Ultrasonography (USG) as an adjuvant diagnostic aid in fascial space infections
The aim: to evaluate the efficiency of USG as an adjuvant diagnostic aid in fascial space infections and help draw a treatment plan as per the diagnosis made by USG examination
Materials and methods: 60 patients having odontogenic superficial fascial space infection of the maxillofacial region were included. All of the patients included in our study were properly examined clinically with proper work up done, ordering different radiographs necessary to ascertain odontogenic cause most patients diagnosed with cellulitis were given medical line of treatment, and those with abscess were subjected to incision and drainage. Informed consent was obtained from all the participants involved in the study.
Results: in this study, total of 60 patients were studied. Out of 60 patients of odontogenic facial space infections, 24 were male and 36 were female. Buccal space was the most common space involved (24;40 %) followed by submandibular space (9;15.0 %) than Canine space (6;10 %). In a total of 60 cases, clinical diagnosis of cellulitis was made in 18 cases (30 %) and that of abscess in 42 patients (70.0 %).
All patients were subjected to the USG examination in which cellulitis was diagnosed in 24 cases (40 %) and abscess in 36 cases (60 %).
Conclusion: USG could be considered to be a valuable adjuvant to clinical examination in patients with fascial space infection and help in delivering better treatment, after intervention 34 cases were found to be abscess while USG found 36 cases hence clearly proving the superiority of USG in diagnosis of abscess than clinical examination.
It has its own advantages like minimal cost, repeated examinations, and readily available in especially in developing countries where people could not easily afford better imaging modalities
Rega, A. J., Aziz, S. R., Ziccardi, V. B. (2006). Microbiology and Antibiotic Sensitivities of Head and Neck Space Infections of Odontogenic Origin. Journal of Oral and Maxillofacial Surgery, 64 (9), 1377–1380. doi: http://doi.org/10.1016/j.joms.2006.05.023
Huang, T., Tseng, F., Liu, T., Hsu, C., Chen, Y. (2005). Deep neck infection in diabetic patients: comparison of clinical picture and outcomes with nondiabetic patients. Otolaryngology–Head and Neck Surgery, 132 (6), 943–947. doi: http://doi.org/10.1016/j.otohns.2005.01.035
Stalfors, J., Adielsson, A., Ebenfelt, A., Nethander, G., Westin, T. (2004). Deep neck space infections remain a surgical challenge. A study of 72 patients. Acta Oto-Laryngologica, 124 (10), 1191–1196. doi: http://doi.org/10.1080/00016480410017864
Jank, S., Robatscher, P., Emshoff, R., Strobl, H., Gojer, G., Norer, B. (2003). The diagnostic value of ultrasonography to detect occult lymph node involvement at different levels in patients with squamous cell carcinoma in the maxillofacial region. International Journal of Oral and Maxillofacial Surgery, 32, 39–42. doi: http://doi.org/10.1054/ijom.2002.0326
Squire, B. T., Fox, J. C., Anderson, C. (2005). ABSCESS: applied bedside sonography for convenient evaluation of superficial soft tissue infections. A Academic Emergency Medicine, 12, 601–606. doi: http://doi.org/10.1197/j.aem.2005.01.016
Bhardwaj, D., Rakareddi, M., Barthunia, B., Singla, R. M. M., Chavda, S. (2017). Efficacy of Ultrasonography in Head and Neck Swellings and Compare with Histopathological and Clinical Diagnosis. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 16 (3), 104–106. doi: http://doi.org/10.9790/0853-160306104116
Sato, F. R., Hajala, F. A., Filho, F. W., Moreira, R. W. (2009). Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. Journal of Oral and Maxillofacial Surgery, 67, 1092–1097. doi: http://doi.org/10.1016/j.joms.2008.09.008
Mathew, G. C., Ranganathan, L. K., Gandhi, S., Jacob, M. E., Singh, I., Solanki, M., Bither, S. (2012). Odontogenic maxillofacial space infections at a tertiary care center in North India: a five-year retrospective study. International Journal of Infectious Diseases, 16 (4), e296–302. doi: http://doi.org/10.1016/j.ijid.2011.12.014
Flynn, T. R., Shanti, R. M., Levi, M. H., Adamo, A. K., Kraut, R. A., Trieger, N. (2006). Severe odontogenic infections, part 1: prospective report. Journal of Oral and Maxillofacial Surgery, 64 (7), 1093–1103. doi: http://doi.org/10.1016/j.joms.2006.03.015
Huang, T.-T., Liu, T.-C., Chen, P.-R., Tseng, F.-Y., Yeh, T.-H., Chen, Y.-S. (2004). Deep neck infection: Analysis of 185 cases. Head & Neck, 26 (10), 854–860. doi: http://doi.org/10.1002/hed.20014
Ariji, Y., Gotoh, M., Kimura, Y., Naitoh, M., Kurita, K., Natsume, N., Ariji, E. (2002). Odontogenic infection pathway to the submandibular space: imaging assessment. International Journal of Oral and Maxillofacial Surgery, 31 (2), 165–169. doi: http://doi.org/10.1054/ijom.2001.0190
Nisha, V., Parthiban, J., Santana, N., Giridhar, A. G., Yashoda Devi, B. K., Sujatha Reddy, S., Rakesh, N. (2013). The role of colour doppler ultrasonography in the diagnosis of fascial space infections. Journal of clinical and diagnostic research, 7 (5), 962–967. doi: http://doi.org/10.7860/jcdr/2013/5617.2990
Mohan, K. R., Rao, N. K., Krishna, G. L., Kumar, V. S., Ranganath, N., Lakshmi, U. V. (2015). Role of ultrasonography in oral and maxillofacial surgery: a review of literature. Journal of Maxillofacial and Oral Surgery, 14 (2), 162–170. doi: http://doi.org/10.1007/s12663-014-0616-x
Shah, A., Ahmed, I., Hassan, S., Samoon, A., Ali, B. (2015). Evaluation of USG as diagnostic tool in management of head and neck facial space infections A clinical study National. National Journal of Maxillofacial Surgery, 6 (1), 55–61. doi: http://doi.org/10.4103/0975-5950.168213
Shah, N., Patel, S., Rupawala, T., Makwana, S., Mansuri, S., Bhimani, K. (2021). Evaluation of Efficacy of Ultrasonography as an Additional Diagnostic Tool for Deciding Management Protocol of Odontogenic Superficial Fascial Space Infections: A Prospective Clinical Study. Journal of Maxillofacial and Oral Surgery. doi: http://doi.org/10.1007/s12663-021-01560-x
Copyright (c) 2022 Asif Muzaffer Reshi, Mohd Younis Bhat, Ajaz Ahmad Shah
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.