Comparison of intubation and tracheotomy in patients with deep neck infection

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Tapiovaara , L , Back , L & Aro , K 2017 , ' Comparison of intubation and tracheotomy in patients with deep neck infection ' , European Archives of Oto-Rhino-Laryngology , vol. 274 , no. 10 , pp. 3767-3772 . https://doi.org/10.1007/s00405-017-4694-5

Title: Comparison of intubation and tracheotomy in patients with deep neck infection
Author: Tapiovaara, Laura; Back, Leif; Aro, Katri
Contributor: University of Helsinki, University of Helsinki
University of Helsinki, University of Helsinki
University of Helsinki, Korva-, nenä- ja kurkkutautien klinikka
Date: 2017-10
Language: eng
Number of pages: 6
Belongs to series: European Archives of Oto-Rhino-Laryngology
ISSN: 0937-4477
URI: http://hdl.handle.net/10138/245627
Abstract: Possible airway compromise further complicates treatment of deep neck infections (DNI). Airway management is crucial, but factors affecting the method of choice are unclear. We retrospectively evaluated adult DNIs in a single tertiary center covering 10 years, with special attention on airway management. Patient data were retrieved from electronic data files from 2007 to 2016, and included adult patients with DNI operated through the neck. Of the 202 patients, 127 (63%) were male, with a median age of 47 years. Odontogenic (n = 74; 35%) infection was the most common etiology. Intubation was the most common method of airway management (n = 165; 82%), and most patients (n = 102; 50%) were extubated immediately after surgery. Tracheotomy was performed primarily for 35 (17%) patients, and secondarily for 25 (15%). Two patients were managed in local anesthesia. Altogether 80 (40%) patients required care in the intensive care unit for a median of 7 days. Median hospital stay was 6 days for intubated patients and 10 days for primarily tracheotomized (p = 0.036). DNI extended to the mediastinal space in 25 (12%) patients, most of whom with odontogenic infection (48%), and necrotizing fasciitis (32%). Odontogenic infection was the most common etiology for DNI with increased risk for mediastinal involvement. Intubation was most common type of airway management with high success in immediate extubation after surgery. The need for tracheotomy seemed to lead to a longer hospital care and was associated with a more severe clinical course.
Subject: Airway management
Infection
Abscess
Tracheotomy
Head and neck
SPACE INFECTIONS
ENDOTRACHEAL INTUBATION
AIRWAY MANAGEMENT
TRACHEOSTOMY
RISK
MEDIASTINITIS
METAANALYSIS
ADULT
3125 Otorhinolaryngology, ophthalmology
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