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11| Deep Neck Space Infection
3 common spaces for infection :red_cross:
…
11| Deep Neck Space Infection
- 3 common spaces for infection :red_cross:
- When attempting a sublingual drain where to avoid, posterolateral FoM lingual artery vein nerve
- General mx: ABC (intubation/trachestomy), intravenous Ab, surgical drainage
USE SENIORS NOTES :check:
-
Clinical presentation: Slide 17
- Pain
- Trismus
Fascia
Superficial cervical fascia
- Ensheathes: Platysma, Muscles of facial exp
- Boundaries: Slide 9
Deep cervical fascia
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-
Middle layer
- Div 1: Muscular
- Div 2: Visceral
Etiology: RETROPHARYNGEAL
- Infection: Odontogenic
- Trauma: FB, instrument, IV user
- Congenital cysts (eg. branchial cyst)
- Infection: Spread (eg. Pharynx/tonsils)
Microbiology: Slide 17
- S.Aureus
- Step viridan / B-haem strep
- Anaerobes
- Klebsiella
Investigation :check:
- CXR (below hyoid)
- Lateral neck xray (wider space = infection)
- CT Neck/thorax (with contrast); gold standard
Slide 19 eg :red_cross:
Mx*
Pharmalogical
- IV Abx (Aug/Ceph/Clind/Vanco)
- Rehydration
- DM tx
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Etiology: SUBMANDIBULAR
- Infection: Odontogenic (Apex of teeth intrude)
- Infection: Sialadenitis
- Submandibular LN suppuration
Ludwig's angina a subset definition, cellulitis of the FOM (sublingual, submandibular, submental space) :red_cross:
Acute tonsillitis - Infectious mononucleosis (IMS)
Quinsy peritonsillar abscess
Parapharyngeal space boundaries (Slide 39)
- Source: Tonsil, teeth, parotid
Retropharyngeal space boundaries (Slide 43)
Complications: Mediastinitis, IJV thrombosis, Carotid artery erosion (Slide 47)