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Multidisciplinary Approach to Obesity Management: A Case Report
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953
Descending cervical mediastinitis: the multidisciplinary surgical approach
Marcus Taylor1, Harshil Patel2, Sadie Khwaja3
1Department of Thoracic Surgery, Wythenshawe Hospital, Manchester Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK. Marcus.taylor1@nhs.net.
Summary
Prompt surgical intervention for descending cervical mediastinitis (DCM) is crucial. Aggressive management in specialist centers led to no in-hospital deaths in this series, demonstrating favorable outcomes are achievable.
Area of Science:
- Medicine
- Surgery
- Infectious Diseases
Background:
- Descending cervical mediastinitis (DCM) is a rare but serious infection.
- It involves the spread of oropharyngeal or odontogenic infections into the mediastinum.
- DCM is associated with a high mortality rate.
Purpose of the Study:
- To evaluate the outcomes of surgical management for descending cervical mediastinitis.
- To highlight the importance of prompt and aggressive treatment strategies.
Main Methods:
- A retrospective review of six patients with DCM treated between November 2013 and October 2016.
- Surgical interventions included cervical drainage and subsequent thoracic surgery for mediastinal and pleural collections.
- Assessment of patient outcomes, including length of stay and mortality.
Main Results:
- All six patients survived their hospital stay, with no in-hospital deaths.
- The average length of hospital stay was 73 days.
- Four patients required reoperation, with two needing a third thoracic procedure.
Conclusions:
- Prompt surgical intervention by ENT and cardiothoracic surgeons is essential for managing DCM.
- Aggressive and timely management in specialist centers with multidisciplinary team involvement can lead to favorable outcomes.
- This study suggests that even severe cases of DCM can be successfully treated with a proactive surgical approach.
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