Journal of Clinical Otolaryngology Head and Neck Surgery (임상이비인후과)

The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery (대한이비인후과학회 부산,울산,경남 지부회)
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A Clinical Aspect Analysis of the Cervical Necrotizing Fasciitis

경부에 발생한 괴사성 근막염에 대한 임상적 양상 분석

  • Yang, Jeong Hwan (Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Choi, Hyo Geun (Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Ju Han (Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Park, Bumjung (Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine)
  • 양정환 (한림대학교 의과대학 한림대학교성심병원 이비인후-두경부외과학교실) ;
  • 최효근 (한림대학교 의과대학 한림대학교성심병원 이비인후-두경부외과학교실) ;
  • 이주한 (한림대학교 의과대학 한림대학교성심병원 이비인후-두경부외과학교실) ;
  • 박범정 (한림대학교 의과대학 한림대학교성심병원 이비인후-두경부외과학교실)
  • Received : 2018.04.25
  • Accepted : 2018.10.29
  • Published : 2018.12.30

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Abstract

Background and Objectives : Necortizing fasciitis in the cervical region is a very rare disease with high mortality and morbidity rates. The purpose of this study was to analyze the clinical characteristics, treatment results, complication and prognosis of necrotizing fasciitis patients. Materials and Methods : We retrospectively reviewed the inpatient charts treated for cervical necrotizing fasciitis at our Otorhinolaryngology clinic. We diagnosed necrotizing fasciitis by the clinical findings such as swelling, redness and pain of infected area and necrosis of subcutaneous fat layer and fascia observed during surgery. Twenty such patients were identified and treated from January 2011 to December 2016. Results : 20 adults consisting of 14 male and 6 females with cervical necrotizing fasciitis were diagnosed and treated. The most commonly known associated preceding illness were dental abscess and tonsillitis. The most pathogen was Streptococcus species (12/20), followed by Klebsiella pneumonia (6/20), Staphylococcus species (2/20). The mean duration of hospitalization was 32.2 days (range,14-86). The mean Modified Laboroatory Risk Indicator for Necrotizing Fasciitis (M-LRINEC) score is 7.4 and more than 4 points was eighteen. All patients received parenteral antibiotics and surgical drainage after admission. Conclusions : The reason for the high survival rate in the study was the early diagnosis, as well as the early surgical procedure and antibiotics. After the operation, frequent betadine irrigation could improve the patient's condition and recover without severe complication.

Keywords

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