Pattern And Treatment Outcome Of Orofacial Infections In Benin-City, Nigeria

Objectives: To study the presentation of orofacial fascial infections and the outcome of interventions in a tertiary health facility.
Methods: Location and duration: Department of Oral and Maxillofacial Surgery of the University of Benin Teaching Hospital, Benin-City, Nigeria, between January 2019 and September 2019.
Design: This was a prospective interventional study of patients presenting with fascial space infections.
Study population: Consecutive consenting patients in whom a diagnosis of fascial space infection is made. Included were patients with the presence of clinical features supportive of orofacial infections.
Methods of data collections: These include interview, clinical and radiographic examination and patients’ response to treatment.
Ethical considerations: Patient education and information, consent and assent.
Results: The age range of the study population was 14-80 years, mean (SD) was 50(19.4) years. This population was made up of 22(51.2%) and 21(48.8%) females and males, respectively. The symptom complex includes swelling 43(100.0%), pain 36(83.7%), trismus 21(48.8%), fever 9(20.9%), mobile teeth 6(13.9%) and paraesthesia 2(4.6%). The duration complex ranges from 1 day to 21 days, with a mean (SD) of 5(3.3) days. The clinical diagnosis was mostly submandibular space infection (44.2%). Ludwig’s angina was diagnosed in 10(23.3%) cases and one case was diagnosed as necrotizing fasciitis. The most implicated cause was carious teeth, accounting for 35(81.4%) of the cases. Diabetes mellitus was the most associated systemic condition (5, 11.6). Extraction of the involved teeth, incision and drainage with adjuvant antibiotic therapy were the treatment done. Twenty-five of the cases were managed on hospital admission, mean (SD) duration of hospital stay was 4(1.5) days. All cases had satisfactory outcome
Conclusions: Orofacial fascial space infections are common in our environment. Associated medical conditions tend to prolong the clinical course. Early diagnosis and aggressive intervention are required to ensure a satisfactory outcome.