Maxillofacial inflammatory processes: a retrospective review of 108 cases

Abstract

Objective: Maxillofacial inflammatory processes (either abscess or cellulitis) occur within the potential spaces and fascial planes of the head and neck. Maxillofacial inflammatory processes should not be ignored, and no surgeon should underestimate the necessity of appropriate and timely treatment of deep neck infections due to the serious and potentially life-threatening nature of these infections. The purpose of this study is to review our recent experience with maxillofacial inflammatory processes and emphasize the importance of appropriate treatment selection in those patients. Methods: The case history of 108 patients treated for maxillofacial inflammatory processes at the Department of Dentistry of Ternopil University Hospital during the 2011 were retrospectively reviewed. Their demography, symptoms, etiology, seasonal distribution, bacteriology, radiology, site of maxillofacial inflammatory processes, durations of the hospital admission and hospital stay, treatment, complications, and outcomes were evaluated. The findings were compared to those in the available literature. Results: Dental infection was the most common cause of maxillofacial inflammatory processes (63.6%); cause of skin infections (10.7%) and lymphadenitis (6.9%) were the other most common causes. Pain, odynophagia, dysphagia, and fever were the most common presenting symptoms. Radiologic evaluation was performed on almost all of the patients (98.3%) to identify the location, extent, and character (cellulitis or abscesses) of the infections. The most commonly - involved site was the submandibular space (34,8%). In 39.5% of cases, the infection involved more than one space. All the patients were given intravenous antibiotic therapy. Surgical intervention was required in 95 patients (87.9%), whereas 13 patients (12,1%) were treated with intravenous antibiotic therapy alone. 105 patients (97,2%) were discharged in stable condition. Conclusions: Despite the wide use of antibiotics, maxillofacial inflammatory processes are commonly seen. Although surgical drainage remains the main method of treating maxillofacial inflammatory processes, conservative medical treatment is effective in selective cases.