Necrotizing fasciitis of the head and neck: report of 5 cases and review of the literature

N.S. Mastronikolis 1, T. Stathas 1, S.S. Naxakis 1, A. Mallis 1, T. Papadas 1, C. Kalogeropoulou 2, P. Zampakis 2, D. Koukouras 3, P.D. Goumas 1

1 Department of Otorhinolaryngology-Head and Neck Surgery, 2Department of Radiology, and 3 Department of General Surgery, University Hospital of Patras, Patras (Greece)

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• Surgery

Background: Necrotizing fasciitis (NF) is a severe, rapidly spreading soft tissue infection of polymicrobial origin. This condition most frequently affects thorax, abdominal wall, extremities, perineum and groin, but according to recent literature the head and neck area is also involved with increasing frequency.

Patients and Methods: Five cases of head and neck NF were detected among patients who were admitted at the Department of Otorhinolaryngology-Head and Neck Surgery of the University Hospital of Patras, Patras, Greece, over a 5-years period. Various parameters including patients’ health status, co-morbidity, etiology, microbiology, affected area, antibiotic therapy, hospital stay, surgical treatment and complications were considered.

Conclusions: The management of NF should comprise of hemodynamic and respiratory evaluation and monitoring, broad-spectrum i.v. antimicrobial therapy, surgical debridement and nutritional support. Close postoperative management of NF patients remains of paramount importance.

Corresponding Author: Nicholas S. Mastronikolis, MD,PhD; e-mail: nmastr@otenet.gr

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