Ultrasound protocol in odontogenic infections: a new proposal

• Samuel Macedo Costa ^[1] ; Bruna Campos Ribeiro ^[1] ; Alessandro Oliveira de-Jesus ^[2] ; Gustavo Rezende Libanio ^[3] ; Roger Lanes-Silveira ^[4] ; Marcio Bruno Figueiredo Amaral ^[5]
  1. [1] Universidade de São Paulo

     Universidade de São Paulo

     Brasil

     
  2. [2] Orcid: 0000-0003-1858-1096. DDS, MSC, OMFS, FBCOMS. Resident of the Oral and Maxillofacial Surgery Service of the João XXIII Hospital/ Hospitalar Foundation of Minas Gerais, Belo Horizonte, Brazil
  3. [3] Orcid: 0000-0003-1983-6716. DDS, MSC, OMFS. Chief of the Oral and Maxillofacial Surgery Service of the João XXIII Hospital/ Hospitalar Foundation of Minas Gerais, Belo Horizonte, Brazil
  4. [4] Orcid: 0000-0003-2907-8066. DDS, MD, OMFS, PhD. Professor of the Oral and Maxillofacial Surgery Service of the João XXIII Hospital/ Hospitalar Foundation of Minas Gerais, Belo Horizonte, Brazil
  5. [5] Orcid: 0000-0003-0350-5170. DDS, OMFS, Ph.D. Head of the Oral and Maxillofacial Surgery Residency Service of the João XXIII Hospital/ Hospitalar Foundation of Minas Gerais, Belo Horizonte, Brazil

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 28, Nº. 1 (January), 2023
• Idioma: inglés
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• Resumen

  • Point-of-care-ultrasound can be applied to preview a difficult airway, detect the presence of fluid collection, and soft-tissue edema, and guide the drainage location, although is rarely used. The purpose of this study is to validate a protocol for the assessment of these clinical features on patients with severe odontogenic infections.

    This was a single-group prospective cohort study (n=20) including patients with the diagnosis of deep-neck propagation of odontogenic infection. A transcervical linear high-frequency probe transducer (13-6 MHz) was used to scan the structures of the upper airway and the infectious collections. The drainage was guided by ultrasound and the patients were daily evaluated, according to the protocol. The data were extracted and the airway volume, midline deviation, and other important data such as length of hospital stay, dysphagia, voice alteration, raised floor of the mouth, dyspnea, and neck swelling were registered.

    The ultrasound examination was correlated with multiple clinical findings, such as dyslalia (p=0,069), dysphagia (p=0,028), dyspnea (p=0,001), among others. This protocol has an advantage as it can be used at bedside evaluation, allowing the assessment of severe and unsTable patients, and predicting the increase of the hospitalization time (p=0,019).

    This protocol is reliable for the assessment of the upper airway, even in an emergency, predicting not only the severity of the clinical features but aids in the determination of the length of the hospitalization time.