A nationwide survey of dysphagia as a complication of deep neck infection with abscess in Japan

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Auris Nasus Larynx Pub Date : 2025-02-01 DOI:10.1016/j.anl.2024.12.009

Rina Kato , Ryota Iinuma , Hiroshi Hidaka , Kenichi Mori , Hirofumi Shibata , Hiroshi Okuda , Kosuke Terazawa , Natsuko Obara , Yukio Katori , Takenori Ogawa

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Abstract

Objective

Deep neck infection with abscess (DNI) may cause dysphagia as a late complication. This study aimed to determine the rate of DNI related dysphagia (DNIRD) and the effectiveness of rehabilitation and surgery for DNIRD.

Methods

As a multicenter retrospective study, we conducted a nationwide survey by sending questionnaires to specialist training institutions certified by the Japan Broncho-esophagological Society (JBES). The questionnaire was sent to 227 facilities. This survey targeted patients with DNI aged 20 years or older who were hospitalized after April 1, 2011 and discharged by March 31, 2021.

Results

Of the 1058 cases of DNI included in this study, DNIRD was observed in 161 of 1058 patients (15.2 %). Of the 1058 cases of DNI, 139 cases showed descending necrotizing mediastinitis (DNM) (13.1 %), and DNIRD was observed in 64 of the DNM cases (46 %). DNIRD cases tended to be older (71 ± 13.5 vs. 64 ± 17.7 years old, p < 0.001), have a higher tracheostomy rate (91.3 % vs. 43.7 %, p < 0.0001), and have a longer hospital stay (51 ± 34.7 vs. 17 ± 15.4 days, p < 0.0001) than non-DNIRD cases. There were 125 cases in which only rehabilitation was performed, 8 cases in which surgery was performed to improve swallowing function, and 28 cases in which the natural course was observed. The improvement rates of DNIRD in the natural history group, rehabilitation group, and surgery group were 78.6 %, 91.8 %, and 100 %, respectively, and the rehabilitation group tended to improve more than the natural course group (p = 0.08).

Conclusion

This nationwide survey revealed that 15.2 % of patients with DNI resulted in DNIRD and that 46 % of descending necrotizing mediastinitis patients developed DNIRD. Rehabilitation for DNIRD is generally useful, and that additional surgical treatment can improve outcomes for DNIRD patients where rehabilitation alone is not effective.

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来源期刊

Auris Nasus Larynx 医学-耳鼻喉科学

CiteScore

3.40

自引率

5.90%

发文量

169

审稿时长

30 days

期刊介绍： The international journal Auris Nasus Larynx provides the opportunity for rapid, carefully reviewed publications concerning the fundamental and clinical aspects of otorhinolaryngology and related fields. This includes otology, neurotology, bronchoesophagology, laryngology, rhinology, allergology, head and neck medicine and oncologic surgery, maxillofacial and plastic surgery, audiology, speech science. Original papers, short communications and original case reports can be submitted. Reviews on recent developments are invited regularly and Letters to the Editor commenting on papers or any aspect of Auris Nasus Larynx are welcomed. Founded in 1973 and previously published by the Society for Promotion of International Otorhinolaryngology, the journal is now the official English-language journal of the Oto-Rhino-Laryngological Society of Japan, Inc. The aim of its new international Editorial Board is to make Auris Nasus Larynx an international forum for high quality research and clinical sciences.