مدياستينيت حاد به دنبال عفونت فضاهاي عمقي سروگردن

Acute Mediastinitis After Deep Neck Infection

Objective: Descending mediastinitis is a highly fetal disease originating from odontogenic pharyngeal, or cervical infection that descends along facial planes into the mediastinum. Materials and Methods: We present a retrospective 5 years study series of 47 patients with diagnosis of deep neck infection treated surgically between 1977 - 2002. Patients with serious complications admitted to the I.C.U and developed mediastinitis that were documented by C.T. scan. Operative procedures included wide neck incision and thoracotomy. Results: 47 patients were admitted, 3 patients underwent medical therapy, and 44 patients underwent both medical and surgical treatment. Seven patient developed serious post - operative complications and were admitted to the I.C.U. Four patient had parapharyngeal infections and developed acute mediastinitis , myocarditis , lung abcess and were operated successfully. Serious postoperative complications followed by delayed in diagnosis and surgical treatment. The mean duration from symptom to operation was 4 days. Conclusion: The main cause of this delay was referral of patients from other centers. Patients that developed mediastinitis underwent early operative procedure including wide neck incision and thoractomy with multiple antibiotic therapy to lower the incidence of mediastinitis and mortality.