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. 2024 Feb;76(1):168-175.
doi: 10.1007/s12070-023-04119-z. Epub 2023 Aug 10.

Intra-oral Drainage of Submandibular Abscess: A Minimally Invasive Technique. A Prospective Study

Affiliations

Intra-oral Drainage of Submandibular Abscess: A Minimally Invasive Technique. A Prospective Study

Ahmed Amin Nassar et al. Indian J Otolaryngol Head Neck Surg. 2024 Feb.

Abstract

Purpose: To evaluate the efficacy of intraoral drainage of isolated submandibular space abscess as a minimally invasive surgical technique compared to the standard trans-cervical approach.

Patients and methods: This prospective study included 40 subjects with isolated submandibular space abscesses. They were randomly divided into 2 equal groups: trans-cervical surgical drainage (group A) and intra-oral surgical drainage (group B). The included data were demographics, repeated surgery requirement, postsurgical hospitalization duration, formation of scar, and complications.

Results: Intraoral drainage (Group B) reduced the mean operative time by 15.25 min (P < 0.001) compared with trans-cervical incision (Group A). No considerable difference was found between the 2 groups in regarding hospitalization postoperatively. No weakness in marginal mandibular nerve was found in both groups. Three patients only have a cervical scar in a group (B) who required external drainage due to recollection. No recurrence was detected in a group (A).

Conclusion: The current study demonstrated that isolated submandibular abscesses can be successfully managed with an intraoral drainage modality, and it is a better option than the trans-cervical approach regarding better cosmetic outcome and shorter operative time.

Keywords: Abscesses; External approach; Intraoral; Submandibular space.

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Conflict of interest statement

Competing InterestsNone to declare. This study was conducted using the available resources at Cairo University Hospitals. The authors do not have any conflict of interest to declare. No author identifying information is present anywhere in the blinded manuscript.

Figures

Fig. 1
Fig. 1
CECT scan of the neck shows the right submandibular abscess
Fig. 2
Fig. 2
(a) Skin incision site marked 2 fingers below mandible; (b) Skin incision; (c) dividing platysma; (d) Rubber drain inserted after trans-cervical I&D of the left submandibular abscess
Fig. 3
Fig. 3
(a) Preoperative view of left submandibular abscess; (b) Minnesota cheek retractor; (c) Site of intra-oral incision; (d) Intra-oral drainage of the pus; (e) The incision remains open to allow further drainage; (f) Submandibular area after drainage
Fig. 4
Fig. 4
(a) 1st lower molar dental caries as the source of infection; (b) Postoperative dental extraction

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