Severe Cervicofacial Cellulitis in Pregnancy- A Review of 18 Cases

Document Type : Original

Authors

1 Department of Oral and Maxillofacial Surgery, Bayero University, Kano and Consultant, Oral and Maxillofacial Surgeon, Aminu Kano Teaching Hospital, Kano, Nigeria.

2 Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano.

3 Department of Oral and Maxillofacial Surgery, College of Health Sciences, University of Jos, Plateau state, Nigeria.

Abstract

Introduction:
Cervicofacial cellulitis can be rapidly complicated with a difficult airway when prompt management is not instituted. It may have some serious consequences for developing baby when a pregnant woman is involved. This study presented the experiences gained from the management of cervicofacial cellulitis in pregnant women.
 
Materials and Methods:
The present study was conducted on 18 pregnant women withcervicofacial cellulitis affecting more than one facial space at the presentation in a regional tertiaryhospital within a five-year period (January 2013 to December 2017). The collected information included patient age, clinical diagnosis, number of involved facial spaces, gestational periods, and duration of hospital stay.The collected data were analyzed using SPSS software (version 15.0).
 
Results:
A total of 131 patients with cervicofacial cellulitis were admitted during the study period, out of which 18 patients met the inclusion criteria and were investigated in the present study. These 18 patients were within the age range of 20-43 years with the mean age of 29±7.1 years. There was a statistically significant relationship between the number of fascial spaces involved and duration of hospital stay (P=0.04). All the patients had incision and drainage of the affected facial spaces under local anesthesia with good outcomes.
 
Conclusion:
The prompt management of pregnant women with cervicofacial cellulitis in a multidisciplinary manner is important to ensure uneventful outcomes in the lives of both the pregnant woman and unborn child.
 
 
 

Keywords

References

  1. Patterson H, Kelly JH, Strone M. Ludwig’s angina: An update. Laryngoscope1982;92(4):370-8.
  2. Allen D, Loughnan TE, Ord RA. A re-evaluation of the role of tracheostomy in Ludwig’s angina. J Oral MaxillofacSurg 1985; 43(6):436-9.
  3. Topazian RG, Goldberg MH, Hupp JR. Oral and Maxillofacial Infections. 4th ed. Philadelphia, Pa: W. B. Saunders; 2002.
  4. Gordon MC. Maternal physiology in pregnancy In: Gabbe SG, Niebyl JR, Simpson J (eds). Obstetrics: normal and problem pregnancies, 4th edition New York, Churchill Livingstone, 2002; 63–91.
  5. Gupta AK, Dhulkhed VK, Rudagi BM. Drainage of Ludwigs angina in a pregnant patient under superficial cervical plexus block. Anaesth Pain and Intensive Care 2009; 13 (2):68-70.
  6. Marple BF. Ludwig angina: a review of current airway management. Archives of Otolaryngology – Head and Neck Surgery. 1999; 125(5):596–600.
  7. Tarsitano BF, Rollings RE. The pregnant dental patient: evaluation and management. Gen Dent 1993; 41:226–34 quiz 233-4.
  8. Kurien S, Kattimani VS, Sriram RR, Sriram SK, Rao VKP, Bhupathi A, et al. Management of pregnant patient in dentistry. J Int Oral Health 2013; 5:88–97.
  9. Cheek TG, Gutsche BB. Maternal physiologic alterations during pregnancy. AnesthObstet 1993; 3:1–17.
  10. Naseem M, Khurshid Z, Khan HA, Niazi F, Zohaib S, Zofar MS. Oral health challenges in pregnant women: Recommendations for dental care professionals. The Saudi Journal for Dental Research 2016; 7: 138-46.
  11. López NJ, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: A randomized controlled trial. J Periodontol 2002; 73:911‑
  12. Jarjoura K, Devine PC, Perez‑Delboy A, Herrera‑Abreu M, D’Alton M, Papapanou PN. Markers of periodontal infection and preterm birth. Am J ObstetGynecol 2005; 192:513‑
  13. Lawrenz DR, Whitley BD, Helfrick JF. Considerations in the management of maxillofacial infections in the pregnant patient. J Oral MaxillofacSurg 1996; 54:474‑
  14. Giglio JA, Lanni SM, Laskin DM, Giglio NW. Oral health care for the pregnant patient. J Can Dent Assoc 2009; 75:43–8.
  15. Wong D, Cheng A, Kunchur R, Lam S, Sambrook PJ, Goss AN. Management of severe odontogenic infections in pregnancy. Australian Dental Journal 2012; 57: 498-503.
  16. Doumbia-Singare K, Timbo S.K, Keita M, Mohamed A, Guindo B, Soumaor S.Cervico-facial cellulitis during pregnancy: about a series of 10 cases in Mali Bull. Soc. Pathol. Exot 2014;107:
    312-16.
  17. Fomete B, Agbara R, Osunde DO, Ononiwu CN. Cervicofacial infection in a Nigerian tertiary health institution: a retrospective analysis of 77 cases. J Korean Assoc Oral Maxillofac Surg. 2015; 41(6):293-8.
  18. Osunde OD, Bassey GO, Ver-or N. Management of Ludwig’s Angina in Pregnancy: A Review of 10 Cases. Annals of Medical and Health Science Research 2014; 41 (3): 361-4.
  19. Celebi N, Kutuk MS, Tas M, Soylu E, Etoz OA, Alkan A. Acute foetal distress following tooth extraction and abcess drainage in a pregnant patient with maxillofacial infection. Australian Dental Jouurnal 2013; 58: 117-19.
  20. Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG 2006; 113:135–43.
  21. Wazir S, Khan M, Mansoor N, Wazir A. Odontogenic Fascial Space Infections in Ppregnancy – A study. Pak Oral Dent J 2013; 33(1):17-22.
  22. Moorhead K, Guiahi M. Pregnancy complicated by Ludwigs angina requiring delivery. Infectious Diseases in Obstetrics and Gynaecology 2010; 1: 1-3.
  23. Hought RT, Fitzgerald BE, Latta JE, Zallen RD: Ludwig’s angina: A report of two cases and review of the literature from 1945 to January 1979. J Oral Surg1980;38: 849-55.
  24. Snow N, Lucas AE, Grau M, Steiner M: Purulent mediastinal abscess secondary to Ludwig’s angina. Arch Otolaryngol 1983;109: 53-5.
  25. Penelope AR, Jerry W. Farr’s physics for Medical Imaging. Saunders Elsevier. Second Edition page 26.
  26. Giglio JA, Lanni SM, Laskin DM, Giglio NW. Oral health care for the pregnant patient. J Can Dent Assoc 2009; 75:43–8.
  27. Czeizel AE, Pataki T, Rockenbauer M. Reproductive outcome after exposure to surgery under anesthesia during pregnancy. Arch GynecolObstet 1998; 261: 193–9.
  28. Nickoloff E, Alderson P. Radiation exposure to patients from CT: reality, public perception, and policy. AJR Am J Roentgenol 2001; 177: 285–7.

 

 

 

Iranian Journal of Otorhinolaryngology
Volume 32, Issue 2
March and April 2020
Pages 93-100

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