Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

Descending Necrotizing Mediastinitis from Odontogenic Infection: a Case Report

치성감염에 의한 하행 괴사성 종격동염: 증례보고

  • Jeong, Yong-Seon (Department of Oral and Maxillofacial Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Chae, Byung-Moo (Department of Oral and Maxillofacial Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Jo, Hyun-Joo (Department of Oral and Maxillofacial Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, So-Hyun (Department of Oral and Maxillofacial Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Jung, Tae-Young (Department of Oral and Maxillofacial Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Park, Sang-Jun (Department of Oral and Maxillofacial Surgery, Busan Paik Hospital, College of Medicine, Inje University)
  • 정용선 (인제대학교 의과대학 부산백병원 구강악안면외과학교실) ;
  • 채병무 (인제대학교 의과대학 부산백병원 구강악안면외과학교실) ;
  • 조현주 (인제대학교 의과대학 부산백병원 구강악안면외과학교실) ;
  • 김소현 (인제대학교 의과대학 부산백병원 구강악안면외과학교실) ;
  • 정태영 (인제대학교 의과대학 부산백병원 구강악안면외과학교실) ;
  • 박상준 (인제대학교 의과대학 부산백병원 구강악안면외과학교실)
  • Received : 2010.08.19
  • Accepted : 2010.09.27
  • Published : 2010.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Descending necrotizing mediastinitis (DNM) is a complication of odontogenic or oropharyngeal infections that can spread to the mediastinum. Such infections is serious, leading to sepsis and frequently to death. Even in this era of antibiotics, the mortality rate associated with DNM is approximately 40%. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. Delayed diagnosis is the principal reason for the high mortality in DNM. Therefore, descending necrotizing mediastinitis requires an early and aggressive surgical approach to reduce the high morbidity and mortality associated with this disease. We experienced a case of odontogenic infection followed by acute mediastinitis, so present now with the review of literatures.

Keywords

References

  1. Richard K, Eric Vallieres, Edward D et al : Descending necrotizing mediastinitis: An analysis of the effects of serial surgical debridement on patient mortality. J Thorac Cardiovasc Surg 119 : 260, 2000. https://doi.org/10.1016/S0022-5223(00)70181-4
  2. Marty-Ane CH, Berthet JP, Alric P et al : Management of Descending Necrotizing Mediastinitis : An Aggressive Treatment for an Aggressive Disease. Ann Thorac Surg 68 : 212, 1999. https://doi.org/10.1016/S0003-4975(99)00453-1
  3. Robert DM : Clinical considerations in head and neck infections. Principles of oral and maxillofacial surgery Vol.1 : 189, 1992.
  4. Wheatley MJ, Stirling MC, Kirsh MM : Descending necrotizing mediastinitis: transcervical drainage is not enough. Ann Thorac Surg 49 : 780, 1990. https://doi.org/10.1016/0003-4975(90)90022-X
  5. Cordero L, Torre W, Freire D : Descending necrotizing mediastinitis and respiratory distress syndrome treated by aggressive surgical treatment. J Cardiovasc Surg 37 : 87, 1996.
  6. Yoon YC, Cho KH, Kim SR et al : Descending necrotizing mediastinitis casued by yeast. Korean J Thorac Cardiovasc Surg 37 : 386, 2004.
  7. Lee JJ, Shin HS, Shin YC et al : Descending necrotizing mediastinitis: the retrospective review of surgical management. Korean J Thorac Cardiovasc Surg 34 : 769, 2001.
  8. Estrera AS, Landay MJ, Grisham JM et al : Descending necrotizing mediastinitis. Surg Gynecol Obstet 157 : 545, 1983.
  9. Pearse Jr HE : Mediastinitis following cervical suppuration. Ann Surg 107 : 588, 1938.
  10. Freeman RK, Vallieres E, Verrier ED et al : Descending necrotizing mediastinitis: an analysis of the effects of serial surgical debridement on patient mortality. J Thorac Cardiovasc Surg 119 : 260, 2000. https://doi.org/10.1016/S0022-5223(00)70181-4
  11. Papalia E, Rena O, Oliaro A et al : Desending necrotizing mediastinitis: surgical management. Eur J Cardiothorac Surg 20 : 739, 2001. https://doi.org/10.1016/S1010-7940(01)00790-4
  12. Yang X, Soimakallio S : The role of different imaging procedures in early diagnosis and management of descending necrotizing mediastinitis. Eur Arch Otorhinolaryngol 253 : 316, 1996.
  13. Moncada R, Warpeha R, Pickleman J et al : Mediastinitis from odontogenic and deep cervical infection: anatomical pathways of propagation. Chest 73 : 497, 1978. https://doi.org/10.1378/chest.73.4.497
  14. Sancho LMM, Minamoto H, Angelo F et al : Descending necrotizing mediastinitis: a retrospective surgical experience. Eur J Cardiothorac Surg 16 : 200, 1999. https://doi.org/10.1016/S1010-7940(99)00168-2
  15. Corsten MJ, Shamji FM, Odell PF : Optimal treatment of descending necrotizing mediastinitis. Thorax 52 : 702, 1997. https://doi.org/10.1136/thx.52.8.702