Abstract
Purpose
This study aimed to determine if there is a relation between odontogenic infection severity score (OISS) and difficult intubation at the time of surgical treatment for severe odontogenic infections (SOI). A secondary goal of this study was to determine the utility of OISS as a predictor of difficult intubations.
Methods
This retrospective cohort study was composed of consecutive patients admitted and surgically treated in the operating room (OR) for SOIs. Patients with an OISS ≥ 5 were designated as Group 1 and < 5 Group 2.
Results
There was a statistically significant difference in difficult intubations between the two groups (p = 0.018). Patients with an OISS ≥ 5 were nearly four times more likely to be difficult intubations compared to patients with an OISS < 5 (OR 3.70, 95% CI 1.19–11.45). When OISS ≥ 5 was used to predict difficult intubation, the sensitivity was 69%, the specificity was 63%, the positive predictive value was 23%, and the negative predictive value was 93%.
Conclusion
OISS ≥ 5 was associated with a higher prevalence of difficult intubations compared to an OISS < 5. OISS may provide clinically relevant data that can be used with established risk factors, laboratory values, and clinical judgment.
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References
Ogle OE (2017) Odontogenic infections. Dent Clin N Am 61:235
Opitz D, Camerer C, Camerer DM et al (2015) Incidence and management of severe odontogenic infections-A retrospective analysis from 2004 to 2011. J Craniomaxillofac Surg 43:285
Farmahan S, Tuopar D, Ameerally P et al (2014) Microbiological examination and antibiotic sensitivity of infections in the head and neck: Has anything changed? Br J Oral Surg 52:632
Boscolo-Rizzo P, Stellin M, Muzzi E et al (2012) Deep neck infections: A study of 365 cases highlighting recommendations for management and treatment. Eur Arch Otorhinolaryngol 269:1241
Jevon P, Abdelrahman A, Pigadas N (2020) Management of odontogenic infections and sepsis: an update. Br Dent J 229(6):363–370
Chen SJ, Ji N, Chen YX, Zhao SJ et al (2015) Management and maintenance of the airway in cervical necrotizing fasciitis: a retrospective analysis of 15 cases. Br J Oral Maxillofac Surg 53(7):642–646
Nouruzi-Sedeh P, Schumann M, Groeben H (2009) Laryngoscopy via macintosh blade versus glidescope: success rate and time for endotracheal intubation in untrained medical personnel. Anesthesiology 110:32–37
Rosenstock CV, Thøgersen B, Afshari A et al (2012) Awake fiberoptic or awake video laryngoscopic tracheal intubation in patients with anticipated difficult airway management: a randomized clinical trial. Anesthesiology 116(6):1210–1216
Tuzuner-Oncul AM, Kucukyavuz Z (2008) Prevalence and prediction of difficult intubation in maxillofacial surgery patients. J Oral Maxillofac Surg 66:1652–1658
Riekert M, Kreppel M, Zöller JE et al (2019) Severe odontogenic deep neck space infection: risk factors for difficult airways and ICU admissions. Oral Maxillofac Surg 23:331–336
Flynn TR, Shanti RM, Levi MH et al (2006) Severe odontogenic infections, Part 1: prospective report. J Oral Maxillofac Surg 64(7):1093–1103
Flynn TR, Shanti RM, Levi MH et al (2006) Severe odontogenic infections, Part 2: prospective report. J Oral Maxillofac Surg 64(7):1104–1113
Apfelbaum JL, Hagberg CA, Connis RT et al (2022) 2022 American society of anesthesiologists practice guidelines for management of the difficult airway. Anesthesiology 136:31–81
Neal TW, Hammad Y, Carr BR et al (2022) Assessment of pro re nata inpatient opioid consumption following surgical treatment of severe odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol 134(2):159–162
Neal TW, Hammad Y, Carr BR et al (2022) The cost of surgically treated severe odontogenic infections: a retrospective study using severity scores. J Oral Maxillofac Surg 80(5):897–901
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Timothy W. Neal and Brian R. Carr. The first draft of the manuscript was written by Timothy W. Neal and Brian R. Carr. All authors commented on previous versions of the manuscript. Final approval and editing was completed by the senior author Thomas Schlieve. All authors read and approved the final manuscript.
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This is a retrospective study. This study was granted exemption by our institution’s review board with confirmation that no ethics approval is required.
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No consent to participate/publish was required given the retrospective nature of this study. Waiver from our institution’s review board was obtained.
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Neal, T.W., Carr, B.R. & Schlieve, T. Are higher odontogenic infection severity scores associated with difficult intubations?. Oral Maxillofac Surg 28, 435–440 (2024). https://doi.org/10.1007/s10006-023-01168-0
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DOI: https://doi.org/10.1007/s10006-023-01168-0