Necrotizing fasciitis as a complication of odontogenic infection: a review of management and case series.

BACKGROUND: The aims of the present study were to establish the incidence of head and neck necrotizing fasciitis (NF) in the Adelaide Oral and Maxillofacial Surgery Unit; review the current literature regarding the management of head and neck NF; and determine the evidence for the role of hyperbaric oxygen therapy in the management of NF. METHODS: A retrospective audit of all patients admitted to the Royal Adelaide Hospital Oral and Maxillofacial Surgery Unit 2006-2015 with severe odontogenic infections was carried out. Patient demographics were recorded and treatment details were collected and analysed. RESULTS: A total of 672 patients were admitted for management of severe odontogenic infections. Of these, three were identified as NF. One case was treated using hyperbaric oxygen as an adjunct to conventional surgical and medical management. Two cases were managed using aggressive surgical management alone. Two patients survived. The incidence of head and neck NF in South Australia is 48/100 000 infections per year. CONCLUSIONS: The first-line treatment of severe odontogenic infections remains conventional surgical and medical management; however, hyperbaric oxygen therapy may have an additional role in the management of NF and other rare severe infections in medically complex patients.

Deep neck infections: clinical considerations in aggressive disease.

Deep neck infections are common and occur as a consequence of several etiologies. Antibiotic therapy, interventional radiology, and patient support modalities have become increasingly sophisticated, although surgery continues to be the mainstay of treatment for most patients. Today, neck infections are rarely life threatening when sound and timely management is applied.

[The prevention and treatment of patients with suppurative-inflammatory diseases of the maxillofacial area by using vibromassage at autoresonance frequencies]. / Profilaktika i lechenie bol'nykh s gnoino-vospalitel'nymi zabolevaniiami cheliustno-litsevoi oblasti s primeneniem vibromassazha na autorezonansnykh chastotakh.

Autoresonance frequency vibromassage sessions were administered to patients with pyoinflammatory processes in maxillofacial soft tissues. Comprehensive examinations of these patients were carried out to assess the efficacy of this treatment modality; the examinations included rheographic and ultrasonic examinations of blood flow intensity, analysis of neutrophilic activity by chemiluminescence amplitude, measurements of trypsin inhibitor levels and cholinesterase activity, assessment of wound exudate pH values and of resorption capacity of purulent wound tissues. Microbiologic, histologic, cytologic, clinical and biochemical studies were carried out. The findings permit a conclusion that autoresonance vibromassage enhanced biologic purification of the wound from pyonecrotic mass and accelerated reparative regeneration.

[The mechanism of the action of UV-irradiated autotransfusions in treating patients with suppurative-inflammatory diseases of the face and neck]. / O mekhanizme deistviia transfuzii UFO-autokrovi pri lechenii bol'nykh s gnoino-vospalitel'nymi zabolevaniiami litsa i shei.

An analysis of examination and treatment of 36 patients with acute pyo-inflammatory diseases of face and neck has shown the inclusion of UV-irradiated autotransfusions into the complex of therapeutic measures to decrease blood viscosity and to increase deformability of erythrocytes. It elevates the intensity of blood circulation in the system of macro- and microcirculation. The increased arteriovenous oxygen difference after UV-irradiated autotransfusions points to improved utilization of tissue blood and enhanced bioenergetic processes.

[Critical observations on "focal loci"]. / Kritische Bemerkungen zum "Herdgeschehen".

Adherents of methods not based on scientific proof, especially the disciples of Huneke's "neural therapy", believe not only that foci represent local lesions, but also that they may cause remote effects. Therefore, in the opinion of these physicians, foci should be regarded as "fields of disturbance" with regulatory consequences, as described by Huneke and Pischinger. Thus when the diagnosis is in doubt, such "zones of interference" are searched for using function tests which are much in dispute. The most important of these "tests" are: electroacupuncture (Voll), the electro focus test (Glaser-Türk and Türk), neural therapy (Huneke) and thermoregulation (Schwamm). Moreover, it should be remembered that the adherents of the above-mentioned methods, on the basis of diagnoses worked out by the above techniques, will "cure" these foci, a serious matter. It is, therefore, recommended, that medical societies and medical and arbitration boards pay attention to this problem which also concerns unqualified practitioners. The results of such efforts should be published for the information of patients, doctors and insurance companies.