gms | German Medical Science

76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 08.05.2005, Erfurt

Etiology, extension and management of deep neck space infections in infancy and adolescence

Meeting Abstract

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  • corresponding author Ariane Julia Zimmer - Dept. of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg
  • Carsten C. Boedeker - Dept. of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg
  • Gerd J. Ridder - Dept. of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno252

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2005/05hno122.shtml

Veröffentlicht: 22. September 2005

© 2005 Zimmer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Deep neck space infections in the infancy and adolescence are dangerous diseases in otolaryngology. Feared complications such as laryngeal edema, mediastinitis, thrombosis of the internal jugular vein or sepsis may develop in cases of delayed diagnosis and therapy.

In the period between 1997 and 2005 we treated 33 children and adolescents (17 male, 16 female) with deep neck space infections and abscesses. The median age was 9,9 years (median: 11 years).

The most common locations were the submandibular space (n=7), the parapharyngeal space (n=6) and latero-cervically (n=6). Therapeutically we performed the drainage of an abscess using an external approach in 17 patients and an intraoral approach in 8 cases. In 93% of cases the operation took place in general anesthesia. The most frequently isolated bacteria were Staphylococcus aureus (n=8), Streptococcus pyogenes (n=3) and Bartonella henselae (n=9). S. intermedius, S. constellatus and atypical mycobacteria were found in 1 case each. We found anaerobe and mixed infections in 2 patients each. In only 2 children the postoperative treatment was complicated by a laryngeal edema, a beginning sepsis as well as a torticollis. The mean hospital stay was 10.3 days.

With regard to the histopathological and microbiological results we could assign the abscess genesis to abscessing lymphadenitis (n=9), an infected branchial cleft cyst, a thyroglossal duct cyst as well as tonsillitis (n=1 each).

Management of deep neck space infections during infancy requires rapid diagnostic and therapeutic acting. Besides staphylococci and streptococci, Bartonella henselae - the causative agent of cat-scratch-disease - has also to be particularily considered.