| Background: There are some debates on the treatments, especially on the
operation timing, over the deep neck infections. This study makes further
research on the pus culture result, etiology, symptoms, diagnosis, and proper
Methods: From August of 1990 to July of 1996, we collect 83 in-patients meeting
the criteria of deep neck infections, including 60 cases of peritonsillar
abscess, 11 of parapharyngeal abscess, 3 of Ludwig's angina, 4 of submandibular
abscess, 4 of parotid abscess and 1 of retropharyngeal abscess. The ratio of
male to female is 50 to 33. The average age of those patients is 41.7y/o from
the range from 11y/o to 80y/o. The intravenous antibiotics were administrated
during admission. Incision and drainage as well as tracheostomy were performed
on the necessary condition.
Results: In our series, pus culture result reveals that the most common strain
is Streptococcus, followed by Neisseria, Klebsiella pneumoniae etc. Besides
unknown cause, the deep neck infections are commonly caused by tonsillitis and
pharyngitis, then by odontogenic origin. Also in the surgical group, there was a
higher percentage in the odontogenic origin (7 in 8) and DM patients (9 in 10).
Conclusions: The therapeutic principle for deep neck infections is the accurate
diagnosis, high dose antibiotics, maintenance of upper airway and performing
incision and drainage in proper time. Penicillin and clindamycin are the drugs
of choice. The maintenance of upper airway depends mainly on tracheostomy with
local anesthesia. The timing for surgical interventions in according to the
findings of neck CT, the effect of antibiotic treatment, the infection source
and the patients' immune status etc.