{"title":"Descending necrotizing mediastinitis - a surgical view.","authors":"J Šafránek","doi":"10.48095/ccrvch2024502","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Descending necrotizing mediastinitis (DNM) is a relatively uncommon but serious type of inflammation. Even today, the mortality is around 20%. An overview of DNM issues, recent literature and clinical practice of our department is presented. Anatomy and etiology: The cause is the descent of an originally oropharyngeal infection from the deep neck space into the mediastinum.</p><p><strong>Therapy: </strong>Treatment takes place in an intensive care department, with a combination of antibiotics. Elimination of the neck source of inflammation is a prerequisite. The type of surgical drainage depends on the stage and extent of mediastinal involvement. Cervicomediastinal, mediastinothoracic, or cervicomediastinothoracic \"Rendezvous\" drainage are options.</p><p><strong>Conclusion: </strong>The basis of DNM treatment is adequate surgical drainage, but interdisciplinary care (surgeon, anesthesiologist, ENT and dental surgeon) is a necessary condition.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 12","pages":"502-507"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rozhledy v Chirurgii","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.48095/ccrvch2024502","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Descending necrotizing mediastinitis (DNM) is a relatively uncommon but serious type of inflammation. Even today, the mortality is around 20%. An overview of DNM issues, recent literature and clinical practice of our department is presented. Anatomy and etiology: The cause is the descent of an originally oropharyngeal infection from the deep neck space into the mediastinum.
Therapy: Treatment takes place in an intensive care department, with a combination of antibiotics. Elimination of the neck source of inflammation is a prerequisite. The type of surgical drainage depends on the stage and extent of mediastinal involvement. Cervicomediastinal, mediastinothoracic, or cervicomediastinothoracic "Rendezvous" drainage are options.
Conclusion: The basis of DNM treatment is adequate surgical drainage, but interdisciplinary care (surgeon, anesthesiologist, ENT and dental surgeon) is a necessary condition.