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Comparison of the sensitivity of lateral neck radiographs and computed tomography scanning in pediatric deep‐neck infections
Author(s) -
Nagy Mark,
Backstrom James
Publication year - 1999
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199905000-00017
Subject(s) - medicine , radiography , radiology , dysphagia , neck mass , computed tomography , retrospective cohort study , presentation (obstetrics) , surgery
Objective : To compare the sensitivity of lateral neck films and computed tomography (CT) scanning with contrast in evaluating children with a high index of suspicion for a deep‐neck infection, either retropharyngeal, parapharyngeal, or combined based in clinical presentation. Study Design : A retrospective chart review of children presenting to the Children's Hospital of Buffalo, New York, with the diagnosis of a deep‐neck infection between January 1991 and November 1997 was conducted. In total, 57 children were included in the study, ranging in age from 12 to 119 months (1–10 y). Methods : Charts were reviewed for presenting signs, symptoms, and laboratory values and included only those children with the presence of fever, limited neck range of motion, a lateral neck mass, dysphagia, and a leukocyte count greater than 15,000 cells/mm 3 . Results of lateral neck radiographs and CT scanning with contrast were evaluated and compared when available. Results : Lateral neck radiographs were found to have a sensitivity of 83% for determining the presence of a pediatric deep‐neck infection, whereas CT scanning with contrast had a sensitivity of 100%. Conclusion : Lateral neck radiographs were found to offer no benefit in the workup of children strongly suspected of having a deep‐neck infection based on clinical presentation. Despite the higher cost, CT scanning with contrast is the recommended radiologic test in such cases. This single study allows the determination of size, type, and location of the infectious process and is invaluable in treatment planning for pediatric patients with infection in deep‐neck spaces.