Role of socioeconomic factors in deep neck abscess: A prospective study of 120 patients

Abstract 

Objective

To assess the socioeconomic factors, presentation, aetiological factors, microbiology, and management of deep neck abscesses.

Design

Prospective study.

Setting

Tertiary health care centre.

Patients and methods

We studied 120 patients with deep neck abscess who were managed in the department of otolaryngology between May 2004 and December 2005.

Results

There were 54 male patients (45%) and 66 female (55%) with ages ranging from 18 months to 60 years. Most of the patients were of low socioeconomic status and 84 (70%) were illiterate. None were aware of the predisposing factors and potential complications of deep neck abscess. Ninety-six (80%) had poor orodental hygiene with dental infections and extraction as the most common predisposing factor followed by recurrent oropharyngeal infections. The median duration of delay before the patient presented to us was 1 week, and only 6 (5%) were aware of the primary health services available in their locality. The most common site was the submandibular region. Pain, fever, and dysphagia were the most common presenting symptoms, and Staphylococcus aureus was the most common micro-organism. All patients were treated by incision and drainage, and 10 required emergency tracheostomy. All patients responded with no complications.

Conclusion

Socioeconomic factors, particularly ignorance, illiteracy, and poverty, are important contributory factors towards the high incidence of deep neck abscess in developing countries.

Keywords: Deep neck abscess, Ludwig's angina, Parapharyngeal abscess, Peritonsillar abscess, Retropharyngeal abscess, Submandibular abscess