Necrotizing odontogenic fasciitis of head and neck extending to anterior mediastinum in elderly patients: innovative treatment with a review of the literature.
Aging Clin Exp Res
; 29(Suppl 1): 159-165, 2017 Feb.
Article
em En
| MEDLINE
| ID: mdl-27798811
BACKGROUND: Necrotizing fasciitis (NF) of odontogenic origin affecting the head and neck region is a rare but serious clinical condition, which, if diagnosed late, can lead to a fatal outcome. The early diagnosis of necrotizing fasciitis can be difficult. Delay in diagnosis leads to increase in the area of necrosis with a resulting increase in cosmetic deformity and life-threatening complication. In this study, we present two cases of elderly patients with aggressive NF affecting the neck and anterior mediastinum, which were of odontogenic origin. METHODS: In the two patients selected necrotic skin and soft tissue were removed and wide exposure was achieved with debridement of the neck at the level of the affected layer of superficial cervical fascia. Saline solution was used as irrigation to treat the patients with acute necrotizing fasciitis. Difficulties in managing this condition with NF extent to deep anterior mediastinum is related to clavicle osteotomy or thoracotomy need with high surgical risks. In our technique, by gentle suction in anterior mediastinum, necrotic tissue resection was possible without any osteotomy need. CONCLUSIONS: Suctioning resection technique associated with hyperbaric, metabolic rebalance, and amino acid support in association with three types antibiotic therapy are fundamental points for correct therapy strategy, leading to full recovery and healing of NF patients even if in very unfavorable conditions. Multidisciplinary approach is paramount for proper treatment of this disease.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções Estreptocócicas
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Doenças Estomatognáticas
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Fasciite Necrosante
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Desbridamento
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Abscesso
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Mediastino
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Antibacterianos
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Pescoço
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Screening_studies
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Aging Clin Exp Res
Assunto da revista:
GERIATRIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Itália