Extent of abscess development in cervical abscesses and pathogenic bacteria related to swallowing function.

Abstract

Background: Deep neck infections (DNIs) in the cervical fascial planes can cause severe complications such as airway obstruction, mediastinitis, and sepsis.

Aims/objectives: This study examines cervical abscess development, its relationship with postoperative swallowing function, and hospital stay duration.

Material and methods: A retrospective case series of 55 DNI patients was divided by hospital stay (<30 days: Group A, ≥30 days: Group B) and swallowing recovery (<6 days: Group C, ≥6 days: Group D). Swallowing was assessed using FOIS; abscesses were categorized via CT and surgery.

Results: Longer hospital stays (Group B) were associated with tracheostomy (p = .027) and thoracoscopic mediastinal drainage (p = .038), shorter time between symptom onset and surgery (p = .016), and abscesses in the anterior cervical (p = .007), retropharyngeal space (p = .026), and mediastinal spaces (p = .002). Dysphagia (Group D) was linked to longer hospital stays (p = .006), more abscesses in the anterior cervical (p = .049) and retropharyngeal spaces (p = .009), and higher cases of intubated feeding (p < .001). Streptococcus constellatus was more prevalent in Group D (p = .04), whereas Staphylococcus aureus was less common (p = .043).

Conclusions and significance: Dysphagia is associated with abscesses in the anterior cervical and retropharyngeal spaces and higher Streptococcus constellatus prevalence, indicating delayed oral intake recovery. Thoracoscopic mediastinal drainage and shorter time to surgery were linked to prolonged hospital stays.