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 114
- Downloads 0
Chronic Secondary Otalgia: Multidisciplinary Evaluation and Relationship with Cervical Spine Disease
Objective: We developed an algorithm to evaluate secondary otalgia and examined the role of cervical spine disease in chronic secondary otalgia. Otalgia may arise from the ear itself (primary) or may indicate pathologies...
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...
Transoral Robotic Supraglottic Laryngectomy in Laryngeal Squamous Cell Carcinoma
The most common histological type of laryngeal cancer is squamous cell carcinoma, and the supraglottic and glottic regions are the most common sites of this type. Supraglottic laryngectomy is the most common treatment in...
Risk Factors for Refractory and Delayed De novo Otitis Media Requiring Pressure Equalization Tube Insertion
Objective: Limited data exists regarding risk factors for otitis media in older children and specifically those for which surgical intervention is performed. This study investigated potential risk factors in this older a...
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...