Guideline for the Surgical Management of Locally Invasive Differentiated Thyroid Cancer From the Korean Society of Head and Neck Surgery

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.

Foreign Body Complications in Ears due to Mishandled Hearing Aid Fitting and Proposed Clinical Guidelines to Address the Complications

Background@#South Korea has one of the world’s fastest aging populations and is witnessing increased age-related hearing impairment cases as well as an increase in the number of hearing aid users. The aim of this study was to analyze complications caused by hearing aid mold materials. In addition, we hope to raise awareness of the harm and danger that inexperienced hearing aid providers can cause to patients. @*Methods@#We retrospectively reviewed the medical records of 11 patients who were diagnosed with hearing aid mold material as a foreign body in the ear at a tertiary center between 2016 and 2020. The following data were analyzed: symptoms, endoscopic findings, audiometry, temporal bone CT images, treatment methods, and complications after removal. The currently available literature was also reviewed to develop clinical guidelines, to identify the systematic weaknesses in the South Korean hearing aid market, and to identify policies that warrant better quality control. @*Results@#Among the 11 cases, 9 were restricted to the external auditory canal, all of which were successfully removed under endoscopy with minor complications. Two cases with middle ear involvement resulted in infection and thus required surgical removal with mastoidectomy. The average age of these patients was 76.4, and all patients received their molding procedure at private hearing aid shops without an otolaryngologist’s examination. @*Conclusion@#Thorough patient history-taking and otologic examination must be performed to identify patients at higher risk of complications. Such patients should be referred to an otolaryngologist. If a patient exhibits alarming symptoms, early referral is critical since prompt surgery can minimize complications. A CT scan is highly recommended to determine an optimal approach for foreign body removal. Systematic and regulatory changes in hearing aid dispensers, such as requiring apprenticeship, raising the required level of education, and legally mandating referrals, can help reduce these complications.

Hearing Impairment Increases Economic Inequality

Objectives@#. We evaluated changes in income levels in a hearing-impaired population. @*Methods@#. The study subjects were selected from the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 of Koreans ≥40 years old. In total, 5,857 hearing-impaired subjects were matched with 23,428 comparison participants. Differences between the initial income level and income levels at 1, 2, 3, 4, and 5 years post-enrollment were compared between the hearing-impaired and comparison groups. The interaction of time and hearing impairment/comparison was estimated. @*Results@#. Both the hearing-impaired group and the comparison group showed increased income levels over time. In the hearing-impaired group, the income levels at 4 and 5 years post-enrollment were higher than the initial income level (each P<0.001). In the comparison group, the income levels of all the participants after 1–5 years were higher than the initial income level (each P<0.001). The interaction of time and hearing impairment was statistically significant (P=0.021). @*Conclusion@#. The increase in income over time was relatively lower in the hearing-impaired adult population; therefore, the income gap widened between this population and the normal-hearing population.

Hearing Impairment Increases Economic Inequality

Objectives@#. We evaluated changes in income levels in a hearing-impaired population. @*Methods@#. The study subjects were selected from the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 of Koreans ≥40 years old. In total, 5,857 hearing-impaired subjects were matched with 23,428 comparison participants. Differences between the initial income level and income levels at 1, 2, 3, 4, and 5 years post-enrollment were compared between the hearing-impaired and comparison groups. The interaction of time and hearing impairment/comparison was estimated. @*Results@#. Both the hearing-impaired group and the comparison group showed increased income levels over time. In the hearing-impaired group, the income levels at 4 and 5 years post-enrollment were higher than the initial income level (each P<0.001). In the comparison group, the income levels of all the participants after 1–5 years were higher than the initial income level (each P<0.001). The interaction of time and hearing impairment was statistically significant (P=0.021). @*Conclusion@#. The increase in income over time was relatively lower in the hearing-impaired adult population; therefore, the income gap widened between this population and the normal-hearing population.

A Case of Blue Nevus of Posterior Wall of Pharynx / 대한이비인후과학회지

Menalocytic nevi are benign localized pigmented lesions, which usually occur on the cutaneous surface of the body but rarely on the mucous membranes. It is comparatively easy to encounter pigmented lesions of the oral cavity, but the melanocytic nevi of the pharyngeal wall are extremely rare worldwide and, to the best of our knowledge, there is no reported case of melanocytic nevus arising from pharyngeal wall. We report a case of a pigmented lesion on the posterior wall of pharynx, which was microscopically confirmed as oropharyngeal blue nevus.

A Clinical Study of Acute Epiglottitis: Retrospective Review of 315 Patients in Korea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#Acute epiglottitis is a life-threatening condition that can result in airway obstruction. The present study reports clinical features, management and patient outcomes in an acute epiglottitis.SUBJECTS AND METHOD: Included in our retrospective study were 315 patients who were admitted with the diagnosis of acute epiglottitis between January 2006 and July to the department Otolaryngology-Head and Neck surgery, Hallym University Sacred Heart Hospital 2018. The diagnosis of acute epiglottitis was established by confirmation of inflamed epiglottis using laryngoscope or computed tomography.@*RESULTS@#Among 315 patients, 89 cases (28%) and 83 cases (26%) were found in the fifth and fourth decades, respectively. The mean age of patients was 45.0±13.94 years. The male to female ratio was 1.33:1. A total of 75 patients (23.8%) had co-morbidities, with hypertension (13.6%) being the most common. Fever was relatively uncommon, whereas most patients complained of sore throat. Ceftriaxone was the most common empirical antibiotic regimen prescribed and the use of steroids did not affect the length of hospital stay. Nine patients required airway intervention, including eight who underwent endotracheal intubation and one emergency tracheostomy. In patients who need airway intervention, systolic blood pressure, body temperature, respiratory rate, heart rate, white blood cells and the proportion of dyspnea were significantly higher in comparison to the patients without airway intervention.@*CONCLUSION@#Although acute epiglottitis often has nonspecific symptoms, it may lead to sudden dyspnea and unstable vital signs, so an in-depth understanding of this disease is needed.

Tobacco Smoking and Alcohol Consumption Are Related to Benign Parotid Tumor: A Nested Case-Control Study Using a National Health Screening Cohort

OBJECTIVES: To evaluate the relationship among smoking, alcohol consumption, and obesity and benign or malignant parotid tumors in a Korean population. METHODS: The Korean National Health Insurance Service-Health Screening Cohort (for ≥40-year-olds) was assessed from 2002 to 2013. In total, 336 benign parotid tumors and 46 malignant parotid tumors were matched with controls at a ratio of 1 to 4 with respect to age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed previous histories of smoking, alcohol consumption, and obesity. By unconditional logistic regression analyses, the crude and adjusted odds ratios (ORs) were investigated and the 95% confidence intervals (CIs) were counted. RESULTS: The estimated annual incidence of the benign parotid tumors was 5.66 per 100,000, and that of the malignant parotid tumor was 0.81 per 100,000. The adjusted ORs of smoking for the benign parotid tumors was 2.52 (95% CI, 1.84 to 3.46). This finding was consistent in the subgroups of <60 years old, ≥60 years old, and men. The adjusted ORs of alcohol consumption for the benign parotid tumors showed the statistical significance only in women (adjusted OR, 2.35; 95% CI, 1.10 to 5.00). Obesity did not reach a statistical significance in any analysis. CONCLUSION: Benign parotid tumor was related with smoking, and it was linked with alcohol consumption in women only.

In-Depth, Proteomic Analysis of Nasal Secretions from Patients With Chronic Rhinosinusitis and Nasal Polyps

PURPOSE: Chronic rhinosinusitis (CRS) is a complex immunological condition, and novel experimental modalities are required to explore various clinical and pathophysiological endotypes; mere evaluation of nasal polyp (NP) status is inadequate. Therefore, we collected patient nasal secretions on filter paper and characterized the proteomes. METHODS: We performed liquid chromatography-mass spectrometry (MS)/MS in the data-dependent acquisition (DDA) and data-independent acquisition (DIA) modes. Nasal secretions were collected from 10 controls, 10 CRS without NPs (CRSsNP) and 10 CRS with NPs (CRSwNP). We performed Orbitrap MS-based proteomic analysis in the DDA (5 controls, 5 CRSsNP and 5 CRSwNP) and the DIA (5 controls, 5 CRSsNP and 5 CRSwNP) modes, followed by a statistical analysis and a hierarchical clustering to identify differentially expressed proteins in the 3 groups. RESULTS: We identified 2,020 proteins in nasal secretions. Canonical pathway analysis and gene ontology (GO) evaluation revealed that interleukin (IL)-7, IL-9, IL-17A and IL-22 signaling and neutrophil-mediated immune responses like neutrophil degranulation and activation were significantly increased in CRSwNP compared to control. The GO terms related to the iron ion metabolism that may be associated with CRS and NP development. CONCLUSIONS: Collection of nasal secretions on the filter paper is a practical and non-invasive method for in-depth study of nasal proteomics. Our proteomic signatures also support that Asian NPs could be characterized as non-eosinophilic inflammation features. Therefore, the proteomic profiling of nasal secretions from CRS patients may enhance our understanding of CRS endotypes.

A Clinical Study of Acute Epiglottitis: Retrospective Review of 315 Patients in Korea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Acute epiglottitis is a life-threatening condition that can result in airway obstruction. The present study reports clinical features, management and patient outcomes in an acute epiglottitis. SUBJECTS AND METHOD: Included in our retrospective study were 315 patients who were admitted with the diagnosis of acute epiglottitis between January 2006 and July to the department Otolaryngology-Head and Neck surgery, Hallym University Sacred Heart Hospital 2018. The diagnosis of acute epiglottitis was established by confirmation of inflamed epiglottis using laryngoscope or computed tomography. RESULTS: Among 315 patients, 89 cases (28%) and 83 cases (26%) were found in the fifth and fourth decades, respectively. The mean age of patients was 45.0±13.94 years. The male to female ratio was 1.33:1. A total of 75 patients (23.8%) had co-morbidities, with hypertension (13.6%) being the most common. Fever was relatively uncommon, whereas most patients complained of sore throat. Ceftriaxone was the most common empirical antibiotic regimen prescribed and the use of steroids did not affect the length of hospital stay. Nine patients required airway intervention, including eight who underwent endotracheal intubation and one emergency tracheostomy. In patients who need airway intervention, systolic blood pressure, body temperature, respiratory rate, heart rate, white blood cells and the proportion of dyspnea were significantly higher in comparison to the patients without airway intervention. CONCLUSION: Although acute epiglottitis often has nonspecific symptoms, it may lead to sudden dyspnea and unstable vital signs, so an in-depth understanding of this disease is needed.

Association between BMI for Obesity and Distress about Appearance in Korean Adolescents

BACKGROUND: Previous research has related obesity to body dissatisfaction and low self-esteem. This study aimed to evaluate this relation between obesity and distress about appearance. METHODS: We performed a cross-sectional study using data from the Korea Youth Risk Behavior Web-based Survey for 288,390 participants assessed from 2009 to 2012. The participants were categorized according to body mass index; obese, overweight, healthy weight, and underweight. The relation between obesity and distress was analyzed using simple and multiple logistic regression with complex sampling adjusted for age, sex, region of residence, economic level, parental education level, alcohol consumption, and smoking habits as confounders. RESULTS: The adjusted odds ratio (AOR) was higher for participants with obesity (AOR for healthy weight = 1.15 [95% confidence interval {CI}, 1.08–1.22]; AOR for overweight = 1.85 [95% CI, 1.72–1.98]; AOR for obese = 2.45 [95% CI, 2.27–2.64]; reference = underweight, P < 0.001). In males, healthy weight was associated with an AOR below 1 (AOR for healthy weight = 0.92 [95% CI, 0.85–0.99]; AOR for overweight = 1.26 [95% CI, 1.14–1.38]; AOR for obese = 1.66 [95% CI, 1.50–1.84], P < 0.001). In females, higher AORs were associated with obesity (AOR for healthy weight = 1.44 [95% CI, 1.33–1.57]; AOR for overweight = 2.71 [95% CI, 2.45–2.99]; AOR for obese = 3.71 [95% CI, 3.32–4.14], P < 0.001). CONCLUSION: Obesity is related to distress about appearance, and the relation is stronger in girls than in boys.

Adenoidectomy May Not Be Effective to Reduce the Number of Hospital Visits for Sinusitis

BACKGROUND: The objective of this study was to compare post-operative (post-op) visits for sinusitis between adenoidectomy and non-adenoidectomy participants (control). METHODS: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, we used 1:4 matching to select 2,593 adenoidectomy participants and 10,372 control participants. Post-op visits for sinusitis were measured from post-op 1 year through post-op 9 years. Equivalence testing was used. Margin of equivalence of difference was set as −0.5 to 0.5 in this study. RESULTS: There were trivial differences between the two groups from post-op 1 to 2 years. However, there was no difference between the two groups from post-op 3 through 9 years. Visits for sinusitis gradually decreased in both groups. In the rare and frequent pre-operative sinusitis group, there were minor differences in both groups from post-op 1 to 2 years. In contrast, there were no differences between the two groups in rare and frequent pre-operative sinusitis groups from post-op 3 through 9 years. In the 0–4 years old group, there were minor differences between both groups from post-op 1 to 2 years. However, no differences in the number of visits for sinusitis were found between the two groups during follow up periods from post-op 3 through 9 years. Additionally, there were no differences between the two groups during the entire follow up period. CONCLUSION: Adenoidectomy does not reduce post-op visits for sinusitis. Sinusitis decreased over time whether adenoidectomy was performed or not.

Prognosis of Patients with Benign Vocal Fold Lesions after Laryngeal Microsurgery

BACKGROUND AND OBJECTIVES: This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. MATERIALS AND METHODS: The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. RESULTS: Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p < 0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p < 0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). CONCLUSION: Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.

Physical Activity, Sedentary Habits, Sleep, and Obesity are Associated with Asthma, Allergic Rhinitis, and Atopic Dermatitis in Korean Adolescents

PURPOSE: Since pathophysiologic evidence has been raised to suggest that obesity could facilitate an allergic reaction, obesity has been known as an independent risk factor for allergic disease such as asthma. However, the relationship between sedentary behavior and lifestyle which could lead to obesity, and those allergic diseases remains unclear. MATERIALS AND METHODS: We analyzed the relations between physical activity, including sitting time for study, sitting time for leisure and sleep time, and obesity, asthma, allergic rhinitis, and atopic dermatitis using the Korea Youth Risk Behavior Web-based Survey, which was conducted in 2013. Total 53769 adolescent participants (12 through 18 years old) were analyzed using simple and multiple logistic regression analyses with complex sampling. RESULTS: Longer sitting time for study and short sitting time for leisure were associated with allergic rhinitis. High physical activity and short sleep time were associated with asthma, allergic rhinitis, and atopic dermatitis. Underweight was negatively associated with atopic dermatitis, whereas overweight was positively correlated with allergic rhinitis and atopic dermatitis. CONCLUSION: High physical activity, and short sleep time were associated with asthma, allergic rhinitis, and atopic dermatitis.

Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.

Characteristics of Microbiology of Peritonsillar Abscess / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aimed to review the characteristics of microbiology of peritonsillar abscess and to recommend adequate empirical antibiotics. SUBJECTS AND METHOD: Patients (437) who underwent surgical drainage for peritonsillar abscess were reviewed retrospectively. We analyzed correlations between age, gender, obesity and diabetes mellitus and cultured organisms with respect to susceptibility of antibiotics. RESULTS: The leading pathogens were α-hemolytic streptococcus (44.3%), Streptococcus viridians (12.3%), β-hemolytic streptococcus (8.2%) and Streptococcus pyogenes (6.8%). The rates of α-hemolytic streptococcus and Streptococcus pyogenes growth were p=0.002 and p=0.032, respectively; these values were significantly higher in patients under the age of 40 than those over the age of 40. Klebsiella pneumoniae infection was observed more frequently in the diabetic group than in the non-diabetic group. Antibiotics susceptibility test showed that four leading pathogens were susceptible to ampicillin/sulbactam. CONCLUSION: Only ampicillin/sulbactam was sufficient to treat peritonsillar abscess empirically. In conclusion, the use of third generation Cephalosporin or other antibiotics for anaerobes is not considered necessary for the empirical treatments of peritonsillar abscess.

Chronic Obstructive Pulmonary Disease Is Negatively Related with Nasal Polyp in Middle Aged and Elderly Chronic Rhinosinusitis Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is known to induce chronic rhinosinusitis (CRS). Nasal polyp, which is frequently found in patients with CRS, seems to have close relationship with COPD, but little is known about its relationship with COPD. In this study, we investigated the relationship between COPD and nasal polyp in middle aged and elderly CRS patients. SUBJECTS AND METHOD: We analyzed the clinical data of 174 patients (age of over 50 years) with CRS. Patients were divided as COPD [forced expiratory volume (FEV1)/forced vital capacity (FVC)<70%, n=30] and non-COPD group (FEV1/FVC≥70%, n=144) according to the pulmonary function test results. Binary logistic regression analysis was used to describe the relationships between clinically relevant factors related to nasal polyp. RESULTS: On logistic regression analysis, no significant relationship was found between age [adjusted odds ratio (AOR): 1.058, 95% confidence interval for the difference (CI)=0.995-1.126, p=0.073], sex AOR: 0.897, 95% CI=0.366-2.415, p=0.897), smoking (AOR: 0.434, 95% CI=0.154-1.219, p=0.113) and obesity (underweight AOR: 3.833, 95% CI=0.781-18.808, p=0.098, overweight AOR: 5.169, 95% CI=0.996-26.814, p=0.051, obese AOR: 2.911, 95% CI=0.335-25.329, p=0.333) with polyp. However, there was a negative correlation between COPD history and nasal polyp with statistical significance (AOR: 0.288, 95% CI=0.102-0.809, p=0.018). CONCLUSION: Our findings suggest that patients with COPD are less likely to have nasal polyp than patients without COPD.

Prevalence and Risk Factors of Subjective Dizziness in Korean / 대한평형의학회지

BACKGROUND AND OBJECTIVES: To evaluate the prevalence and risk factors of subjective dizziness complaints in general population. MATERIALS AND METHODS: A cross-sectional study was performed using data from The Korea National Health and Nutrition Examination Surveys. We evaluated data from 12,653 subjects who were interviewed between 2010 and 2012. RESULTS: The prevalence of subjective dizziness was 21.7%. Female gender (adjusted odds ratio, AOR=1.959; 95% confidence interval [CI], 1.680-2.284; p or =2 times a week, AOR=0.812, 95% CI=0.705-0.935, p=0.002), higher stress (AOR=1.784, 95% CI=1.613-1.973, p<0.001), lower income (reference=lowest; middle low, AOR=0.815, 95% CI=0.720-0.923; middle high, AOR=0.696, 95% CI=0.606-0.799; highest, AOR=0.682, 95% CI=0.594-0.784, p<0.001) increased odds ratio of subjective dizziness, while body mass index and smoking was not associated with subjective dizziness. CONCLUSION: This large population-based study provides reliable information about the prevalence and risk factors of subjective dizziness of Korean population.

Analysis of Predisposing Factors for Hearing Loss in Adults

We aimed to estimate the effects of various risk factors on hearing level in Korean adults, using data from the Korea National Health and Nutrition Examination Survey. We examined data from 13,369 participants collected between 2009 and 2011. Average hearing thresholds at low (0.5, 1, and 2 kHz) and high frequencies (3, 4, and 6 kHz), were investigated in accordance with various known risk factors via multiple regression analysis featuring complex sampling. We additionally evaluated data from 4,810 participants who completed a questionnaire concerned with different types of noise exposure. Low body mass index, absence of hyperlipidemia, history of diabetes mellitus, low incomes, low educational status, and smoking were associated with elevated low frequency hearing thresholds. In addition, male sex, low body mass index, absence of hyperlipidemia, low income, low educational status, smoking, and heavy alcohol consumption were associated with elevated high frequency hearing thresholds. Participants with a history of earphone use in noisy circumstances demonstrated hearing thresholds which were 1.024 dB (95% CI: 0.176 to 1.871; P = 0.018) higher, at low-frequencies, compared to participants without a history of earphone use. Our study suggests that low BMI, absence of hyperlipidemia, low household income, and low educational status are related with hearing loss in Korean adults. Male sex, smoking, and heavy alcohol use are related with high frequency hearing loss. A history of earphone use in noisy circumstances is also related with hearing loss.

A Case of External Jugular Vein Thrombosis Originating from Phlebectasia / 대한이비인후과학회지

External jugular vein thrombosis is an infrequent disease that has been associated with altered blood flow, vascular endothelium lesion or a hypercoagulable state. It could be originated from phlebectasia, but very rare. It could be diagnosed with detailed history taking, when patients had no specific previous history of intervention or treatment. The authors report a case of external jugular vein thrombosis originated from phlebectasia without risk factor. This patient was successfully managed by ligation and excision of the vein without any complications.

Characteristics of Microbiology of Deep Neck Abscess / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aimed to review the characteristics of microbiology of deep neck abscess and to recommend adequate empirical antibiotics. SUBJECTS AND METHOD: Medical records of the 71 patients who underwent surgical drainage for deep neck abscess were reviewed retrospectively. We analyzed correlations between age, gender, etiology and diabetes mellitus and the cultured organism with respect to susceptibility of antibiotics. RESULTS: The leading pathogens were Streptococcus viridians group (18.3%), Klebsiella pneumonia (K. pneumonia, 15.5%), Staphylococcus aureus (S. aureus, 15.5%) and alpha-hemolytic Streptococcus (12.7%). The most common source of infection had a dental origin. Streptococcus viridians group was associated with infections of dental origin and K. pneumonia infection was over-represented in the diabetic group compared to the non-diabetic group. Antibiotics susceptibility test showed that four leading pathogens were susceptible to ampicillin/sulbactam. The rate of methicillin-resistant S. aureus accounting for S. aureus infections was only 18.2%. CONCLUSION: Only ampicillin/sulbactam without other antibiotics was sufficient to treat deep neck abscess empirically. Thus we suggest that other antibiotics that target anaerobes or 3rd generation cephalosporin are not necessary for the empirical treatments of deep neck abscess.