This study from Shanghai is a retrospective review of 142 patients presenting to an ENT hospital with deep neck infections (DNIs). The findings of the study are comparable to many of the previous studies, however the authors found tonsillitis and foreign bodies to be the most common cause for DNIs, as opposed to dental infections. This may well be due to the fact that this study took place in a specialist ENT hospital with no oral and maxillofacial surgery cover. The most common causative organism was found to be streptococci, which is comparable to the literature. The literature reports Klebsiella pneumonia as the most common causative organism in diabetic patients but the authors here describe that out of 30 patients with diabetes only one patient grew K. pneumoniae. The most common subsite for infections was the parapharyngeal space which is probably due to the high rate of tonsillitis patients in this study. There is a significantly lower rate of prophylactic tracheostomy for these patients that the authors postulate may be due to their use of intravenous steroids routinely in patients with pharyngeal infections. The authors have discussed the limitations in this study including the small numbers, retrospective data collection and the follow-up by telephone. The most important message that the authors make is regarding the significant possibility (46%) of underlying congenital lesions, such as a branchial cyst, in patients who have recurrent infections and the importance of thorough imaging in this subset.

Deep neck infections: a retrospective study of 142 patients.
Jin L, Zhang T.
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Sunil Sharma

Great Ormond Street Hospital, UK.

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