Manisha Gupta1, Virendra Singh. 1. Dept. of Oral and Maxillofacial Surgery, Postgraduate Institute of Medical Sciences, Haryana Ghaziabad, India ; Dept. of Oral and Maxillofacial Surgery, ITS Dental College and Hospital, Delhi-Merrut Road, Ghaziabad, India.
Abstract
AIM: The purpose of this study was to retrospectively evaluate a series of patients with space infection. PATIENTS AND METHODS: In this study 256 patients with space infection over a period of two years were treated with intravenous antibiotic and prompt incision and drainage followed by culture and sensitivity tests in some cases. Data collection included demographic, anatomic treatment and complication information. RESULTS: The sample consisted of 256 patients with a mean age of 28 years. 7 patients were immunocompromised and 20 female patients were pregnant out of 84 female patients who were included in the study. Caries followed by implant failure were identified to be the most frequent cause for space infection. Trismus and dysphagia were present in over 70% of the cases. The vestibular masticator, perimandibular (submandibular, submental and/or sublingual) and parapharyngeal, submaxillary spaces were involved. Abscess was found in 76% of the cases. All the patients were drained under local anesthesia or conscious sedation except one patient who was drained under GA. Three deaths occurred. CONCLUSION: This study indicated that prompt incision and drainage along with intravenous antibiotic under local anesthesia or conscious sedation was the mainstay of treatment of severe space infection. Patients were relieved of their signs and symptoms by third day, however trismus may persist for 5-7 days.
AIM: The purpose of this study was to retrospectively evaluate a series of patients with space infection. PATIENTS AND METHODS: In this study 256 patients with space infection over a period of two years were treated with intravenous antibiotic and prompt incision and drainage followed by culture and sensitivity tests in some cases. Data collection included demographic, anatomic treatment and complication information. RESULTS: The sample consisted of 256 patients with a mean age of 28 years. 7 patients were immunocompromised and 20 female patients were pregnant out of 84 female patients who were included in the study. Caries followed by implant failure were identified to be the most frequent cause for space infection. Trismus and dysphagia were present in over 70% of the cases. The vestibular masticator, perimandibular (submandibular, submental and/or sublingual) and parapharyngeal, submaxillary spaces were involved. Abscess was found in 76% of the cases. All the patients were drained under local anesthesia or conscious sedation except one patient who was drained under GA. Three deaths occurred. CONCLUSION: This study indicated that prompt incision and drainage along with intravenous antibiotic under local anesthesia or conscious sedation was the mainstay of treatment of severe space infection. Patients were relieved of their signs and symptoms by third day, however trismus may persist for 5-7 days.
Entities:
Keywords:
Incision and Drainage; Odontogenic space infection; Spaces
Authors: Thomas R Flynn; Rabie M Shanti; Michael H Levi; Arthur K Adamo; Richard A Kraut; Norman Trieger Journal: J Oral Maxillofac Surg Date: 2006-07 Impact factor: 1.895
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