Surgical treatment of deep neck infections: a retrospective analysis of patients at the Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Comenius University and University Hospital Bratislava in 2013–2024

Česká verze

Authors: V. Babková ¹ ; B. Fides Bercíková ¹ ; Bálinth Tóth ¹ ; E. Tedlová ² ; Z. Javorská ¹ ; H. Hajdúová Sallay ¹ ; Miroslav Tedla ¹
Authors place of work: Klinika otorinolaryngológie, a chirurgie hlavy a krku LF UK a UN Bratislava ¹; Klinika pneumológie a ftizeológie LF UK a UN Bratislava ²
Published in the journal: Otorinolaryngol Foniatr, 75, 2026, No. 1, pp. 17-26.
Category: Původní práce
doi: https://doi.org/10.48095/ccorl202617

Summary

Introduction: Deep neck infections (DNSIs) are serious diseases with a risk of rapid progression and life-threatening complications. Despite improved diagnostic and therapeutic options, they remain a significant clinical challenge. Materials and methods: In a retrospective study, we analyzed 168 cases of deep neck infections surgically treated at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bratislava from January 2013 to December 2024. We evaluated demographic data, clinical symptoms, etiology, involved anatomical spaces, imaging modalities, microbiological findings, treatment methods, complications and hospitalization outcomes. Results: The mean age of patients was 47.5 years (SD ± 18.5 years), with a slight male predominance (53.6%). The most common identified source of infection was tonsillopharyngitis (50; 29.8%), while in 75 cases (44.6%) the primary source remained unknown. Multiple cervical spaces were affected in 97 patients (57.7%). The most frequently isolated pathogen was Streptococcus pyogenes (21; 12.5%). All patients underwent surgical drainage, predominantly via a transcervical approach (135; 80.4%). Complications occurred in 39 patients (23.2%), most commonly sepsis (24; 14.3 %), mediastinitis (20; 11.9%) and necrotizing fasciitis (15; 8.9%). Overall mortality was 3.6% (6 patients); in the diabetic subgroup it was 12.5%, and 10% among patients with mediastinitis. The mean length of hospitalization was 9.6 days. Conclusion: DNSIs predominantly affect patients of working age, with a high proportion of multispace involvement and serious complications. Contrast-enhanced CT remains the key diagnostic method. Surgical drainage combined with intravenous antibiotic therapy is the basic therapeutic approach. Despite high morbidity, mortality remains low under conditions of multidisciplinary care.

Keywords:

necrotizing fasciitis – abscess – drainage – parapharyngeal space

Zdroje

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