A new clinical classification of severe oromaxillofacial head and neck multi-space infections

doi:10.19438/j.cjoms.2023.02.004

Abstract

Abstract: PURPOSE: To explore a new clinical classification method for oromaxillofacial head and neck multi-space infections. METHODS: The clinical and radiographic data of patients with severe oromaxillofacial head and neck multiple-space infections treated under general anesthesia in Panzhihua Central Hospital from July 2015 to March 2022 were retrospectively analyzed, and a new classification method was proposed. SPSS 17.0 software package was used for data analysis. RESULTS: Severe oromaxillofacial head and neck multi-space infections can be divided into five types. Type Ⅰ(n=82, 68.33%), the infection was concentrated between the hyoid plane and the zygomatic arch plane, and the infection in each space could be fully drained through the submaxillary incision. Type Ⅱ(n=13, 10.83%), the infection spread upward to the deep temporal space, and two submandibular and temporal incisions were needed for full drainage. Type Ⅲ(n=14, 11.67%), the infection spread down to the lower cervical space above the clavicle, and full drainage through submaxillary and supraclavicular incision was needed. Type Ⅳ(n=5, 4.17%), the infection spread from the temporal to the supraclavicle area, and multiple submaxillary, temporal and supraclavicle incisions were needed for drainage. In 6 cases (5%) of type Ⅴ, the infection broke through the clavicular plane and spread to the mediastinum and thorax. Mediastinum and thorax drainage must be combined with cardiothoracic surgery at the same time. From typeⅠto typeⅤ, the general condition gradually worsened, the treatment difficulty and risk gradually increased, and the consumption of medical resources such as average ICU monitoring time, hospitalization time, hospitalization cost and antibacterial drug cost also gradually increased (P<0.0001). CONCLUSIONS: Severe oromaxillofacial head and neck multi-space infections are life-threatening, and multidisciplinary therapy is the premise of treatment. Reasonable classification of the disease is the basis of accurate and standardized treatment. Extensive incision and drainage combined with effective auxiliary irrigation technology is the key to treatment.

Key words: Oromaxillofacial head and neck region, Life-threatening multiple space infection, Odontogenic infection, Classification, Treatment

CLC Number:

R782.3

QIU Yin-xiu, DAI Tian-guo, XU Bo, CHENG Jin-qiang, LIU Zhong-long. A new clinical classification of severe oromaxillofacial head and neck multi-space infections[J]. China Journal of Oral and Maxillofacial Surgery, 2023, 21(2): 125-130.

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