• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.236-242
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• 2013

Purpose: The objective of this retrospective study is to evaluate the factors affecting the spread of odontogenic infection. Furthermore, this study was performed to apply to future treatments. Methods: A total of 65 patients, who had received treatment for odontogenic infections from 2010 to 2012 for 3 years, were enrolled in this study. The causes of infection, presence of systemic disease, and complications, durations of treatment, treatment methods, and inflammation levels were compared with the data. Results: Patients over 70 years with systemic disease required immediate drainage, systemic antibiotic therapy and hospitalization. We can determine the direction of the early diagnosis and treatment through blood tests (white blood cells, neutrophil, C-reactive protein [CRP]) and computed tomography. Patients over 70 years with systemic disease had the highest percentage. In addition, these patients showed high levels of inflammation index, such as CRP average of 24.8 and needed for a long-term treatment period and a wide range of surgical incision & drainage several times. Systemic diseases, particularly diabetes mellitus and hypertension, accelerate the spread of infection and had a negative effect that delays healing. Eventually, five of the 65 patients showed serious systemic complications. Conclusion: When evaluating cervico-facial infected patients due to odontogenic infection, the most important thing is deciding the appropriate diagnosis and degree of disease. Considering the patient's systemic status and age, we need to decide the treatment plan. Especially, those patients over 70 years with systemic disease should be treated with rapid surgical approach, and the use of a wide range of antibiotics and intensive care. If proper treatment principle does not apply, severe life-threatening complications will result, such as necrotizing fascitis, acute airway obstruction, mediastinitis, and others.

• Korean Journal of Head & Neck Oncology
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• v.26 no.2
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• pp.225-227
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• 2010

Actinomycosis is an unusual granulomatous infection caused by gram-positive anaerobic bacteria called Actinomyces species(predominantly Actinomyces israelii), which is a common and normally nonpathogenic organism found in the nose and throat. The three major clinical presentations of actinomycosis include the cervico-facial(the most common, 55%), thoracic, and abdominopelvic region. Actinomycosis typically has a chronic, indolent course characterized by swelling and induration of the soft tissues and eventual spontaneous drainage through multiple sinus tracts. Actinomycosis is difficult to diagnose because of variable presentation mimicking neoplasm and fastidious nature of the organism in culture. We present a case of actinomycosis in the parotid tip area which was mistaken for a salivary tumor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.74-80
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• 2002

Necrotizing fasciitis is rare acute infection showing rapidly necrosis involve the subcutaneous tissue and fascia. If treatment is delayed, infection can spread to involve the subcutaneous tissue, skin, deep fascia, and even muscle in rapid sequence, resulting in widespread necrosis and moderate to severe systemic toxicity. Most commonly this disease presents in the extremities, trunk, and perineum; it is relatively rare in the head and neck regions. If not diagnosed and treated in its early stages, necrotizing fasciitis can be potentially fatal, with a motality rate approaching 40%. Historically, the clinical entity now referred to as necrotizing fasciitis was described in the literature under various name. : hospital gangrene, necrotizing erysipelas, streptococcal gangrene, suppurative fasciitis. Necrotizing fasciitis was first described by Wilson in 1952. We experienced 3 cases of necrotizing fasciitis and will report review of literature with diagnosis, treatment, complication and consideration.