Bakir et al intended to evaluate “the importance of radiologic evaluation and appropriate treatment selection” in patients affected with deep neck infections (DNIs).

In fact, they “performed radiological evaluation on almost all of the patients to identify the location, extent, and character (cellulitis or abscesses) of the infections.”

I noted that the authors failed to display those data, which are necessary to gain understanding of their research. In addition, giving that they performed a retrospective analysis, was the operator assessing the computed tomographic (CT) scans blind to the intraoperative findings?

As known, the possible assessed variables include low-density core, rim enhancement, soft tissue swelling, obliterated fat planes, and mass effect. Based on these characteristics, a radiologist should be able to differentiate abscess vs cellulitis in DNIs. This is the authors’ assumption, and in fact, they chose the treatment based on CT findings, performing a prompt surgical drainage in all the cases with a radiologic diagnosis of neck abscess.

Unfortunately, Daya et al pointed out that CT scans are not always accurate in discriminating the abscess, although helpful in assessing the extent and location of DNIs. Similarly, discrepancies between CT interpretation and intraoperative findings have been reported especially in the cases of abscesses in initial stages . In this respect, it would be interesting to know whether the authors had a similar experience.

An additional point of criticism regards the incompleteness of the laboratory test performed by the authors. In fact, Wang et al showed that a high C-reactive protein frequently tends to develop complications in patients affected with DNIs, and this information might complementary to CT findings in guiding toward the more appropriate treatment.