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- Title
A Prospective, Blinded Comparison of Clinical Examination and Computed Tomography in Deep Neck Infections.
- Authors
Miller, William D.; Furst, Ian M.; Sàndor, George K.B.; Keller, M. Anne
- Abstract
Objectives/Hypothesis: To determine whether there is a scientific basis for the routine use of contrast-enhanced computed tomography (CECT) in the evaluation of suspected deep neck infection (DNI). Study Design: We conducted a prospective, blinded comparison of clinical examination and CECT in DNI. Methods: Thirty-five consecutive patients with suspected DNI were prospectively assessed by clinical examination and CECT for the presence and extent of surgically drainable purulent collections. Before CECT a surgeon recorded clinical data and predicted the extent of infection. A head and neck neuroradiologist, blinded to the clinical evaluation, predicted the extent of infection based on CECT. Final outcome (the presence of a purulent collection) was determined at surgery or in long-term follow-up. The clinical and CECT findings were compared with the final outcome to determine the sensitivity, specificity, and accuracy of each modality. Results: Twenty patients had purulent drainable collections. The accuracy of clinical examination alone in identifying a drainable collection was 63%, the sensitivity was 55%, and the specificity was 73%. The accuracy of CECT alone was 77%, the sensitivity was 95%, and the specificity 53%. When CECT and clinical examination were combined, the accuracy in identifying a drainable collection was 89%, the sensitivity was 95%, and the specificity 80%. If fluid collections with volumes of 2 mL or greater on CECT were considered, the accuracy of CECT would have been 85%, the sensitivity 89%, and the specificity 80%. Conclusion: CECT and clinical examination are both critical components in the evaluation of suspected DNI.
- Publication
Laryngoscope, 1999, Vol 109, Issue 11, p1873
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1097/00005537-199911000-00029