Descending necrotizing mediastinitis from deep neck infection.
Eur Arch Otorhinolaryngol
; 270(4): 1463-6, 2013 Mar.
Article
in En
| MEDLINE
| ID: mdl-22986415
ABSTRACT
This study aims to identify predisposing characteristics of descending necrotizing mediastinitis (DNM) arising from deep neck infection (DNI) and to determine appropriate therapeutic intervention strategies. We retrospectively reviewed 54 patients (male, n = 34; female, n = 20; mean age, 64.5 years) who had been treated at Mie University Hospital for DNI between April 2001 and October 2011. Eight of nine patients who developed DNM confirmed by computed tomography of the neck and chest, underwent mediastinal drainage (video-assisted thoracic surgical drainage, n = 6; mediastinoscopy-assisted drainage, n = 2). A patient developed uncontrolled acute respiratory distress syndrome after aggressive surgery, resulting in a mortality rate of 12 %. High blood CRP values, and the pharynx and tonsils as origins of infection were factors involved in the development of DNM arising from DNI. In conclusion, DNM remains a destructive and fatal disease that requires aggressive treatment including mediastinal exploration.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pharyngitis
/
Tonsillitis
/
Sepsis
/
Mediastinitis
/
Mediastinum
Type of study:
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur Arch Otorhinolaryngol
Journal subject:
OTORRINOLARINGOLOGIA
Year:
2013
Document type:
Article
Affiliation country:
Japan