RESUMEN
BACKGROUND: Point-of-care-ultrasound can be applied to preview a difficult airway, detect the presence of fluid collection, and soft-tissue edema, and guide the drainage location, although is rarely used. The purpose of this study is to validate a protocol for the assessment of these clinical features on patients with severe odontogenic infections. MATERIAL AND METHODS: This was a single-group prospective cohort study (n=20) including patients with the diagnosis of deep-neck propagation of odontogenic infection. A transcervical linear high-frequency probe transducer (13-6 MHz) was used to scan the structures of the upper airway and the infectious collections. The drainage was guided by ultrasound and the patients were daily evaluated, according to the protocol. The data were extracted and the airway volume, midline deviation, and other important data such as length of hospital stay, dysphagia, voice alteration, raised floor of the mouth, dyspnea, and neck swelling were registered. RESULTS: The ultrasound examination was correlated with multiple clinical findings, such as dyslalia (p=0,069), dysphagia (p=0,028), dyspnea (p=0,001), among others. This protocol has an advantage as it can be used at bedside evaluation, allowing the assessment of severe and unstable patients, and predicting the increase of the hospitalization time (p=0,019). CONCLUSIONS: This protocol is reliable for the assessment of the upper airway, even in an emergency, predicting not only the severity of the clinical features but aids in the determination of the length of the hospitalization time.
Asunto(s)
Odontología , Infecciones , Pruebas en el Punto de Atención , Ultrasonografía , Humanos , Trastornos de Deglución , Disnea , Hospitalización , Cuello/diagnóstico por imagen , Estudios Prospectivos , Control de Infección Dental , Pruebas en el Punto de Atención/normas , Ultrasonografía/normas , Boca/diagnóstico por imagen , Odontología/métodos , Infecciones/diagnóstico por imagenRESUMEN
Penetrating head and face injuries can cause hemorrhages, neurological lesions, visual acuity loss, fractures and facial deformities. This report discusses an injury caused by a knife that penetrated the left orbit and reached the skull base without damaging any important structures. The knife was removed through the entrance wound and no complications were observed either during or after surgery.