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Eur Arch Otorhinolaryngol 2021 Jun 23. Epub 2021 Jun 23.

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.

Purpose: Infections of the deep neck, although becoming scarcer due to the widespread use of antibiotics, still represent a dangerous and possibly deadly disease, especially when descending into the mediastinum. Due to the different specialities involved in the treatment and the heterogenous presentation of the disease, therapeutic standard is still controversial. This study analyzes treatment and outcome in these patients based on a large retrospective review and proposes a therapeutic algorithm. Read More

Br J Neurosurg 2021 Jun 20:1-4. Epub 2021 Jun 20.

Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

Introduction: Deep brain stimulation (DBS) is a common surgical option for the treatment of medically refractory Parkinson's disease (PD). Manufacturer and User Facility Device Experience (MAUDE), a United States Food and Drug Administration (FDA)-compiled database of adverse event reports related to medical devices, is a public resource that can provide insight into the relative frequency of complications and patient complaints.

Materials And Methods: We accessed the MAUDE database and queried for adverse reports for deep brain stimulators implanted for PD from January 1, 2009 to December 31, 2018. Read More

J Surg Res 2021 Jun 10;267:17-24. Epub 2021 Jun 10.

Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences. Washington, DC.

Background: Prior to thyroid surgery, a subset of patients chronically uses steroids to manage medical conditions such as Grave's disease, auto-immune conditions, or organ transplantation. Existing literature describes adverse effects of prolonged steroid use on surgical outcomes, however there remains a paucity of data investigating the specific effects of steroid use on postoperative outcomes after thyroidectomy. This study aims to identify complication risks steroid users are predisposed to after thyroidectomy. Read More

Acta Otorhinolaryngol Ital 2021 Apr;41(Suppl. 1):S138-S144

Department of Oral and Maxillo-Facial Surgery, University Sapienza of Rome, Italy.

Int J Surg Case Rep 2021 May 15;83:105988. Epub 2021 May 15.

Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco; University Hospital Center Mohamed VI, Oujda, Morocco.

Introduction: The internal jugular vein thrombosis is usually due to intravenous drug abuse, prolonged central venous catheterization or deep head-neck infections or trauma. Related malignancies, or inflammatory etiologies are described. Our case is interesting by the ingestion of a sewing needle that passes from the pharynx to the internal jugular vein via migration, leading to life-threatening complications: deep neck space infection and internal jugular vein thrombosis. Read More

Med J Malaysia 2021 May;76(3):438-440

Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Paediatrics, Malaysia.

Venous thrombosis is a potentially life-threatening condition with varied aetiology. First described in 1912 as a complication of peritonsillar abscess, internal jugular vein (IJV) thrombosis is a rare entity in children with very few cases reported until now. Among the leading causes of this condition are prolonged use of IJV for venous access and central venous catheterisation, acute mastoiditis and Lemierre's syndrome. Read More

J Int Med Res 2021 May;49(5):3000605211011972

Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Integrated Traditional and Western Medicine Hospital (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China. Currently working in Hangzhou Occupational Disease Prevention Hospital.

Retropharyngeal abscess (RPA) is an acute or chronic deep neck tissue infection. Tuberculous RPA is chronic and extremely rare in adults. A 20-year-old female patient visited the local hospital due to cough and sputum. Read More

Cureus 2021 Apr 25;13(4):e14680. Epub 2021 Apr 25.

Internal Medicine, Chicago Medical School Internal Medicine Residency Program at Northwestern McHenry Hospital, McHenry, USA.

Lyme borreliosis is a multisystem inflammatory disease caused by the spirochete ( and transmitted through the tick. Nervous system involvement is known as Lyme neuroborreliosis; it only occurs in disseminated Lyme disease and is manifested by the classic triad of meningitis, cranial neuritis, and radiculoneuritis. Timeline is a significant factor when staging Lyme manifestations. Read More

BMJ Case Rep 2021 Apr 26;14(4). Epub 2021 Apr 26.

Serviço de Medicina Intensiva, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal.

Ludwig's angina is a deep neck space infection defined as a rapidly progressive bilateral cellulitis of the submandibular space. In spite of being an uncommon entity in developed countries and the reduction of mortality and morbidity due to modern era of antibiotics, improved imaging and airway management, it is still an important and potentially life-threatening condition. The authors present 3 cases of Ludwig's angina that occurred in a developed country, and that required admission in intensive care unit and extensive surgical and medical treatment. Read More

J Stroke Cerebrovasc Dis 2021 Jul 8;30(7):105805. Epub 2021 Apr 8.

Department of Neurology, University of Central Florida - HCA Consortium Neurology, Orlando, Florida, USA.

Introduction: There is limited literature on coronavirus disease 2019 (COVID -19) complications such as thromboembolism, cardiac complications etc. as possible trigger for stroke. Hence, we aim to evaluate the prevalence and outcomes of COVID-19 related cardiovascular complications and secondary infection and their possibility as potential triggers for the stroke. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Apr;56(4):387-389

Department of Neurology, Capital Institute of Pediatrics Children's Hospital, Beijing 100020, China.

Medicine (Baltimore) 2021 Apr;100(14):e25458

Department of Head and Neck Cancer Center.

Rationale: The free fibular flap is considered the gold standard, particularly for a mandibular defect combined with a significant soft tissue defect. However, the fibular flap has the disadvantages of a lack of height for postoperative dental restoration and donor site skin graft if the skin paddle is wider than 5 cm. The larger bone and soft tissue defects tend to be reconstructed using either a scapula or a combination of iliac artery and radial free flap. Read More

BMJ Case Rep 2021 Apr 2;14(4). Epub 2021 Apr 2.

Otorhinolaryngology - Head and Neck Surgery, Aalborg Universitetshospital, Aalborg, Denmark.

A 64-year-old woman was acutely referred to the Department of Otorhinolaryngology, Head and Neck Surgery, Aalborg University Hospital due to rapidly progressing neck swelling, fever and dysphagia. Clinical examination revealed submental swelling, trismus and laryngeal inflammation. A contrast-enhanced CT scan showed infection in the deep neck spaces with multiple abscesses. Read More

Int J Environ Res Public Health 2021 03 19;18(6). Epub 2021 Mar 19.

Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan.

(1) Background: Sleep apnea may be a risk factor for deep neck infection (DNI). The objective of this study was to investigate the effects of sleep apnea on DNI. (2) Methods: In this first nationwide retrospective cohort study on the sleep apnea-DNI correlation, we obtained data from the Longitudinal Health Insurance Database 2005, a subset of the Taiwan National Health Insurance Research Database. Read More

Int J Pediatr Otorhinolaryngol 2021 May 28;144:110694. Epub 2021 Mar 28.

Department of Otorhinolaryngology and Head and Neck Surgery, Turku University Hospital and University of Turku, Kiinanmyllynkatu 4-8, 20520, Turku, Finland. Electronic address:

Purpose: Pediatric deep neck space infection (DNI) is a relatively rare but potentially life-threatening condition and requires prompt and accurate management. This study retrospectively reviews our experience in a tertiary referral hospital from 2004 to 2019.

Methods: Systematic data collection from medical records using ICD10 codes between 2004 and 2019. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Apr;35(4):324-327

Department of Otolaryngology Head and Neck Surgery，Zhongshan Hospital Affiliated to Sun Yat-sen University，Zhongshan People's Hospital，Zhongshan，528403，China.

To summarize the clinical manifestations and treatment of patients with deep neck infection with descending mediastinal infection. The clinical data of 12 patients with deep neck infection with descending mediastinal infection were reviewed. The clinical manifestations, infection origin, bacterial culture results, related systemic diseases, surgical drainage methods and treatment results were analyzed. Read More

Am J Case Rep 2021 Mar 27;22:e930559. Epub 2021 Mar 27.

Department of Endocrinology and Diabetes Mellitus, George Eliot Hospital NHS Trust, Nuneaton, United Kingdom.

BACKGROUND Dialister pneumosintes is a suspected periodontal pathogen. It can affect different parts of the body either by hematogenous transmission or regional spread. Here, we report a case of 30-year-old previously healthy woman diagnosed with mediastinal and neck abscess caused by this pathogen. Read More

Medicine (Baltimore) 2021 Mar;100(10):e25047

Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, West China Second University Hospital.

Rationale: Nevus sebaceous (NS) is a lesion caused by congenital hyperplastic disorder of the sebaceous glands. It commonly noted in the scalp and face and rarely in the trunk, neck, or oral mucosa. We present a rare case of a lesion arising in the genital region. Read More

Head Neck 2021 Jul 2;43(7):2002-2012. Epub 2021 Mar 2.

Department of Otolaryngology Head and Neck Surgery, Kansai Medical University, Hirakata, Japan.

Backgrounds: Data on risk factors for deep neck infection including descending necrotizing mediastinitis (DNM) have been limited. Using a nationwide database, the aim was identifying the factors related to patient death and delay in recovering oral intake.

Methods: Data of 4949 patients were extracted from a Japanese inpatient database between 2012 and 2017. Read More

Ann R Coll Surg Engl 2021 Mar;103(3):208-217

The Rotherham Foundation Trust, Moorgate Road, Rotherham.

Introduction: Tonsillectomy is a common surgical procedure performed chiefly for recurrent tonsillitis. The Scottish Intercollegiate Guidance Network (SIGN) introduced guidelines in 1998 to improve patient selection for tonsillectomy and reduce the potential harm to patients from surgical complications such as haemorrhage. Since the introduction of the guidance, the number of admissions for tonsillitis and its complications has increased. Read More

Indian J Thorac Cardiovasc Surg 2021 Mar 5;37(2):195-199. Epub 2020 Sep 5.

Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Apuane Hospital, Via E. Mattei 31, 54100 Massa, Italy.

Cervical necrotizing fasciitis (CNF) is the name for a group of bacterial infections characterized by necrosis of the fascia and subcutaneous cellular tissue of the neck. Descending necrotizing mediastinitis (DNM) is a well-known and feared complication of CNF that severely affects the prognosis. Abdominal involvement is rare. Read More

BMC Infect Dis 2021 Feb 27;21(1):232. Epub 2021 Feb 27.

Department of Diagnostic Radiology, Humanitas Clinical and Research Center IRCCS, Via Alessandro Manzoni 56, 20089 Rozzano, Milan, Italy.

Background: Although there are reports of otolaryngological symptoms and manifestations of CoronaVirus Disease 19 (COVID-19), there have been no documented cases of sudden neck swelling with rash in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection described in literature.

Case Presentation: We report a case of a sudden neck swelling and rash likely due to late SARS-CoV-2 in a 64-year-old woman. The patient reported COVID-19 symptoms over the previous three weeks. Read More

J Laryngol Otol 2021 Feb 18;135(2):176-178. Epub 2021 Feb 18.

Department of Ear, Nose and Throat Surgery, Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK.

Background: Peritonsillar abscess, or quinsy, is one of the most common emergency presentations to ENT departments, and is the most common deep tissue infection of the head and neck. In the UK, junior members of the ENT team are regularly required to independently assess, diagnose and treat patients with peritonsillar aspiration or incision and drainage.

Issue: Inexperienced practitioners can stumble at several obstacles: poor access due to trismus; poor lighting; difficulty in learning the therapeutic procedure; and difficulty in accurately documenting findings and treatment. Read More

Medicine (Baltimore) 2021 Feb;100(5):e24367

Department of Otolaryngology, Head and Neck Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract: Deep neck abscesses are dangerous. Artificial dermis combined with seal negative pressure drainage is a new technique for treating refractory wounds.To compare the efficacy of vacuum sealing drainage (VSD) with that of traditional incision drainage approaches for treating deep neck multiple spaces infections. Read More

Br Dent J 2021 Feb 12;230(3):170-172. Epub 2021 Feb 12.

Consultant in Oral and Maxillofacial Surgery, North Manchester General Hospital, Manchester, UK.

Introduction Dental infection can progress to life-threatening cervicofacial and deep space infections. Therefore, safe management requires early identification of serious infections in primary care with appropriate referral to secondary care. We have developed an acronym to aid assessment of the red flag clinical features for serious dental infection in primary care by general dental practitioners. Read More

Eur Arch Otorhinolaryngol 2021 Feb 9. Epub 2021 Feb 9.

2nd Otolaryngology Department, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 124 62, Athens, Greece.

Purpose: The aim of this retrospective review study is to evaluate Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score as an indicative parameter in early detecting cervical necrotizing fasciitis (CNF) from deep neck infections (DNI).

Methods: We reviewed 12 cases of CNF and 538 cases of non-necrotizing deep neck infection hospitalized in our hospital over the last decade. Cervical necrotizing fasciitis was histologically confirmed. Read More

Hosp Pediatr 2021 Mar 3;11(3):277-283. Epub 2021 Feb 3.

Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts; and.

Background And Objectives: Children with deep neck infections (DNIs) are increasingly being managed nonsurgically with intravenous antibiotics. Our objective was to examine variation in the management of children with DNIs across US children's hospitals.

Methods: We conducted a retrospective cohort study using the Pediatric Health Information System database. Read More

Am J Trop Med Hyg 2021 Feb 1. Epub 2021 Feb 1.

1Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India.

Melioidosis, caused by Burkholderia pseudomallei, is increasingly recognized in several regions of the globe. The present study was performed to identify and determine the frequency of B. pseudomallei infection in localized pyogenic lesions in eastern India and describe their clinico-microbiological profile. Read More

J Am Coll Emerg Physicians Open 2021 Feb 19;2(1):e12336. Epub 2020 Dec 19.

Department of Emergency Medicine University of Michigan Ann Arbor Michigan USA.

Deep neck space infections are commonly seen in the pediatric population. The diagnosis, however, can be challenging to make and requires a high degree of suspicion because of developmental and age-related factors in children and non-specific presenting symptoms. Diagnosis becomes further complicated in patients whose comorbid conditions mask some of the more severe systemic symptoms. Read More

Ear Nose Throat J 2021 Jan 20:145561321989453. Epub 2021 Jan 20.

Department of Otorhinolaryngology, 2468Rush University Medical Center, Chicago, IL, USA.

Isolated primary sphenoid sinusitis is a rare occurrence, estimated to make up less than 3% of sinus infections. The posterior anatomic location of the sphenoid makes treatment challenging when it becomes infected. Complications involving intracranial extension to surrounding structures often result in cranial nerve deficits due to their proximity. Read More