[Odontogenic mediastinitis. Diagnostics and treatment].
The aim of our work was to evaluate the diagnostic and treatment of patients with odontogenic mediastinitis.


METHODS
The last 10 years (1991-2001) 13 males and 4 females, mean age 43 years, with odontogenic mediastinitis were submitted to surgical treatment. Primary odontogenic abscess occurred in all. Before admission to our clinic, 14 patients were treated at stomatological department. Diagnosis was made by clinical manifestation, roentgenographical features and confirmed by findings at mediastinum tissues during operation.


RESULTS
All patients at the admission day underwent broad cervicotomies with transcervical mediastinal drainage. In 5 cases this management was associated with mediastinal drainage by transthoracic approach. For another 5 patients thoracotomies were performed late, the last 7 survived without thoracotomy. Six patient died, mortality rate was 35.2%. The reason of the high mortality rate-delay of transthoracic mediastinal drainage in 5 cases, when transcervical was inadequate.


CONCLUSIONS
Ample cervicotomy, associated with transcervical and transthoracic mediastinal drainage can significantly reduce the mortality rate for odontogenic mediastinitis.
Kiskis
Gintaras
G
Clinic of General Thoracic Surgery, Vilnius University, Zygimantu 3, 2001 Vilnius, Lithuania.
Gruslys
Vygantas
V
Jovaisas
Vytautas
V
Kybartas
Algis
A
Liubertiene
Irena
I
Narbutas
Jonas
J
Zilinskas
Arūnas
A
Sucila
Antanas
A
Janilionis
Ricardas
R
D000328:Adult; D000368:Aged; D002481:Cellulitis / Q000150:complications; D004322:Drainage; D016724:Empyema, Pleural / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D008875:Middle Aged; D010508:Periodontal Abscess / Q000150:complications*; D013902:Radiography, Thoracic; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed