Absceso profundo de cuello, un reto terapéutico

Objective: To analyze the experience in the surgical treatment of the deep neck abscess. Setting: Third level health care hospital. Design: Retrospective, observational study. Patients and methods: We reviewed the clinical histories of 62 patients with deep abscess of the neck, admitted from May 2002 to January 2003. We analyzed the following data: gender and age, origin, associated disease, number of affected cervical spaces, morbidity, mortality, bacteriological cultures, mediastinitis development, additional surgical procedures. Results: Sixty-two patients were included, 30 men, 32 women, age range of 20 to 73 years, average 41 years. Dental origin infections were the cause in 70.9% of the cases. Associated disease was found in 52% of the patients, being diabetes mellitus the most frequent with 69%. Cultures were made in 31 patients (50%), 16 patients presented a single development (52%), predominating the gram-positive cocci; the main complication in 12 patients was mediastinitis (19%). Some patients with deep abscess of the neck without mediastinitis required tracheostomy and 50% of those coursing with mediastinitis. Hospital stay days were 12 when the abscess was limited to the neck, and of 42 when mediastinitis was present. Average of surgeries was 1.2 in the first group vs. 4 in the second; 32 (50%) of the patients with mediastinitis required tracheostomy as compared to 8% with only deep abscess. Mortality associated to mediastinitis was of 8%.