A comparison between ultrasonography-guided drainage with open surgical drainage of deep neck space abscesses Neck space abscesses are common; conventional drainage involves intra-oral or extra-oral approaches. The former can compromise the airway and the latter can cause neurovascular injuries, scarring and in rare cases tumour implantation. Ultrasonography-guided drainage is aimed at avoiding these risks. In this randomised prospective study, the authors compared 30 cases drained by ultrasonographic approach with matched numbers who underwent open incision and drainage. Most of the deep space abscesses were odontogenic. The commonest site was the submandibular gland space and the most frequent organism was Streptococcus pyogenes. Cultures were positive only in 76% of cases. The requirement for second drainage did not differ between the two groups, but there was a significant difference in the hospital stay, the ultrasonographic drainage being much lower. The authors conclude that ultrasonography-guided drainage is equally safe, probably less likely to be complicated and more cost effective. It is a valid deployment of technology which should be encouraged.

Is ultrasonography-guided drainage a safe and effective alternative to incision and drainage for deep neck space abscesses? Dabirmoghaddam P, Mohseni A, Navvabi Z, et al.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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