Presentation diagnosis and management of deep neck space infections in children

the objective of this study is to review the pattern, the presenting symptoms and signs, bacteriology and management of deep neck spaces infection [DNSI] in children. Method: This is a retrospective review of the charts of all children seen in Ear Nose and Throat [ENT] department of Assir central Hospital of King Khalid University Abha. Saudi Arabia. The patients database was searched by using the diagnosis Peritonsillar Space Infection [PTSI], Parapharyngeal Space Infection [RTSI]. The search included inpatients and those on outpatients' visits of patients below the age of 12 years from 1999-2002. The charts were reviewed and data regarding presentation, management and outcome were recorded. Some comparisons with current trend in the literature were made, Twenty- four patients were identified, 16 with PTSI, 6 with PPSI and 2 with RTSI. The most common symptoms in the 3 groups were fever and dysphagia. Intravenous antimicrobial therapy was the main stay of treatment in 16 [66.6%] of the 24 patients. In patients with already formed abscess antimicrobial therapy with surgical drainage was the preferred treatment. Positive culture was obtained in 75% of patients with the predominance of streptococcus species. Descending mediastinitis complicated one case. All the patients survived without residual sequalae. Deep neck space infections in children are rapidly progressive and often cause obstruction. Patients are effectively treated with surgical drainage coupled with intravenous followed by oral antibiotics

Nasal polyposis and fungal sinusitis - Efficaay of endoscoric sinus surgery

The purpose of this study is to compare Caldwell- Luc operation to Functional Endoscopy Sinus Surgery [FESS] in the treatment of fungal sinusitis associated with nasal polyps. Method: This is a retrospective study from January 1994 to June 2001, involving a series of 32 sinus procedures performed on adult patients. The study was carried out in a tertiary referral institution covering South Western region of Saudi Arabia with estimated population of about 3 million.During the period under review the mean age was 39 years. Eighteen patients underwent Galdwell- Luc operations with intranasal polypectomy while 14 patients had Functional Endoscopy Sinus Surgery [FESS]. It was found that the recurrent rate in patients who has Caldwell-Luc operations was about four times [4:1] higher than those who has functional Endoscopic Sinus Surgery within the first 12 months. Conclusions: FESS was more efficient in the treatment of nasal polyposis with fungal infections