Magister Scientiae Dentium - MSc(Dent) / Purpose: To assess the value of postoperative CT scans in the management of severe cervicofacial infections or deep neck abscesses. Patients and Methods: Thirteen patients underwent post-operative contrast enhanced CT scans after initial incision and drainage followed by a tracheostomy. As per surgical protocol, the CT scans were taken with radiopaque surgical drains in situ from the brain down to the mediastinum and chest/lungs. Data were collected on the presence of abscesses, their location, the location of surgical drains and presence of other pathology. Results: The most common initially affected space was the submandibular space (69%), followed by the submental space (62%). Almost half of the cases studied had two spaces affected and slightly less than a third had three spaces affected. Slightly more than half (54%) of the patients were in good health generally. More than a third (38.5%) of the patients were HIV positive, and thus immuno-compromised. The mean time lapse between the CT and surgery was 2.61 days (SD = 1.56). In the majority (69.23%) of post-operative scans a residual pus collection was found. In just over a quarter (30.8 %) of the patients no residual pus collection was detected on the postoperative CT scan, while in seven patients (53.8%) affected fascial spaces were missed by the surgeon. These spaces included the submasseteric, anteriormediastinum and parotid spaces. Almost half (44.15%) of the patients required a repeatincision and drainage. Conclusion: This study demonstrates clinical value of post-operative CT scans in severe cervicofacial infections. This study also advances the argument for acquisition of preoperative CECT scans for all patients with severe cervicofacial infection.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uwc/oai:etd.uwc.ac.za:11394/5201 |
| Date | January 2015 |
| Creators | Ngcwama, Yanga |
| Contributors | Morkel, JA |
| Publisher | University of the Western Cape |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Rights | University of the Western Cape |
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