Which factors contribute to the complexity of deep neck infections?

Updated: Apr 30, 2020
  • Author: Alan D Murray, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Infections of the deep neck spaces present a challenging problem for the following reasons:

  • Complex anatomy: The anatomy of the deep neck spaces is highly complex and can make precise localization of infections in this region difficult.

  • Deep location: The deep neck spaces are located deep within the neck. This makes diagnosis of infections difficult because they are often covered by a substantial amount of unaffected superficial soft tissue. Deep neck infections may be difficult to palpate and impossible to visualize externally.

  • Access: Superficial tissues must be crossed to gain surgical access to the deep neck spaces, placing all of the intervening neurovascular and soft tissue structures at risk of injury.

  • Proximity: The deep neck spaces are surrounded by a network of structures that may become involved in the inflammatory process. Neural dysfunction, vascular erosion or thrombosis, and osteomyelitis are just a few of the potential sequelae that can occur with involvement of surrounding nerves, vessels, bones, and other soft tissue.

  • Communication: The deep neck spaces have real and potential avenues of communication with each other. Infection in one space can spread to adjacent spaces, thus gaining access to increasingly larger portions of the neck. In addition, certain deep neck spaces extend to other portions of the body (eg, mediastinum, [4] coccyx), placing areas outside of the head and neck at risk of involvement when these spaces are involved.

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