Systematic review of the role of corticosteroids in cervicofacial infections |
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| Affiliation: | 1. Maxillofacial surgery Trainees Research Collaborative, Aberdeen Royal Infirmary, Aberdeen;2. Maxillofacial surgery Trainees Research Collaborative, Manchester Foundation Trust, Manchester;3. Maxillofacial surgery Trainees Research Collaborative, Aintree University Hospital, Liverpool;4. Maxillofacial surgery Trainees Research Collaborative, Abertawe Bro Morgannwg University Health Board, Wales;5. Maxillofacial surgery Trainees Research Collaborative, Leeds University Medical School, Leeds;6. Maxillofacial surgery Trainees Research Collaborative, Northampton General Hospital, Northampton;7. Maxillofacial surgery Trainees Research Collaborative, Queen Elizabeth University Hospital, Glasgow;8. Maxillofacial surgery Trainees Research Collaborative The Whittington Hospital NHS Trust, London;9. Maxillofacial surgery Trainees Research Collaborative, Royal London Hospital, London;10. Maxillofacial surgery Trainees Research Collaborative, Cambridge University Hospitals, Cambridge;11. Maxillofacial surgery Trainees Research Collaborative, Pennine Acute Hospital, North Manchester;1. Resident, Department of Oral Surgery, Shanghai Ninth People''s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine National Clinical Research Center for Oral Diseases and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, People''s Republic of China;2. Master, Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People''s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine National Clinical Research Center for Oral Diseases and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, People''s Republic of China;3. Attending Physician, Department of Oral Surgery, Renji Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, People''s Republic of China;4. Professor, Department of Stomatology, Meitian Dental Clinic, Shanghai, People''s Republic of China;6. Professor, Department of Oral Surgery, Ninth People''s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine and Shanghai Key Laboratory of Stomatology, Shanghai, People''s Republic of China;5. Attending Physician, Department of Oral Surgery, Shanghai Ninth People''s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, People''s Republic of China;1. Oral and Maxillofacial Surgery Department, Hospital Sultan Abdul Halim, Kedah, Ministry of Health, Malaysia;2. Clinical Research Centre, Hospital Sultan Abdul Halim, Kedah, Ministry of Health, Malaysia;1. Department of Oral and Maxillofacial Surgery, Boston University, Boston, MA, USA;2. Private Practice in Oral and Maxillofacial Surgery, Milford, MA, USA;1. Sección de Cirugía de Cabeza y Cuello, Hospital Prof. A. Posadas, El Palomar, Argentina;2. Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina;1. Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;2. Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland |
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| Abstract: | The role of corticosteroids in the management of cervicofacial infections continues to cause controversy. Systemic anti-inflammatory and immunomodulatory effects that reduce swelling and improve symptoms in the head and neck may make these agents an effective addition to the antibiotics used and to surgical management, although this same effect may dull the physiological response to infection, and allow infections to progress. We have systematically reviewed the evidence for the use of corticosteroids in common cervicofacial infections following the PRISMA guidelines. MeSH terms included “head”, “neck”, “infection”, and “glucocorticoid”. In total, 31 papers were identified. Eight reported the use of corticosteroids for peritonsillar abscess (PTA), 10 for pharyngitis, four for deep neck space infection (DNSI), four for periorbital cellulitis, and five for supraglottitis. Whilst there is an established evidence base for their use in the treatment of PTA and pharyngitis, other indications need further study, and we highlight the potential pitfalls. The evidence suggests that the use of adjunctive, short-term, high-dose corticosteroids in cervicofacial infections may be safe and effective. |
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| Keywords: | MeSH terms: Head Neck Glucocorticoid Infection Surgery |
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