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Prognostic factors for tracheostomy in patients with cervicofacial cellulitis.

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Title: Prognostic factors for tracheostomy in patients with cervicofacial cellulitis.
Authors: Hennocq Q; Sorbonne University, Paris, France; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France. Electronic address: quentin.hennocq@aphp.fr., Plantin S; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France., Salettes R; Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital de la Pitié Salpêtrière, Service d'Anesthésie-Réanimation et Médecine Périopératoire, 91 boulevard de l'Hôpital, Paris 75013, France., Bouaoud J; Sorbonne University, Paris, France; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France., Raux M; Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital de la Pitié Salpêtrière, Service d'Anesthésie-Réanimation et Médecine Périopératoire, 91 boulevard de l'Hôpital, Paris 75013, France., Bertolus C; Sorbonne University, Paris, France; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Sorbonne University, INSERM UMRS 938, Centre de Recherche de Saint Antoine, Team Cancer Biology and Therapeutics Paris, France., Foy JP; Sorbonne University, Paris, France; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Sorbonne University, INSERM UMRS 938, Centre de Recherche de Saint Antoine, Team Cancer Biology and Therapeutics Paris, France.
Source: Journal of stomatology, oral and maxillofacial surgery [J Stomatol Oral Maxillofac Surg] 2026 Oct; Vol. 127 (5), pp. 102838. Date of Electronic Publication: 2026 May 12.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Elsevier Masson SAS Country of Publication: France NLM ID: 101701089 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-7855 (Electronic) Linking ISSN: 24687855 NLM ISO Abbreviation: J Stomatol Oral Maxillofac Surg Subsets: MEDLINE
Imprint Name(s): Original Publication: Issy les Moulineaux Cedex : Elsevier Masson SAS, [2017]-
MeSH Terms: Cellulitis*/surgery , Cellulitis*/complications , Tracheostomy*/statistics & numerical data , Tracheostomy*/adverse effects , Trismus*/etiology , Trismus*/epidemiology, Humans ; Female ; Prognosis ; Prospective Studies ; Male ; Neck ; Middle Aged ; Retrospective Studies ; Drainage ; Aged ; Adult
Abstract: Background: Upper airway management is challenging in patients with cervico-facial cellulitis. Our objectives were to determine the prevalence of non-opening of a trismus after induction, as well as to compare the radiological and biological factors associated with tracheostomy.
Material and Methods: We conducted a prospective, single-center cohort study including consecutively all patients with cervicofacial cellulitis with an indication for surgical drainage under general anesthesia, between October 2021 and March 2022, and a retrospective cohort of patients who required a tracheostomy during the management of cervicofacial cellulitis, between January 2019 and September 2021. We first compared mouth opening measurements before and after anesthetic induction in the prospective cohort. We then used logistic regressions to determine clinic-radiological factors associated with tracheostomy.
Results: The prospective cohort included 55 patients. All patients for whom measurements were taken (17/17) had an increase in mouth opening after induction. In multivariate analyses, dysphagia, and a non-homogeneous collection were significantly associated with tracheostomy.
Conclusions: We found that trismus was reversible in all patients for whom measurements were taken after induction. We therefore consider that trismus should not be a criterion for difficult intubation in cases of cervico-facial cellulitis. We then found clinico-radiological factors associated with an increased risk of tracheostomy.
(Copyright © 2026 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
Competing Interests: Declaration of competing interest None.
Contributed Indexing: Keywords: Cellulitis; Deep neck infection; Dental abscess; General anesthesia; Tracheal intubation; Tracheostomy
Entry Date(s): Date Created: 20260513 Date Completed: 20261005 Latest Revision: 20261005
Update Code: 20261006
DOI: 10.1016/j.jormas.2026.102838
PMID: 42128348
Database: MEDLINE
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  Data: Prognostic factors for tracheostomy in patients with cervicofacial cellulitis.
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  Data: <searchLink fieldCode="AU" term="%22Hennocq+Q%22">Hennocq Q</searchLink>; Sorbonne University, Paris, France; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France. Electronic address: quentin.hennocq@aphp.fr.<br /><searchLink fieldCode="AU" term="%22Plantin+S%22">Plantin S</searchLink>; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France.<br /><searchLink fieldCode="AU" term="%22Salettes+R%22">Salettes R</searchLink>; Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital de la Pitié Salpêtrière, Service d'Anesthésie-Réanimation et Médecine Périopératoire, 91 boulevard de l'Hôpital, Paris 75013, France.<br /><searchLink fieldCode="AU" term="%22Bouaoud+J%22">Bouaoud J</searchLink>; Sorbonne University, Paris, France; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France.<br /><searchLink fieldCode="AU" term="%22Raux+M%22">Raux M</searchLink>; Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital de la Pitié Salpêtrière, Service d'Anesthésie-Réanimation et Médecine Périopératoire, 91 boulevard de l'Hôpital, Paris 75013, France.<br /><searchLink fieldCode="AU" term="%22Bertolus+C%22">Bertolus C</searchLink>; Sorbonne University, Paris, France; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Sorbonne University, INSERM UMRS 938, Centre de Recherche de Saint Antoine, Team Cancer Biology and Therapeutics Paris, France.<br /><searchLink fieldCode="AU" term="%22Foy+JP%22">Foy JP</searchLink>; Sorbonne University, Paris, France; Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Sorbonne University, INSERM UMRS 938, Centre de Recherche de Saint Antoine, Team Cancer Biology and Therapeutics Paris, France.
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  Data: <searchLink fieldCode="JN" term="%22101701089%22">Journal of stomatology, oral and maxillofacial surgery</searchLink> [J Stomatol Oral Maxillofac Surg] 2026 Oct; Vol. 127 (5), pp. 102838. <i>Date of Electronic Publication: </i>2026 May 12.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Elsevier+Masson+SAS%22">Elsevier Masson SAS </searchLink><i>Country of Publication: </i>France <i>NLM ID: </i>101701089 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>2468-7855 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2224687855%22">24687855 </searchLink><i>NLM ISO Abbreviation: </i>J Stomatol Oral Maxillofac Surg <i>Subsets: </i>MEDLINE
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  Data: <i>Original Publication</i>: Issy les Moulineaux Cedex : Elsevier Masson SAS, [2017]-
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  Data: <searchLink fieldCode="MM" term="%22Cellulitis%22">Cellulitis*</searchLink>/<searchLink fieldCode="MM" term="%22Cellulitis+surgery%22">surgery</searchLink> <br /><searchLink fieldCode="MM" term="%22Cellulitis%22">Cellulitis*</searchLink>/<searchLink fieldCode="MM" term="%22Cellulitis+complications%22">complications</searchLink> <br /><searchLink fieldCode="MM" term="%22Tracheostomy%22">Tracheostomy*</searchLink>/<searchLink fieldCode="MM" term="%22Tracheostomy+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> <br /><searchLink fieldCode="MM" term="%22Tracheostomy%22">Tracheostomy*</searchLink>/<searchLink fieldCode="MM" term="%22Tracheostomy+adverse+effects%22">adverse effects</searchLink> <br /><searchLink fieldCode="MM" term="%22Trismus%22">Trismus*</searchLink>/<searchLink fieldCode="MM" term="%22Trismus+etiology%22">etiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Trismus%22">Trismus*</searchLink>/<searchLink fieldCode="MM" term="%22Trismus+epidemiology%22">epidemiology</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Prognosis%22">Prognosis</searchLink> ; <searchLink fieldCode="MH" term="%22Prospective+Studies%22">Prospective Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Neck%22">Neck</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Drainage%22">Drainage</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Upper airway management is challenging in patients with cervico-facial cellulitis. Our objectives were to determine the prevalence of non-opening of a trismus after induction, as well as to compare the radiological and biological factors associated with tracheostomy.<br />Material and Methods: We conducted a prospective, single-center cohort study including consecutively all patients with cervicofacial cellulitis with an indication for surgical drainage under general anesthesia, between October 2021 and March 2022, and a retrospective cohort of patients who required a tracheostomy during the management of cervicofacial cellulitis, between January 2019 and September 2021. We first compared mouth opening measurements before and after anesthetic induction in the prospective cohort. We then used logistic regressions to determine clinic-radiological factors associated with tracheostomy.<br />Results: The prospective cohort included 55 patients. All patients for whom measurements were taken (17/17) had an increase in mouth opening after induction. In multivariate analyses, dysphagia, and a non-homogeneous collection were significantly associated with tracheostomy.<br />Conclusions: We found that trismus was reversible in all patients for whom measurements were taken after induction. We therefore consider that trismus should not be a criterion for difficult intubation in cases of cervico-facial cellulitis. We then found clinico-radiological factors associated with an increased risk of tracheostomy.<br /> (Copyright © 2026 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
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  Data: Declaration of competing interest None.
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  Data: <i>Keywords: </i>Cellulitis; Deep neck infection; Dental abscess; General anesthesia; Tracheal intubation; Tracheostomy
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  Data: <i>Date Created: </i>20260513 <i>Date Completed: </i>20261005 <i>Latest Revision: </i>20261005
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      – TitleFull: Prognostic factors for tracheostomy in patients with cervicofacial cellulitis.
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