Core Curriculum Syllabus: Emergencies in Otolaryngology-Head and Neck Surgery
Head and Neck Infections

Treat head and neck infections immediately and aggressively!

Infection can spread to orbit, brain and mediastinum.

• Extension to orbit from ethmoid sinuses can lead to blindness; time course especially rapid in children
• Ear and sinus infections can spread directly and indirectly to brain; in addition infections in central area of face can extend into cavernous sinus
• Extension in neck along fascial planes can result in mediastinitis; expansion can lead to airway compression
• Infection can spread rapidly due to delayed treatment, virulent pathogen or impaired immune competence or combination of above
  • With virulent pathogen like fungus in mucormycosis, blindness and death can occur
  • With strep and staph in necrotizing fasciitis extensive tissue necrosis probable

Treatment

• With neck abscesses, control airway before I&D
• I&D, remove necrotic tissue
• Culture - aerobic, anaerobic, AFB, fungal, special stains
• Use appropriate antibiotic or antifungal agents
• Control associated problems like diabetes mellitus.

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©2001-2006 Baylor College of Medicine
Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery
Mail: One Baylor Plaza, NA102, Houston, TX 77030
Phone: 713-798-5906
E-mail: oto@bcm.edu

Last modified: Jan. 23, 2006