Conservative management of deep neck abscesses in adults: the importance of CECT findings

OBJECTIVES: To review cases of DNAs with special emphasis on contrast-enhanced computed tomography (CECT) findings and their implications for treatment planning. STUDY DESIGN AND SETTINGS: Retrospective evaluation of adult patient records with diagnosis of DNAs on CECT at Treviso Regional Hospital. RESULTS: Eighty patients were identified. In 30.0% of cases, an immediate surgical drainage was performed. In 22.5% of cases, a surgical drainage was necessary because of the lack of clinical response to medical therapy alone. Almost half of the patients were treated with antibiotics alone with complete remission. DM was predictive for lack of response to medical therapy alone (P=0.014). Intraoperative findings confirmed the CECT diagnosis in 88.1%. CONCLUSIONS: Although the mainstay of treatment for deep neck abscesses remains surgical drainage, small abscesses can respond to antibiotics alone. CECT monitoring of DNAs was the essential steps in choosing the more appropriate treatment and, probably, the basis for the good prognosis of patients.