, as well as their etiology and aspects related to microbial virulence and pathogenesis.
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