The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients
Journal Title: International Journal of Otorhinolaryngology - Year 2015, Vol 2, Issue 1
Abstract
Objective: To evaluate the utility of follow-up CT imaging for predicting the need for surgical intervention in pediatric patients with deep neck infections (DNI) admitted for a trial of observation with medical management. Methods: Pediatric patients admitted with DNI from January 2000 to February 2009 who underwent a CT scan, initial medical management, and repeat CT scan were identified and separated into two cohorts: patients who underwent surgical intervention and patients treated with medical management. Necessity of surgical intervention following the repeat CT scan was determined and the predictive values of CT imaging characteristics and clinical characteristics for identifying necessary surgical interventions were calculated. Results: 62 patients met inclusion criteria. Of the 32 patients who underwent surgical intervention following their second CT scan, 75% revealed an abscess. Of the 30 patients who continued with medical management following the second CT scan, 10% failed medical management. The combination of increased size, increased peripheral enhancement, and walling off of collections on subsequent CT imaging yielded 83% specificity for identifying patients who needed surgical intervention. Interpretation of the collection as a phlegmon or abscess on the repeat CT scan by the radiologist yielded 96% sensitivity for identifying patients who needed surgical intervention. Conclusion: Follow-up CT imaging can assist with determining the need for surgical intervention in children with deep neck infections initially managed medically.
Authors and Affiliations
Charles A Elmaraghy
Keywords
Related Articles
- EP ID EP205578
- DOI 10.13188/2380-0569.1000005
- Views 110
- Downloads 0
Mentoplasty for theTreatment of Chin Deformities
Mentoplasty is a surgical procedure that is indicated for the treatment of chin deformities, in the absence of dental malocclusion. In this article the authors describe in a concise way the patient’ s evaluation, surgica...
The Direction of Pediatric Sedation: A Contemporary and Historical Look at its Science, Art, Strengths and Shortcomings
This manuscript takes a critical look at the contemporary state and direction of sedation for the pediatric dental patient from the viewpoint of an academician, researcher, and clinician with over thirty five years exper...
Safety of Cold Tonsillectomy Techniques: Comparison between Wired Snare and Inferior Tonsillar Pole Ligation Methods
Objective: The aim of this study was to assess the safety of wired snare method compared with inferior tonsillar pole ligation method as techniques used in cold dissection tonsillectomy. Study design: Prospective, case...
Choanal Atresia Repair without the Need for Stenting or Drilling: A Technical Modification
We would like to present our modified technique to repair choanal atresia without the need for drilling or postoperative stenting. Traditional repairs utilise postoperative stents for a variable period [1,2]. Stent-less...
Adaptive Immunity in the Middle Ear Mucosa with Chronic Otitis Media
The middle ear is frequently invaded by the upper respiratory commensals. The growth of the commensals in the middle ear frequently causes infectious events. Some of these infectious events occur in children repeatedly w...