Morkel, JANgcwama, Yanga2016-08-232024-06-042016-08-232024-06-042015https://hdl.handle.net/10566/15768Magister Scientiae Dentium - MSc(Dent)Purpose: To assess the value of postoperative CT scans in the management of severe cervicofacial infections or deep neck abscesses. Patients and Methods: Thirteen patients underwent post-operative contrast enhanced CT scans after initial incision and drainage followed by a tracheostomy. As per surgical protocol, the CT scans were taken with radiopaque surgical drains in situ from the brain down to the mediastinum and chest/lungs. Data were collected on the presence of abscesses, their location, the location of surgical drains and presence of other pathology. Results: The most common initially affected space was the submandibular space (69%), followed by the submental space (62%). Almost half of the cases studied had two spaces affected and slightly less than a third had three spaces affected. Slightly more than half (54%) of the patients were in good health generally. More than a third (38.5%) of the patients were HIV positive, and thus immuno-compromised. The mean time lapse between the CT and surgery was 2.61 days (SD = 1.56). In the majority (69.23%) of post-operative scans a residual pus collection was found. In just over a quarter (30.8 %) of the patients no residual pus collection was detected on the postoperative CT scan, while in seven patients (53.8%) affected fascial spaces were missed by the surgeon. These spaces included the submasseteric, anteriormediastinum and parotid spaces. Almost half (44.15%) of the patients required a repeatincision and drainage. Conclusion: This study demonstrates clinical value of post-operative CT scans in severe cervicofacial infections. This study also advances the argument for acquisition of preoperative CECT scans for all patients with severe cervicofacial infection.enCervicofacial infectionsDeep neck abscessesComputer tomogram scanUniversity of the Western Cape