Deep head and neck space infections: a decade of clinical experience

Czech version

Authors: C. Micopulos ¹ ; P. Pošta ¹ ; D. Slouka ² ; T. Kostlivý ² ; J. Šafránek ³
Authors‘ workplace: Stomatologická klinika LF UK a FN Plzeň ¹; Klinika otorinolaryngologie a chirurgie hlavy a krku LF UK a FN Plzeň ²; Chirurgická klinika LF UK a FN Plzeň ³
Published in: Otorinolaryngol Foniatr, 75, 2026, No. 1, pp. 37-45.
Category: Original Article
doi: https://doi.org/10.48095/ccorl202637

Overview

Introduction: Inflammatory processes of the face, neck, and jaw represent a serious complication of infections of various etiologies. Their course can range from mild to fulminant, life-threatening conditions requiring intensive care. The aim of this study is to present the experience of the Department of Stomatology, University Hospital and Faculty of Medicine in Pilsen, Charles University, in the diagnosis and management of these infections between 2015 and 2024. Materials and methods: Retrospective analysis was performed on patients hospitalized between 2015 and 2024. Demographic data, etiology, localization, treatment, and complications were evaluated. Results: A total of 645 patients were hospitalized (396 men, 249 women; mean age 41 years, range 4–93 years). The mean hospital stay was 6.5 days, and 92 required intensive care. Odontogenic infections predominated (570; 88.4%), most commonly apical periodontitis. Complications from third molars accounted for 45% of odontogenic cases. The most frequently affected spaces were submandibular, pterygomandibular, and submental, which were often multiple. Surgical drainage was required in 94.6%, mostly via extraoral incision. Severe complications included mediastinitis (14) and brain abscess (1). Mortality related to hospitalization was 0.3% (2 patients). Conclusion: Odontogenic infections are the dominant cause of severe infections in the facial and cervical regions. Our ten-year experience shows that early diagnosis, prompt surgery, and targeted antibiotic therapy are crucial for treatment. Although most patients were managed according to protocol, severe complications such as mediastinitis or intracranial infections can still occur and are associated with significant morbidity. These findings highlight the necessity of a comprehensive, interdisciplinary approach.

Keywords:

Periodontitis – antibiotics – mediastinitis – impacted tooth

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