Author:
Biron Vincent L,Kurien George,Dziegielewski Peter,Barber Brittany,Seikaly Hadi
Abstract
Abstract
Introduction
Deep neck space abscesses (DNAs) are relatively common otolaryngology-head and neck surgery emergencies and can result in significant morbidity with potential mortality. Traditionally, surgical incision and drainage (I&D) with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound-guided drainage (USD) is a less invasive and effective alternative in select cases.
Objectives
To compare I&D vs USD of well-defined DNAs, using a randomized controlled clinical trial design. The primary outcome measure was effectiveness (length of hospital stay (LOHS) and safety), and the secondary outcome measure was overall cost to the healthcare system.
Methods
Patients presenting to the University of Alberta Emergency Department with a well-defined deep neck space abscess were recruited in the study. Patients were randomized to surgical or US-guided drainage, placed on intravenous antibiotics and admitted with airway precautions. Following drainage with either intervention, abscess collections were cultured and drains were left in place until discharge.
Results
Seventeen patients were recruited in the study. We found a significant difference in mean LOHS between patients who underwent USD (3.1 days) vs I&D (5.2 days). We identified significant cost savings associated with USD with a 41% cost reduction in comparison to I&D.
Conclusions
USD drainage of deep neck space abscesses in a certain patient population is effective, safe, and results in a significant cost savings to the healthcare system.
Publisher
Springer Science and Business Media LLC
Subject
Otorhinolaryngology,Surgery
Cited by
43 articles.
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