Selçuk KUZU, Çağlar GÜNEBAKAN

Deep neck infections in geriatric patients; A clinical retrospective study

In this study, the diagnosis and treatment results of patients over 65 years old who were followed-up with the diagnosis of deep neck infection in a tertiary hospital were evaluated retrospectively. The files of 18 patients over 65 years old who were followed-up with a diagnosis of deep neck infection in a tertiary otorhinolaryngology department between January 2012 and May 2019 were evaluated retrospectively. The most common infection was a peritonsillar abscess (50%) with 9 cases. The most common complaints at the time of admission were fever (83%) and sore throat (67%). The average onset of symptoms before admission to the hospital was 2-5 days (2-15 days). In most cases, ampicillin-sulbactam single or clindamycin or metronidazole were used. Nine patients with peritonsillar abscess were drained with local anesthesia, while four patients with parapharyngeal abscess and two patients with retropharyngeal abscess were operated with general anesthesia. Despite all the improvements in diagnosis and treatment, deep neck infections remain an important problem. The reduction of complications depends on the effective and sufficient duration of treatment in the early period. Especially in the geriatric population, comorbid diseases can accompany deep neck infections more aggressively.

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1. Chen MK, Wen YS, Chang CC, et al. Predisposing factors of lifethreatening deep neck infection: logistic regression analysis of 214 cases. J Otolaryngol. 1998; 27:141-4.

2. Goldstein NA, Hammerschlag MR. Peritonsillar, retropharyngeal and parapharyngeal abscess. In: Feigin RD, Demmler GJ, Cherry JD, Kaplan SL, editors. Textbook of Pediatric Infectious Disease. 5th ed. Philadelphia: WB Saunders; 2004; 178-85.

3. Gavazzi G, Krause KH. Aging and infection. Lancet Infect Dis. 2002; 2(11):659-66.

4. Mouton CP, Bazaldua OV, Pierce B, et al. Common infections in older adults. Am Fam Physician. 2001; 63(2):257-68.

5. Crossley KB, Peterson PK. Infections in the elderly. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Churchill Livingstone; 2010; 3857-64.

6. Abrams WB, Beers MH, Berkow R: The Merck Manual of Geriatrics, 2nd edition, Merck Co., Inc., Whitehouse Station, NJ, 1995.

7. Castle SC: Clinical relevance of age-related immune dysfunction. Clin Inf Dis. 2000; 31:578-85.

8. Busse PJ, Mathur SK. Age-related changes in immune function: effect on airway inflammation. J Allergy Clin Immunol. 2010; 126(4):690-9.

9. Maggi S. Vaccination and healthy aging. Expert Rev Vaccines 2010; 9(3):3- 6.

10. Belet N, Tapısız A, Uçar Y. Deep Neck Infections in Children [Article in Turkish]. J Pediatr Inf. 2007; 1:58-62.

11. Johnson JT. Deep neck abscesses. Operative Otolaryngology: Head and Neck Surgery.1. baskı. Philadelphia, W.B. Saunders Company, 1997; 667- 75.

12. Güney E. Infections between the head and neck region fascia [In Turkish]. In: Topçu AW, Söyletir G, Doğanay M, editors. İnfeksiyon Hastalıkları ve Mikrobiyolojisi. İstanbul: Nobel Tıp Kitapevleri; 2002. p. 492-504.

13. Gidley PW, Ghorayeb BY, Stiernberg CM. Contemporary management of deep neck space infections. Otolaryngol Head Neck Surg. 1997; 116: 16-22.

14. Marra S, Hotaling AJ. Deep neck infections. Am J Otolaryngol. 1996; 17: 287-98.

15. Har-El G, Aroesty JH, Shaha A, et al. Changing trends in deep neck abscess. A retrospective study of 110 patients. Oral Surg Oral Med Oral Pathol. 1994; 77: 446-50.

16. Ungkanont K, Yellon RF, Weissman JL, et al. Head and neck space infections in infants and children. Otolaryngol Head Neck Surg. 1995; 112: 375-82.

17. Miman MC, Öncel S, Kalcıoğlu T, et al. Clinical approach to deep neck infectıons [Article in Turkish]. Kulak Burun Boğaz Ihtis Derg. 2001; 8: 206-13.

18. Russell MD, Russell MS. Urgent Infections of the Head and Neck. Med. Clin. North Am. 2018;102(6):1109-20.

19. Jain A, Singh I, Meher R, Raj A, Rajpurohit P, Prasad P. Deep neck space abscesses in children below 5 years of age and their complications. Int. J. Pediatr. Otorhinolaryngol. 2018;109:40-3.