Emmanuel Kofi Amponsah1, Paul Frimpong1, Mi Young Eo2, Soung Min Kim3,4, Suk Keun Lee5. 1. Oral and Maxillofacial Microvascular Reconstruction Lab, Ghana Health Service, Brong Ahafo Regional Hospital, P. O. Box 27, Sunyani, Brong Ahafo, Ghana. 2. Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea. 3. Oral and Maxillofacial Microvascular Reconstruction Lab, Ghana Health Service, Brong Ahafo Regional Hospital, P. O. Box 27, Sunyani, Brong Ahafo, Ghana. smin5@snu.ac.kr. 4. Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea. smin5@snu.ac.kr. 5. Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea.
Abstract
PURPOSE: Necrotizing fasciitis of the craniofacial region is a rare and potentially life-threatening bacterial infectious disease. Odontogenic infections primarily spread along facial fascia and subcutaneous tissues, resulting in upper chest skin or thoracic necrosis. The purpose of this clinical classification was to demonstrate clinically important guidelines for early diagnosis and prompt management of CNF. METHODS: Although the incidence of cervical necrotizing fasciitis (CNF) is very rare in many developed countries, prompt management with appropriate initial diagnosis is essential, especially in tropical low-economic rural regions of African countries. Over the last 12 years, our charitable team in West Africa made clinical classifications of CNF according to onset time and spreading pattern to thoracic extension. RESULTS: CNF patients could be divided into two primary types, limited to neck type and extended to upper chest type. We also further categorized from each type into three different groups according to the CNF onset and clinical characteristics, including acute type with hematogenous spread within 2 weeks, subacute type with suppuration over 2 to 4 weeks, chronic type without suppuration over 4 weeks, multiple type with partial skin necrosis, island type with necrotic skin coverage, and broad type with whole skin necrosis. CONCLUSIONS: These classifications will help decrease the mortality rate in severely infected patients.
PURPOSE:Necrotizing fasciitis of the craniofacial region is a rare and potentially life-threatening bacterial infectious disease. Odontogenic infections primarily spread along facial fascia and subcutaneous tissues, resulting in upper chest skin or thoracic necrosis. The purpose of this clinical classification was to demonstrate clinically important guidelines for early diagnosis and prompt management of CNF. METHODS: Although the incidence of cervical necrotizing fasciitis (CNF) is very rare in many developed countries, prompt management with appropriate initial diagnosis is essential, especially in tropical low-economic rural regions of African countries. Over the last 12 years, our charitable team in West Africa made clinical classifications of CNF according to onset time and spreading pattern to thoracic extension. RESULTS: CNF patients could be divided into two primary types, limited to neck type and extended to upper chest type. We also further categorized from each type into three different groups according to the CNF onset and clinical characteristics, including acute type with hematogenous spread within 2 weeks, subacute type with suppuration over 2 to 4 weeks, chronic type without suppuration over 4 weeks, multiple type with partial skin necrosis, island type with necrotic skin coverage, and broad type with whole skin necrosis. CONCLUSIONS: These classifications will help decrease the mortality rate in severely infected patients.
Authors: S J Bahu; T Y Shibuya; R J Meleca; R H Mathog; G H Yoo; R J Stachler; J G Tyburski Journal: Otolaryngol Head Neck Surg Date: 2001-09 Impact factor: 3.497
Authors: Johnny C Mao; Michael A Carron; Kimberly R Fountain; Robert J Stachler; George H Yoo; Robert H Mathog; James M Coticchia Journal: Am J Otolaryngol Date: 2008-07-10 Impact factor: 1.808