Efficacy of Computed Tomography for Diagnosis and Treatment of the Deep Neck Infection

Choo, Moo Jin; Kim, Jin Sup; Kim, Jong Wook; Shin, See Ok; Cha, Sang Hoon

Abstract

BACKGROUND: Deep neck infection is an inflammatory disease process within the deep cervical fascia of the head and neck. Although the frequency has declined dramatically with development of antibiotics, the morbidity is still high because the diagnosis is delayed in the course of the disease.
OBJECTIVES
To determine the diagnostic value of neck computed tomography (CT) and treatment modality according to the disease severity.
MATERIALS AND METHODS
Forty-three patients with deep neck infection admitted and treated from January 1992 to December 1996 were analysed retrospectively. CT was checked at the initial state and checked again at the seven to ten days later for evaluation of treatment.
RESULTS
CT was valuable for early diagnosis when this disease was suspected and follow-up evaluation of treatment results. Hospital days were longer in patients with underlying disease. The size of abscess and the involved regions of cellulitis were used guides for the decision of treatment modality. In cases of cellulitis and small abscess less than 3cm, intravenous antibiotic therapy and CT-guided aspiration was efficient. Combined therapy with intervention and antibiotics was needed in patients with abscesses larger than 3cm and progressive disease.
CONCLUSION
CT was an excellent diagnostic method and valuable for the evaluation of treatment. Treatment modality was decided according to the size of abscess and the presence of underlying disease.