logging in or signing up Neck infect 980225 Malden Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 1792 Category: Entertainment License: All Rights Reserved Like it (3) Dislike it (3) Added: January 03, 2008 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: ibrahimbarakat (33 month(s) ago) good Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Deep Neck Space Abscesses and Life-Threatening Infections of the Head and Neck: Deep Neck Space Abscesses and Life-Threatening Infections of the Head and Neck Carl Schreiner, MD F. B. Quinn, MD February 25, 1998INTRODUCTION: INTRODUCTION Life-threatening infections - rare Influence of antibiotics Lack of systemic signs and Sx ImmunosupressionANATOMIC CONSIDERATIONS: ANATOMIC CONSIDERATIONS Teeth, tonsils Polymicrobial infections 10:1 anaerobes Pathways of spread fascial planes intracranial periorbitalDEEP NECK SPACE INFECTIONS: DEEP NECK SPACE INFECTIONS Usually odontogenic young, healthy, delayed Tx Cervical Fascial Layers Superficial fascia Deep fascia superficial (investing) middle(visceral) deep (prevertebral and alar layers)SUBMANDIBULAR SPACE: SUBMANDIBULAR SPACE 1836 - Wilhelm Von Ludwig implies bilateral involvement boundaries Hyoid to FOM Ant/lat - mandible Mylohyoid “sling” bucopharyngeal gapLUDWIG’S ANGINA: LUDWIG’S ANGINA dysphagia, drooling, muffled voice “woody” induration, no fluctuance Treatment airway control IV ABX Surgical drainageLATERAL PHARYNGEAL SPACE: LATERAL PHARYNGEAL SPACE Inverted cone - hyoid to base of skull Pre-styloid compartment fat, lymph nodes, muscle Post-styloid carotid, IJ, CN IX - XII pain, fever, neck swelling, ?trismusLATERAL PHARYNGEAL SPACE: LATERAL PHARYNGEAL SPACE Ominous signs Horners, bleeding, CN palsies, mediastinitis Treatment Surgical drainage IV ABX jugular vein thrombosis RETROPHARYNGEAL SPACE: RETROPHARYNGEAL SPACE Retropharyngeal space between alar layer and sup. constrictors extends to sup mediastinum Danger space between alar and prevertebral layers diaphragm prevertebral space down to coccyxMASTICATOR SPACE: MASTICATOR SPACE Pterygoids, masseter, temporalis m. Comm w/ temporal space superiorly Trismus! CT can direct surgical approachPERITONSILLAR ABSCESS: PERITONSILLAR ABSCESS Areolar tissue bound by sup. constrictors Rarely life-threatening but can spread Serial aspiration vs I and DNECROTIZING FASCIITIS: NECROTIZING FASCIITIS Synergistic, polymicrobial infection Sup layer of deep fascia Determining necrosis is Key gas, crepitance, failure to respond to ABX Treatment IV ABX Radical surgical debridementACUTE EPIGLOTTITIS: ACUTE EPIGLOTTITIS Now rare in children “Hot potato” voice, drooling, fever No FILMS - go to OR! no fiberoptic exam bronch, trach equipment ready change to nasotracheal tube MUCORMYCOSIS: MUCORMYCOSIS Progressive, invasive fungal infection Severe DM or immunocompromised Black necrotic lesions of nose or palate Radical surgical debridement to bleeding Broad, nonseptate hyphae, right angles AmphoterribleCOMPLICATIONS OF SINUSITIS: COMPLICATIONS OF SINUSITIS Parameningeal, periorbital location Frontoethmoid sinuses frontal lobe abscess, meningitis, subdural empyema Sphenoid sinuses Sup orbital fissure, cavernous sinus Sx of increased intracranial pressureOTOLOGIC COMPLICATIONS: OTOLOGIC COMPLICATIONS Involve middle or posterior fossa Epidural abscess>meningitis>brain abscess Warning signs early - malodorous discharge, fever, HA late - facial paralysis., vertigo Multiple complications are common Malignant otitis externa You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.