[Infections of the head and neck leading to descending necrotizing mediastinitis: management of 9 cases].
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.
Lin
Chong-xiang
CX
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou Zhejiang 325000, China. linchongxiang@yahoo.com
Ding
Xi
X
Ma
Yi-ke
YK
Zhang
Xue-fei
XF
Zhu
Xing-hao
XH
D000328:Adult; D000368:Aged; D005490:Focal Infection / Q000150:complications*; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology*; D008875:Middle Aged