Risk factors for transcervical incision and drainage of pediatric deep neck infections

Objectives: The aim of this study was to identify risk factors for transcervical approaches in the treatment of pediatric deep neck infections (DNIs). Methods: We performed a retrospective analysis of data from patients who were diagnosed with DNIs. All medical records were reviewed for demographic characteristics, presenting signs and symptoms, duration of symptoms, size of abscess, laboratory results, duration of intravenous (IV) antibiotic administration, duration of hospitalization, medical treatment, and type of surgical drainage (oral or transcervical approach). We divided 126 patients into three groups according to the approach used to treat the DNI: non-surgical, intraoral surgical and external transcervical surgical. Results: The average ages of the non-surgical, intraoral, and transcervical groups were 10.46 +/- 5.27, 12.75 4.82 and 5.54 +/- 5.15 years, respectively. The transcervical approach was used to treat younger patients (p < 0.01). Abscess size was significantly larger for the transcervical group compared to the other groups (5.72 +/- 8.93, 13.51 +/- 14.74, 18.36 +/- 16.05 mm, non-surgical, intraoral, and transcervical group, respectively, p = 0.009). The average duration of IV antibiotic administration for the transcervical group was 9.77 +/- 3.27 days, which was significantly higher than those for the other groups (5.49 +/- 3.28 for non-surgical and 6.13 +/- 2.85 for intraoral, p < 0.001). Multivariate analysis revealed that submandibular abscesses (Exp (B) = 5.254, p = 0.012) were the only significant risk factor for the transcervical approach in surgical treatment of DNIs. Conclusion: Submandibular space abscesses were the only significant risk factor for the transcervical approach in the treatment of pediatric DNI patients. (C) 2017 Elsevier Inc. All rights reserved.