A Study on Deep Neck Space Infections

  • Shaili PriyamvadaEmail author
  • Gul Motwani
Original Article


Deep neck space infections (DNSI) are serious diseases that involve several spaces in the neck. These are commonly seen in low socioeconomic group with poor oral hygiene, and nutritional disorders. These are bacterial infections originating from the upper aerodigestive tract. The incidence of this disease was relatively high before the advent of antibiotics. Treatment of DNSI includes antibiotic therapy, airway management and surgical intervention. Management of DNSI is traditionally based on prompt surgical drainage of the abscess followed by antibiotics or nonsurgical treatment using appropriate antibiotics in the case of cellulitis. This study was conducted to investigate the age and gender, clinical symptoms, site involved, etiology, co-morbidities, bacteriology, complications and outcomes in the patients of DNSI. A prospective study of deep neck space infections was conducted during the period July 2017 to July 2018 on the patients who attended the outpatient department and were admitted as inpatient in Safdarjung hospital, New Delhi. 40 Cases with DNSI all ages and both genders were included in the study. Patients who didn’t require surgical intervention to drain pus were excluded. All parameters including age, gender, co-morbidities, presentation, site, bacteriology, complications, and investigations were studied. Due to advent of antibiotics, deep neck space infections are in decreasing trend. The common age group found to be affected is in 2nd and 3rd decade in our study. Out of all deep neck space infections, submandibular space infections were common (37.5%) followed by peritonsillar infections (12.5%). Infection of deep neck space remains fairly common and challenging disease for clinicians. Prompt recognition and treatment of DNSI are essential for an improved prognosis. Odontogenic and tonsillopharyngitis are the commonest cause. Key elements for improved results are the prompt recognition and early intervention. Special attention is required to high-risk groups such as diabetics, the elderly and patients with underlying systemic diseases as the condition may progress to life-threatening complications.


Deep neck space infections Odontogenic infections Submandibular space infections Peritonsillar abscess Incision and drainage 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent has been obtained from subjects included in the study.


  1. 1.
    Wang LF, Kuo WR, Tsai SM, Huang KJ (2003) Characterizations of life threatening deep cervical space infections: a review of one hundred ninety six cases. Am J Otolaryngol 24(2):111–117CrossRefGoogle Scholar
  2. 2.
    Gorjón PS, Pérez PB, Martín ACM, Dios JCP, Alonso SE, Cabanillas MIC (2012) Infecciones cervicales profundas. Revisión de 286 casos. Acta Otorrinolaringol Esp 63:31–41CrossRefGoogle Scholar
  3. 3.
    Durazzo M, Pinto F, Loures M, Volpi E, Nishio S, Brandao L et al (1997) Deep neck space infections. Rev Ass Med Bras 43:119–126CrossRefGoogle Scholar
  4. 4.
    Wong TY (1999) A nationwide survey of deaths from oral and maxillofacial infections: the Taiwanese experience. J Oral Maxillofac Surg 57:1297–1299CrossRefGoogle Scholar
  5. 5.
    Ungkanont K, Yellon RF, Weissman JL, Casselbrant ML, Gonzalez VH, Bluestone CD (1995) Head and neck space infections in infant and children. Otolaryngol Head Neck Surg 112(3):375–382CrossRefGoogle Scholar
  6. 6.
    Huang TT, Liu TC, Chen PR, Tseng FY, Yeh TH, Chen YS (2004) Deep neck infection: analysis of 185 cases. J Otolaryngol Head Neck Surg 26(10):854–860Google Scholar
  7. 7.
    Hasegawa J, Hidaka H, Tateda M, Kudo T, Sagai S, Miyazaki M et al (2011) An analysis of clinical risk factors of deep neck infection. Auris Nasus Larynx 38(1):101–107CrossRefGoogle Scholar
  8. 8.
    Chen MK, Wen YS, Chang CC, Huang MT, Hsiao HC (1998) Predisposing factors of life-threatening deep neck infection: logistic regression analysis of 214 cases. J Otolaryngol 27(3):141–144Google Scholar
  9. 9.
    Blomquist IK, Bayer AS (1988) Life-threatening deep fascial space infections of the head and neck. Infect Dis Clin N Am 2(1):237–264Google Scholar
  10. 10.
    Mayor GP, Millan JMS, Martinez VA (2001) Is conservative treatment of deep neck space infections appropriate? J Head Neck 23(2):126–133CrossRefGoogle Scholar
  11. 11.
    Sethi DS, Stanley RE (1994) Deep neck abscesses: challenging trends. J Laryngol Otol 108:138–143CrossRefGoogle Scholar
  12. 12.
    Meher R, Jain A, Sabharwal A, Gupta B, Singh I, Agarwal I (2005) Deep neck abscess: a prospective study of 54 cases. J Laryngol Otol 119(04):299–302CrossRefGoogle Scholar
  13. 13.
    Parhiscar A, Harel G (2001) Deep neck abscess: a retrospective review of 210 cases. Ann Otolo Rhinol Laryngol 110(11):1051–1054CrossRefGoogle Scholar
  14. 14.
    Anil S, Al-Ghamdi HS (2006) The impact of periodontal infections on systemic diseases. An update for medical practitioners. Saudi Med J 27(6):767–776Google Scholar
  15. 15.
    Eftekharian A, Roozbahany NA, Vaezeafshar R, Narimani N (2009) Deep neck infections: a retrospective review of 112 cases. Eur Arch Otorhinolaryngol 266:273–277CrossRefGoogle Scholar
  16. 16.
    Bakir S, Tanriverdi MH, Gun R, Yorgancilar AE, Yildirim M, Tekbas G et al (2012) Deep neck space infections: a retrospective review of 173 cases. Am J Otolaryngol 33(1):56–63CrossRefGoogle Scholar
  17. 17.
    Marioni G, Staffieri A, Parisi S, Marchese RR, Zuccon A (2010) Rational diagnostic and therapeutic management of deep neck infections: analysis of 233 consecutive cases. Ann Otol Rhinol Laryngol 119(3):181–187CrossRefGoogle Scholar
  18. 18.
    Har-El G, Aroesty JH, Shaha A, Lucente FE (1994) Changing trends in deep neck abscess: a retrospective study of 110 patients. Oral Surg Med 77(5):446–450CrossRefGoogle Scholar
  19. 19.
    Sakaguchi M, Sato S, Ishiyama T, Katsuno S, Taguchi K (1997) Characterization and management of deep neck infections. Int J Oral Max Surg 26(2):131–134CrossRefGoogle Scholar
  20. 20.
    Suehara AB, Gonçalves AJ, Alcadipani FAMC et al (2008) Deep neck infection: analysis of 80 cases. Rev Bras Otorrinolaringol 74(2):253–259CrossRefGoogle Scholar
  21. 21.
    Lin C, Yeh FL, Lin JT, Ma H, Hwang CH, Shen BH et al (2001) Necrotizing fasciitis of the head and neck: an analysis of 47 cases. Plast Reconstr Surg 107(7):1684–1693CrossRefGoogle Scholar
  22. 22.
    Smith JL, Hsu JM, Chang J (2006) Predicting deep neck space abscess using computed tomography. Am J Otolaryngol 27:244–247CrossRefGoogle Scholar
  23. 23.
    Miller WD, Furst IM, Sandor GKB, Keller MA (1999) A prospective, blinded comparison of clinical examination and computed tomography in deep neck infections. Laryngoscope 109:1873–1879CrossRefGoogle Scholar
  24. 24.
    Osborn TM, Assael LA, Bell RB (2008) Deep space neck infection: principles of surgical management. Oral Maxillofac Surg Clin N Am 20:353–365CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyVardhman Mahavir Medical College and Safdarjung HospitalNew DelhiIndia

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