Infections of the head and neck leading to descending necrotizing mediastinitis: management of 9 cases / 中华口腔医学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To report nine cases of descending necrotizing mediastinitis (DNM) and to summarize the management experience.</p><p><b>METHODS</b>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).</p><p><b>RESULTS</b>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%.</p><p><b>CONCLUSIONS</b>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.</p>