Should preoperative computed tomography be routine examination for cervicofacial space infections?

Abstract Background Cervicofacial space infections are potentially life-threatening, which require accurate diagnosis, early incision, and adequate drainage. The utilization of computed tomography (CT) in cervicofacial space infections has significantly increased for its advantages in the evaluation...

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Main Authors: Jiayu Liang, Linli Jiang, Maoye Li, Lei Liu, Hui Li
Format: Article
Language:English
Published: BMC 2022-06-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-022-07545-6
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author Jiayu Liang
Linli Jiang
Maoye Li
Lei Liu
Hui Li
author_facet Jiayu Liang
Linli Jiang
Maoye Li
Lei Liu
Hui Li
author_sort Jiayu Liang
collection DOAJ
description Abstract Background Cervicofacial space infections are potentially life-threatening, which require accurate diagnosis, early incision, and adequate drainage. The utilization of computed tomography (CT) in cervicofacial space infections has significantly increased for its advantages in the evaluation of abscesses, its availability, and low cost. However, the clinical value of preoperative CT imaging in cervicofacial space infections remains controversial for its poor specificity, radiation exposure, potential complications, and extra cost. We, therefore, investigated whether CT examination should be used as a routine examination in the treatment of patients with cervicofacial space infections. Methods A retrospective study of all patients affected by cervicofacial space infections that received incision and drainage surgery from Jan 2016 to Dec 2020 was performed at West China Hospital of Stomatology at Sichuan University. Patients were divided into two groups: the group with preoperative CT and without preoperative CT. Outcomes, including reoperation rate, missed diagnosis rate, days of symptom relief, length of stay, duration of surgery, and total cost of hospitalization, were analyzed. Results Out of n = 153 patients, 108 patients underwent surgery with preoperative CT and 45 patients without preoperative CT. The reoperation rate in the preoperative CT group (6/108, 5.6%) was significantly lower (P = 0.00) than that in the group without preoperative CT (10/45, 22.2%). Significant reduction of missed diagnosis rate (P = 0.00), days of symptom relief (P = 0.01), length of stay(P = 0.03), and duration of surgery (P = 0.01) were detected in the preoperative CT group. The results demonstrated that the utilization of preoperative CT can reduce the missed diagnosis rate and repeated surgery complications. Conclusions We recommend preoperative CT as a routine examination in cervicofacial space infections.
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spelling doaj.art-d16fbe8ca7d145a980d5765bd8805adf2022-12-22T03:34:02ZengBMCBMC Infectious Diseases1471-23342022-06-012211810.1186/s12879-022-07545-6Should preoperative computed tomography be routine examination for cervicofacial space infections?Jiayu Liang0Linli Jiang1Maoye Li2Lei Liu3Hui Li4State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityAbstract Background Cervicofacial space infections are potentially life-threatening, which require accurate diagnosis, early incision, and adequate drainage. The utilization of computed tomography (CT) in cervicofacial space infections has significantly increased for its advantages in the evaluation of abscesses, its availability, and low cost. However, the clinical value of preoperative CT imaging in cervicofacial space infections remains controversial for its poor specificity, radiation exposure, potential complications, and extra cost. We, therefore, investigated whether CT examination should be used as a routine examination in the treatment of patients with cervicofacial space infections. Methods A retrospective study of all patients affected by cervicofacial space infections that received incision and drainage surgery from Jan 2016 to Dec 2020 was performed at West China Hospital of Stomatology at Sichuan University. Patients were divided into two groups: the group with preoperative CT and without preoperative CT. Outcomes, including reoperation rate, missed diagnosis rate, days of symptom relief, length of stay, duration of surgery, and total cost of hospitalization, were analyzed. Results Out of n = 153 patients, 108 patients underwent surgery with preoperative CT and 45 patients without preoperative CT. The reoperation rate in the preoperative CT group (6/108, 5.6%) was significantly lower (P = 0.00) than that in the group without preoperative CT (10/45, 22.2%). Significant reduction of missed diagnosis rate (P = 0.00), days of symptom relief (P = 0.01), length of stay(P = 0.03), and duration of surgery (P = 0.01) were detected in the preoperative CT group. The results demonstrated that the utilization of preoperative CT can reduce the missed diagnosis rate and repeated surgery complications. Conclusions We recommend preoperative CT as a routine examination in cervicofacial space infections.https://doi.org/10.1186/s12879-022-07545-6CervicofacialInfectionOdontogenicComputed tomographyReoperation
spellingShingle Jiayu Liang
Linli Jiang
Maoye Li
Lei Liu
Hui Li
Should preoperative computed tomography be routine examination for cervicofacial space infections?
BMC Infectious Diseases
Cervicofacial
Infection
Odontogenic
Computed tomography
Reoperation
title Should preoperative computed tomography be routine examination for cervicofacial space infections?
title_full Should preoperative computed tomography be routine examination for cervicofacial space infections?
title_fullStr Should preoperative computed tomography be routine examination for cervicofacial space infections?
title_full_unstemmed Should preoperative computed tomography be routine examination for cervicofacial space infections?
title_short Should preoperative computed tomography be routine examination for cervicofacial space infections?
title_sort should preoperative computed tomography be routine examination for cervicofacial space infections
topic Cervicofacial
Infection
Odontogenic
Computed tomography
Reoperation
url https://doi.org/10.1186/s12879-022-07545-6
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