A revisit of oral and maxillofacial mortality from orofacial infections in a resource limited setting: Is there a need for a change in management protocol?

Abstract

Background: Orofacial infections are communicable infections usually of odontogenic origin, they often present as rapidly spreading infection involving the fascial spaces of the head and neck. When they are not promptly and adequately intercepted, they may result in fatal outcomes. The common pathway to mortality in these patients is often airway compromise. The advent of antibiotics and improvement in quality of health care has been said to improve the success rate in the management of orofacial infections, however the findings from our setting showed that the mortality from orofacial infections have remained high.
Objective: To report mortalities from patients managed for orofacial infections in our center, review our treatment protocol and ascertain the necessity for a change in management protocol
Design: A retrospective study Setting: Maxillofacial surgery department of Aminu Kano Teaching Hospital (AKTH) Kano, Kano state Nigeria.
Subjects: All patients who died in our facility over a one hundred and thirty eight-month period (January 2005 – June 2016) following management of orofacial infections
Results: A total of 115 (76 males, 39 females) maxillofacial admissions were recorded on account of orofacial infection during the period under review; of these 26 mortalities were recorded (22.6%). Male subjects constituted 19 cases while female subjects were 7 in number. The demised patients’ ages ranged from 19 years to 73 years with a mean age of 34.0 ± 12.0 years.
Conclusion: Orofacial infections are potentially lethal; they constitute one of the commonest causes of mortality in maxillofacial surgery facilities. A standard care of early intervention, aggressive medical and surgical therapy has consistently provided the best results.