A Clinical Study of Deep Neck Infection in Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Children with deep neck infection tend to have a subtle presentation and are seldom able to verbalize their symptoms or cooperate with physical examination. The purpose of this study is to review clinical characteristics in pediatric deep neck infection. SUBJECTS AND METHOD: A retrospecitve study was perfomed on 39 cases with pediatric deep neck infection from June 1994 to June 2004. We analyzed the age and sex distribution, the site of abscess, symptoms and signs, causing factors, microbiology, the treatment outcome and the complications. RESULTS: In pediatric deep neck infection, neck swelling and fever were the most frequent symptoms. The most common known preceding illness was upper respiratory infection. The most common site of infection was the submandibular space, followed by the retropharyngeal space and the parapharyngeal space. Bacterioloically, Staphylococcus aureus was the most common bacteria. Twenty-three cases were treated with antibiotics only or needle aspiration and 16 cases were treated with surgical drainage. The conservative treatment was successful in 64% of retropharyngeal space infection, and in 78% of parapharyngeal space infection. There was no complications in any cases. CONCLUSION: In our results, retrophryngeal abscess and parapharyngeal abscess or small abscess were found to respond well to conservative treatment. However, if there is no improvement with antibiotics within 48-72 hours, surgical treatment might be considered.

A Case of Arteriovenous Fistula between Common Carotid Artery and Internal Jugular Vein / 대한이비인후과학회지

Traumatic arteriovenous fistula between common carotid artery and internal jugular vein is extremely rare. Major cervical vascular injury may present as vigorous external bleeding, an expanding or stable cervical hematoma, or a hemispheric neurologic deficit. A rapidly expanding hematoma is immediate to the patient's airway and severe ongoing hemorrhage may lead to exanguination. The authors have experienced a case of traumatic pseudoaneurysm and arteriovenous fistula between common carotid artery and internal jugular vein. We treated this case successfully with exploration and vascular autograft, and so, we report it with a review of the literature.