Skip to main content
SpringerLink
Log in

Imaging of Neck and Facial Infections

  • Living reference work entry
  • Latest version View entry history
  • First Online:
Atlas of Emergency Imaging from Head-to-Toe

  • 23 Accesses

Abstract

Acute infections in the face and neck can range from minor illnesses to life-threatening surgical emergencies with substantial morbidity and mortality. The cervicofacial soft tissues are compartmentalized in closely approximated spaces such that, despite fascial barriers, there is a high risk for trans-spatial spread with potentially dire consequences. Management relies heavily on understanding not only the anatomic detail but also on the etiopathogenesis and host factors. Delayed or inappropriate management can lead to potentially life-threatening complications. Moreover, the infection can have overlapping features with both neoplasm and chronic inflammation in the face and neck. Thus, systematic analysis of structures in the face/neck is critical for accurate and timely diagnosis. Focused attention on three specific elements – anatomic location of the abnormality (source), the region or compartment in which the abnormality dwells (space), and extent of the abnormality (spread) – can aid in the timely diagnosis, detection of complications, and guidance to appropriate management. In this chapter, we present a systematic approach to analyzing commonly encountered face and neck infections with emphasis on the complex interactions between source, space, and pathways of spread.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Rana RS, Moonis G. Head and neck infection and inflammation. Radiol Clin N Am. 2011;49:165–82.

    Article  PubMed  Google Scholar 

  2. Chalifoux JR, Vachha B, Moonis G. Imaging of head and neck infections: diagnostic considerations, potential mimics, and clinical management. Semin Roentgenol. 2017;52:10–6.

    Article  PubMed  Google Scholar 

  3. Osborn TM, Assael LA, Bell RB. Deep space neck infection: principles of surgical management. Oral Maxillofac Surg Clin N Am. 2008;20:353–65.

    Article  Google Scholar 

  4. Horváth T, Horváth B, Varga Z, Liktor B Jr, Szabadka H, Csákó L, et al. Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases. Eur Arch Otorhinolaryngol. 2015;272:3469–74.

    Article  PubMed  Google Scholar 

  5. Kauffmann P, Cordesmeyer R, Tröltzsch M, Sömmer C, Laskawi R. Deep neck infections: a single-center analysis of 63 cases. Med Oral Patol Oral Cir Bucal. 2017;22:e536–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Ogle OE. Odontogenic Infections. Dent Clin N Am. 2017;61:235–52.

    Article  PubMed  Google Scholar 

  7. Sánchez R, Mirada E, Arias J, Paño J-R, Burgueño M. Severe odontogenic infections: epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal. 2011;16:e670–6.

    Article  PubMed  Google Scholar 

  8. Whyte A, Boeddinghaus R. Imaging of odontogenic sinusitis. Clin Radiol. 2019;74:503–16.

    Article  CAS  PubMed  Google Scholar 

  9. Simuntis R, Kubilius R, Vaitkus S. Odontogenic maxillary sinusitis: a review. Stomatologija. 2014;16:39–43.

    PubMed  Google Scholar 

  10. McCarty JL, David RM, Lensing SY, Samant RS, Kumar M, Van Hemert RL, et al. Root cause analysis: an examination of odontogenic origins of acute maxillary sinusitis in both immunocompetent & immunocompromised patients. J Comput Assist Tomogr. 2017;41:484–8.

    Article  PubMed  Google Scholar 

  11. Matsumoto Y, Ikeda T, Yokoi H, Kohno N. Association between odontogenic infections and unilateral sinus opacification. Auris Nasus Larynx. 2015;42:288–93.

    Article  PubMed  Google Scholar 

  12. Craig JR, Tataryn RW, Aghaloo TL, Pokorny AT, Gray ST, Mattos JL, et al. Management of odontogenic sinusitis: multidisciplinary consensus statement. Int Forum Allergy Rhinol. 2020; https://doi.org/10.1002/alr.22598.

  13. Marple BF. Ludwig angina: a review of current airway management. Arch Otolaryngol Head Neck Surg. 1999;125:596–9.

    Article  CAS  PubMed  Google Scholar 

  14. An J, Madeo J, Singhal M. Ludwig Angina. StatPearls. Treasure Island: StatPearls Publishing; 2019.

    Google Scholar 

  15. DeBoer DL, Kwon E. Acute Sinusitis. StatPearls. Treasure Island: StatPearls Publishing; 2020.

    Google Scholar 

  16. Velayudhan V, Chaudhry ZA, Smoker WRK, Shinder R, Reede DL. Imaging of intracranial and orbital complications of sinusitis and atypical sinus infection: what the radiologist needs to know. Curr Probl Diagn Radiol. 2017;46:441–51.

    Article  PubMed  Google Scholar 

  17. Lipschitz N, Yakirevitch A, Sagiv D, Migirov L, Talmi YP, Wolf M, et al. Nasal vestibulitis: etiology, risk factors, and clinical characteristics: a retrospective study of 118 cases. Diagn Microbiol Infect Dis. 2017;89:131–4.

    Article  PubMed  Google Scholar 

  18. Shekhrajka N, Moonis G. Imaging of nontraumatic temporal bone emergencies. Semin Ultrasound CT M. 2019;40:116–24.

    Article  Google Scholar 

  19. Ren Y, Sethi RKV, Stankovic KM. Acute otitis media and associated complications in united states emergency departments. Otol Neurotol. 2018;39:1005–11.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lepore ML, Hogan CJ, Geiger Z. Bezold Abscess. StatPearls. Treasure Island: StatPearls Publishing; 2020.

    Google Scholar 

  21. Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L. Modern management of obstructive salivary diseases. Acta Otorhinolaryngol Ital. 2007;27:161–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Williams MF. Sialolithiasis. Otolaryngol Clin N Am. 1999;32:819–34.

    Article  CAS  Google Scholar 

  23. Ogle OE. Salivary gland diseases. Dent Clin N Am. 2020;64:87–104.

    Article  PubMed  Google Scholar 

  24. Watanabe H, Odagiri T, Asai Y. Incidence of acute suppurative sialadenitis in end-stage cancer patients: a retrospective observational study. J Pain Symptom Manag. 2018;55:1546–9.

    Article  Google Scholar 

  25. Papadopoulou-Alataki E, Dogantzis P, Chatziavramidis A, Alataki S, Karananou P, Chiona K, et al. Juvenile recurrent parotitis: the role of sialendoscopy. Int J Inflam. 2019;2019:7278907.

    PubMed  PubMed Central  Google Scholar 

  26. Abdel Razek AAK, Mukherji S. Imaging of sialadenitis. Neuroradiol J. 2017;30:205–15.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Johnston JJ, Douglas R. Adenotonsillar microbiome: an update. Postgrad Med J. 2018;94:398–403.

    Article  PubMed  Google Scholar 

  28. Sunnergren O, Swanberg J, Mölstad S. Incidence, microbiology and clinical history of peritonsillar abscesses. Scand J Infect Dis. 2008;40:752–5.

    Article  PubMed  Google Scholar 

  29. Ali SA, Kovatch KJ, Smith J, Bellile EL, Hanks JE, Truesdale CM, et al. Predictors of intratonsillar versus peritonsillar abscess: a case-control series. Laryngoscope. 2019;129:1354–9.

    Article  PubMed  Google Scholar 

  30. Sanmark E, Wikstén J, Välimaa H, Aaltonen L-M, Ilmarinen T, Blomgren K. Peritonsillar abscess may not always be a complication of acute tonsillitis: a prospective cohort study. PLoS One. 2020;15:e0228122.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Sykes EA, Wu V, Beyea MM, Simpson MTW, Beyea JA. Pharyngitis: approach to diagnosis and treatment. Can Fam Physician. 2020;66:251–7.

    PubMed  PubMed Central  Google Scholar 

  32. Moretti M, De Geyter D, Goethal L, Allard SD. Lemierre’s syndrome in adulthood, a case report and systematic review. Acta Clin Belg. 2020:1–11.

    Google Scholar 

  33. Mnatsakanian A, Minutello K, Bordoni B. Anatomy, head and neck, retropharyngeal space. StatPearls. Treasure Island: StatPearls Publishing; 2020.

    Google Scholar 

  34. Sepúlveda A, Sastre N. Necrotizing fasciitis of the face and neck. Plast Reconstr Surg. 1998:814–7. https://doi.org/10.1097/00006534-199809030-00028.

  35. Lin C, Yeh F-L, Lin J-T, Ma H, Hwang C-H, Shen B-H, et al. Necrotizing fasciitis of the head and neck: an analysis of 47 cases. Plast Reconstr Surg. 2001:1684–93. https://doi.org/10.1097/00006534-200106000-00008.

  36. Gunaratne DA, Tseros EA, Hasan Z, Kudpaje AS, Suruliraj A, Smith MC, et al. Cervical necrotizing fasciitis: systematic review and analysis of 1235 reported cases from the literature. Head Neck. 2018;40:2094–102.

    Article  PubMed  Google Scholar 

  37. Zacharias N. Diagnosis of necrotizing soft tissue infections by computed tomography. Arch Surg. 2010:452. https://doi.org/10.1001/archsurg.2010.50.

  38. Ibrahim M, Hammoud K, Maheshwari M, Pandya A. Congenital cystic lesions of the head and neck. Neuroimag Clin N Am. 2011;21:621–39. viii

    Article  Google Scholar 

  39. Koeller KK, Alamo L, Adair CF, Smirniotopoulos JG. Congenital cystic masses of the neck: radiologic-pathologic correlation. Radiographics. 1999;19:121–46. quiz 152–3

    Article  CAS  PubMed  Google Scholar 

  40. Branchial cysts, and other essays on surgical subjects in the facio-cervical region. By Hamilton Bailey, F.R.C.S., Surgeon to the Dudley Road Hospital, Birmingham, etc. Crown 8vo. Pp. 86 viii, with 50 illustrations. 1929. London: H. K. Lewis & Co. Ltd. 5s. net. Br J Surg. 1929. pp. 362–362. https://doi.org/10.1002/bjs.1800176648

  41. Work WP. Newer concepts of first branchial cleft defects. Laryngoscope. 1972;82:1581–93.

    Article  CAS  PubMed  Google Scholar 

  42. Alkire BC, Juliano AF, Hartnick CJ. Neck mass in an adolescent male. Bilateral branchial anomalies of the pyriform sinus. JAMA Otolaryngol Head Neck Surg. 2014;140:275–6.

    Article  PubMed  Google Scholar 

  43. Nicoucar K, Giger R, Pope HG Jr, Jaecklin T, Dulguerov P. Management of congenital fourth branchial arch anomalies: a review and analysis of published cases. J Pediatr Surg. 2009;44:1432–9.

    Article  PubMed  Google Scholar 

  44. Park SW, Han MH, Sung MH, Kim IO, Kim KH, Chang KH, et al. Neck infection associated with pyriform sinus fistula: imaging findings. AJNR Am J Neuroradiol. 2000;21:817–22.

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Miller D, Hill JL, Sun CC, O’Brien DS, Haller JA Jr. The diagnosis and management of pyriform sinus fistulae in infants and young children. J Pediatr Surg. 1983;18:377–81.

    Article  CAS  PubMed  Google Scholar 

  46. Li Y, Lyu K, Wen Y, Xu Y, Wei F, Tang H, et al. Third or fourth branchial pouch sinus lesions: a case series and management algorithm. J Otolaryngol Head Neck Surg. 2019;48:61.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Allard RH. The thyroglossal cyst. Head Neck Surg. 1982;5:134–46.

    Article  CAS  PubMed  Google Scholar 

  48. Gioacchini FM, Alicandri-Ciufelli M, Kaleci S, Magliulo G, Presutti L, Re M. Clinical presentation and treatment outcomes of thyroglossal duct cysts: a systematic review. Int J Oral Maxillofac Surg. 2015;44:119–26.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Houston Methodist Hospital, Houston Radiology Associated, Houston, USA

    Prachi Dubey

  2. Massachusetts Eye and Ear, Harvard Medical School, Boston, USA

    Amy Juliano

  3. New York University Langone Health, NYU Grossman School of Medicine, New York City, USA

    Gul Moonis

Authors
  1. Prachi Dubey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amy Juliano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gul Moonis
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Radiology, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada

    Michael N Patlas

  2. Department of Radiology, NYU Winthrop Hospital, Mineola, NY, USA

    Douglas S. Katz

  3. Department of Radiology, Pineta Grande Hospital, Castel Volturno, Italy

    Mariano Scaglione

Section Editor information

  1. Department of Diagnostic Imaging, Ottawa Hospital Research Institute OHRI, Ottawa, Ontario, Canada

    Carlos Torres

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Dubey, P., Juliano, A., Moonis, G. (2022). Imaging of Neck and Facial Infections. In: Patlas, M.N., Katz, D.S., Scaglione, M. (eds) Atlas of Emergency Imaging from Head-to-Toe. Springer, Cham. https://doi.org/10.1007/978-3-030-44092-3_12-2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-44092-3_12-2

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44092-3

  • Online ISBN: 978-3-030-44092-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Chapter history

  1. Latest

    Imaging of Neck and Facial Infections
    Published:
    04 March 2022

    DOI: https://doi.org/10.1007/978-3-030-44092-3_12-2

  2. Original

    Imaging of Neck and Facial Infections
    Published:
    23 December 2021

    DOI: https://doi.org/10.1007/978-3-030-44092-3_12-1

Search

Navigation