Management of Necrotizing Fasciitis at Head and Neck Region due to Odontogenic Infection

Introduction: Necrotizing fasciitis of odontogenic origin affecting the head and neck region is a rare but serious clinical condition, which, if diagnosed late, can lead to a fatal outcome. The early diagnosis of necrotizing fasciitis can be difficult. Delay in diagnosis leads to increase in the area of necrosis with a resulting increase in cosmetic deformity and life threatening complication. Methods: A retrospective audit of all patients admitted to the Depatment of Oral and Maxillofacial Surgery, Hasan Sadikin Hospital from Januari 2016-April 2019 with necrotizing fasciitis at head and neck region due to odontogenic infection. Patient demographics were recorded and treatment details were collected and analysed. Results: There was 12 patients with confirmed odontogenic necrotizing fasciitis. origin, treated in the Hasan Sadikin Hospital during January 2016-April 2019. In the majority of cases, the disease evolved without the presence of malnutrition condition (66, 67 %). From the appearance of the first symptoms until the presentation for treatment, a time interval of 3-16 days elapsed. During this time period, all of the patients received surgical treatment and antibiotic treatment. Mandibular molars were the most frequent starting point of the disease, and the submandibular space was the first affected by the disease (66, 67 %). Bacteriological exams showed that facultatively aerobic/anaerobic G+ bacteria were the most frequently identified (55.56 %). Conclusion: The odontogenic lesions of the lower molars, complicated by submandibular space infections, are the most frequent starting point of odontogenic necrotizing fasciitis. Early Surgical treatment and antibiotic therapy play an important role in successful treatment.