Pattern of Fascial Space Infections and Upper Airway Alterations: A Retrospective Radiographic Study

Objectives: The objectives of this retrospective analytical study were to investigate the morphologic linear and volumetric alterations of the upper airway associated with fascial space infections. Material and Methods: This study was conducted as a single-center retrospective radiographic analysis at King Fahad Hospital in Madinah, Saudi Arabia, focusing on patients with fascial space infections. Patient data were collected from computed tomography (CT) scans taken from January 2018 to September 2023. Airway Morphology Analysis and Volume Measurement of all included patient CT scans were performed using the Aquilion Prime SP CT scanner. The 3D Slicer software was employed to construct a 3-dimensional model of the pharyngeal airway space. Exclusions were made for cases with underlying pathologies or syndromes potentially affecting the pharyngeal airway space, scans of subpar quality, blurred images, excessive slice thickness, or the presence of artifacts. Results: This study analyzed the characteristics of 83 infection cases that met the criteria for inclusion out of 236 reviewed scans. The adult group (20-40 years) constituted the largest segment (44.05%), indicating a higher susceptibility or exposure to infection risks in this age range. The submandibular space had the highest rate of asymmetry (37.5%), followed by the lateral pharyngeal space (15.62%) ( P < .05) . The least affected was the pre-vertebral space. Conclusions: Fascial space infections affected young and adult males, with the submandibular space most commonly involved. Airway asymmetry and deviation significantly associated with reduced airway volume and compromise patient clinical condition.