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The Assessment and Management of Deep Neck Space Infections: a Systematic Review and Qualitative Evidence Synthesis
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  • Zain Sheikh,
  • Beverley Yu,
  • Emily Heywood,
  • Natasha Quraishi,
  • Shahed Quraishi
Zain Sheikh
The University of Sheffield Medical School
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Beverley Yu
Sheffield Teaching Hospitals NHS Foundation Trust
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Emily Heywood
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
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Natasha Quraishi
Doncaster Royal Infirmary
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Shahed Quraishi
Doncaster Royal Infirmary
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Abstract

Objectives To summarise current practices in the diagnosis and management of Deep Neck Space Infections (DNSIs) To inform future studies in developing a framework in the management of DNSIs Design This review was registered on PROSPERO (CRD42021226449) and reported in line with PRISMA guidelines. All studies from 2000 that reported the investigation or management of DNSI were included. The search was limited to English language only. Databases searched included AMED, Embase, Medline and HMIC. Quantitative analysis was undertaken with descriptive statistics and frequency synthesis with 2 independent reviewers. A qualitative narrative synthesis was conducted using a thematic analysis approach. Setting Secondary or Tertiary Care centres that undertook management of Deep Neck Space Infections. Participants All adult patients with a deep neck space infection. Main outcome measures The role of imaging, radiologically guided aspiration and surgical drainage in DNSIs. Results 60 studies were reviewed. 31 studies reported on imaging modality, 51 studies reported treatment modality. Aside from a single RCT all other studies were observational (n=25) or case series (n=36). CT was used to diagnose DNSI in 78% of patients, Mean percentage of management with open surgical drainage was 81% and 29.4% for radiologically guided aspiration. Qualitative analysis identified 7 major themes were identified on DNSI. Conclusion There are limited methodologically rigorous studies investigating DNSIs. CT imaging was the most used imaging modality. Surgical drainage was commonest treatment choice. Areas of further research on epidemiology, reporting guidelines and management are required.
30 Jun 2022Submitted to Clinical Otolaryngology
01 Jul 2022Assigned to Editor
01 Jul 2022Submission Checks Completed
04 Jul 2022Reviewer(s) Assigned