Frequency of Cervicofacial Necrotizing Fasciitis Secondary to Odontogenic Abscess

Abstract

Introduction: One of the complications of odontogenic abscess is cervicofacial necrotizing fasciitis; which is infrequent in the cervicofacial region. This disease usually occurs in immunosuppressed patients. Treatment is broad spectrum antibiotics and surgery. Material and Method: A research study was conducted with the following characteristics: retrospective, descriptive, cross-sectional and observational, for a year, in the maxillofacial surgery service, of specialty hospital: “Dr. Antonio Fraga Mouret”, national medical center“ La Raza ” (IMSS), Mexico city; all patients (six) diagnosed with necrotizing cervicofacial fasciitis secondary to Odontogenic abscess, older than 18 years were included. The protocol consisted of taking a biopsy, antibiotic, culture with an antibiogram and surgical management. Data were collected to estimate the frequency of this pathology in the maxillofacial surgery service. Results: In one year, 6 patients with a diagnosis of necrotizing cervicofacial fasciitis secondary to odontogenic abscess were treated. No significant differences were found with respect to gender, the mean age was 69.16 years, (86; minimum 40). The mean number of affected aponeurotic spaces was 6.5 (maximum: 14; minimum: 2); the most affected side was the right. The most frequent aponeurotic spaces were: the facial (in turn, more were reported in the submandibular followed by submental and genian aponeurotic space) and one third the cervical. Surgical management was: cannulation and drainage of persistent abscess or purulent collection in four patients, surgical lavage was performed in all, 3 patients required more than 4 surgical washes. Debridement was performed in all patients. Discussion: The importance of this study is to show and report the frequency with which necrotizing cervicofacial fasciitis appears secondary to odontogenic abscess, to continue with the control and report in maxillofacial surgery, as well as improvements and proposals for a better management of patients who are diagnosed with this disease.