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Clinical classification of cervical necrotizing fasciitis

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Necrotizing fasciitis of the craniofacial region is a rare and potentially life-threatening bacterial infectious disease. Odontogenic infections primarily spread along facial fascia and subcutaneous tissues, resulting in upper chest skin or thoracic necrosis. The purpose of this clinical classification was to demonstrate clinically important guidelines for early diagnosis and prompt management of CNF.

Methods

Although the incidence of cervical necrotizing fasciitis (CNF) is very rare in many developed countries, prompt management with appropriate initial diagnosis is essential, especially in tropical low-economic rural regions of African countries. Over the last 12 years, our charitable team in West Africa made clinical classifications of CNF according to onset time and spreading pattern to thoracic extension.

Results

CNF patients could be divided into two primary types, limited to neck type and extended to upper chest type. We also further categorized from each type into three different groups according to the CNF onset and clinical characteristics, including acute type with hematogenous spread within 2 weeks, subacute type with suppuration over 2 to 4 weeks, chronic type without suppuration over 4 weeks, multiple type with partial skin necrosis, island type with necrotic skin coverage, and broad type with whole skin necrosis.

Conclusions

These classifications will help decrease the mortality rate in severely infected patients.

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Acknowledgements

This research was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2017R1D1A1B04029339) and a grant of the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI15C0689).

Funding

This study had no funding.

Author information

Authors and Affiliations

  1. Oral and Maxillofacial Microvascular Reconstruction Lab, Ghana Health Service, Brong Ahafo Regional Hospital, P. O. Box 27, Sunyani, Brong Ahafo, Ghana

    Emmanuel Kofi Amponsah, Paul Frimpong & Soung Min Kim

  2. Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea

    Mi Young Eo & Soung Min Kim

  3. Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea

    Suk Keun Lee

Authors
  1. Emmanuel Kofi Amponsah
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  2. Paul Frimpong
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  3. Mi Young Eo
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  4. Soung Min Kim
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  5. Suk Keun Lee
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Corresponding author

Correspondence to Soung Min Kim.

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Conflict of interest

There are no conflicts of interest in this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board at Seoul National University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Amponsah, E.K., Frimpong, P., Eo, M.Y. et al. Clinical classification of cervical necrotizing fasciitis. Eur Arch Otorhinolaryngol 275, 3067–3073 (2018). https://doi.org/10.1007/s00405-018-5155-5

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  • DOI: https://doi.org/10.1007/s00405-018-5155-5

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