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Published on: December 4, 2023
Descending Necrotizing Mediastinitis: A 7-Year Single-Centre Experience
Catarina Pereira Moita1, Catarina Figueiredo1, Zenito Cruz1
1Thoracic Surgery Department - Hospital de Santa Marta, Unidade Local de Saúde São José, Portugal.
Summary
Descending necrotizing mediastinitis (DNM) requires prompt diagnosis and surgical intervention. This study found that a multidisciplinary approach led to favorable outcomes with low morbidity and no mortality in 14 patients.
Area of Science:
- Thoracic Surgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Descending necrotizing mediastinitis (DNM) is a severe complication of head and neck infections.
- DNM rapidly progresses to the mediastinum, posing a life-threatening risk.
- Early diagnosis and surgical intervention are crucial for survival.
Purpose of the Study:
- To present the clinical experience and management strategies for DNM.
- To evaluate the outcomes of surgical treatment for DNM.
Main Methods:
- Retrospective analysis of 14 adult patients with DNM treated between 2017 and 2023.
- Surgical treatment involved cervical and thoracic procedures.
- Computed tomography scans were used for diagnosis.
Main Results:
- The majority of patients (12/14) progressed to stage II DNM.
- Pharyngeal (7), cervical (5), and odontogenic (2) infections were primary sites.
- A median of 2 cervical and 1 thoracic intervention per patient was performed, with combined cervicotomy and thoracotomy as the preferred approach.
Conclusions:
- Effective DNM management requires early CT diagnosis, antibiotics, and urgent surgical drainage.
- A multidisciplinary approach is vital for successful outcomes.
- This study demonstrated low long-term morbidity and no mortality in DNM patients.
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