Infection of the head and neck leading to descending necrotizing mediastinitis:management of 9 cases

VernacularTitle:头颈部感染致坏死性纵隔炎九例
Author: Chong-Xiang LIN ¹ ; Xi DING ; Yike MA ; Xue-Fei ZHANG ; Xing-Hao ZHU
Author Information

1. 温州医学院附属第一医院
Keywords: Infection; Mediastintis
From: Chinese Journal of Stomatology 2009;44(10):619-620
CountryChina
Language:Chinese
Abstract: Objective To report nine cases of descending necrotizing mediastinitis(DNM)and to summarize the management experience.Methods Between December 2005 and December 2008,nine patients(mean age,55.7 years;age range,38 to 78 years)with DNM were treated.Eight patients underwent surgical drainage of the involved cervical region and mediastinum(4 with cervical drainage alone;4 with cervical drainage and right thoracotomy).Results Two patients died,one of them refused surgical therapy and the other one died of multiorgan failure related to postoperative septic shock.Seven patients recovered.The mortality rate was 22%.Conclusions Delayed diagnosis and inadequate drainage are the main causes of high mortality rate of DNM.Aggressive surgical drainage and debridement of the neck and mediastinum by a multidisciplinary team of surgeons are very important in the treatment of DNM.