Drainage of submandibular abscess by using local anesthetic block technique of transverse cervical cutaneous nerve of the neck

الملخص EN

Background : The purpose of the current study was to create a painless drainage of submandibular abscess by using local anesthetic block technique of transverse cervical cutaneous nerve of the neck.

Patients and Methods : Ninety-seven patients attending College of Dentistry / University of Baghdad, and Private Clinic in the period between (January 2002-October 2004) were selected.

The average age of the patients was ranged between 14-63 years from different socioeconomic status.

Sixty-one were females, and thirty-six were males.

All the patients were complaining of submandibular abscesses with severe pain huge swelling of different duration, and of several odontogenic etiologies.

Clinical and radiographic examination was evaluated depending mainly on orthopantomography due to the presence of severe trismus.

The patients were divided into two groups.

The control groups (48 patients) who were treated by ordinary technique, by using topical ethyl chloride, incision, drainage, insertion of corrugated drain with suturing, covered by heavy dose of antibiotics according to the sensitivities of the patients.

While the study group (49 patients) who were treated by using local anesthetic block technique of transverse cervical cutaneous nerve at the lateral side of the neck at the level of thyroid cartilage (Adams` apple).

Measurement records of pain severity were registered during incision, drainage, and insertion of corrugated drain with suturing.

Also other measurements were recorded for the state of consciousness of the patients during their treatments.

Results : The study reported that 46 (96 %) cases of the control group had severe pain during incision of the skin and subcutaneous layer over submandibular abscess in comparison to 0 (0 %) case of the study group which showed no pain.

The control group showed 48 (100 %) cases having severe pain during drainage of submandibular abscess in comparison to 31(63 %) cases of the study group, which shows no pain.

Also 47 (96 %) cases of the study group shows no pain by using local anesthetic block technique of transverse cervical cutaneous nerve in comparison to 48 (100 %) cases which have severe pain.

The study reported that 17 (35.4 %) cases of control group showed fainting during drainage of submandibular abscess in comparison to only 5(10.4 %) cases of the study group.

No signs and symptoms of hematoma, ecchymosed, or parasthesia was detected during the use of local anesthetic block technique of transverse cervical cutaneous nerve.

Conclusions : Incision through skin, and subcutaneous layer over submandibular region to drain a chronic abscess can be done safely without significant pain or spread infections as well as no significant pain during insertion of corrugated drain with suturing unlike the ordinary technique.