Pneumatosis in cervical fascial space and necrotizing fasciitis of neck

• Published in: Acta oto-laryngologica 2023-06, Vol.143 (6), p.514-517
• Main Authors: Li, Dajian, Wang, Yan, Song, Xicheng
• Format: Article
• Language: English
• Subjects: aerogenic bacteria; fascia space; infection; neck; Necrotizing fasciitis; pneumatosis
• ISSN: 0001-6489; 1651-2251
• DOI: 10.1080/00016489.2023.2220369

Pneumatosis in the cervical fascial space is a common imaging manifestation of cervical necrotizing fasciitis. At present, although there are some literature reports on pneumatosis in the cervical necrotizing fasciitis, there are few comparative reports. To compare the imaging findings of necrotizing fasciitis of the neck and other cervical space infections, and explore the relationship between pneumatosis in cervical fascial space and necrotizing fasciitis of the neck. A retrospective study was conducted on 56 cases of cervical fascia space infection in our department from May 2015 to March 2021, including 22 cases of necrotizing fasciitis and 34 cases of non-necrotizing fasciitis. 22 cases underwent incision, debridement and catheter drainage in the necrotizing fasciitis group. 26 cases underwent incision, debridement and catheter drainage, and 8 cases underwent ultrasound-guided puncture biopsy and catheter drainage in the non-necrotizing fasciitis group. All cases were confirmed by operation or pathological biopsy and took purulent secretions for bacterial culture and drug sensitivity test during or after operation. All cases were examined by neck CT or MRI before operation. The previous history of surgical incision or puncture and the rupture of cervical space infection were excluded. In 22 cases of necrotizing fasciitis, there were 19 cases had air accumulation in the fascial space (86.4%); In 34 cases of non necrotizing fasciitis, 2 cases had air accumulation in the fascial space (5.9%). There was significant difference between the two groups (χ 2 = 36.9141, p