Home Bratislava Medical Journal 2022 Bratislava Medical Journal Vol.123, No.4, p.291–298, 2022

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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

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Bratislava Medical Journal Vol.123, No.4, p.291–298, 2022

Title: Surgical treatment of descending necrotising mediastinitis caused by odontogenic infection: a retrospective analysis of 20 patients
Author: Martin LUCENIC, Katarina TARABOVA, Peter JUHOS, Patrik LAUCEK, Daniel SISKA, Svetozar HARUSTIAK, Miroslav JANIK

Abstract: OBJECTIVES: Analysing the results of patients with odontogenic descending necrotising mediastinitis (DNM) treated predominantly by transcervical approach.
BACKGROUND: Odontogenic DNM is a rare but serious complication of dental disease and dental procedures.
METHODS: Retrospective evaluation of 20 patients who underwent surgery for odontogenic DNM.
RESULTS: The mean age was 33.95±12.24 years, and 18 patients (90 %) were men. Type I and diffuse form of DNM were identified in 8 (40 %) and 12 (60 %) patients, respectively. The mean time between the onset of symptoms and surgery was 7.16±4.23 days. The transcervical approach was used in 16 patients, combined cervicotomy and subxiphoid incision in three patients, and cervicotomy and posterolateral thoracotomy was used in one patient. Four patients were reoperated. The mean mediastinal drainage duration and postoperative length of stay (LOS) were 17.05±10.27 days and 20.70±10.87 days, respectively. Fourteen (70 %) patients received mechanical ventilation with a mean duration of 8.86±9.55 days. Comorbidities were present in five (26 %) patients; there were complications in 17 (85 %) patients. In-hospital mortality reached 5 % (1 patient). Thirty-five teeth were extracted. Lower mandibular molars represented 21 (62 %) of extracted teeth. Submandibular and submental spaces were the most affected by the presence of deep neck infection (five and four cases, respectively).
CONCLUSION: This study supports the role of transcervical mediastinal drainage as an alternative approach in the surgical treatment of odontogenic DNM (Tab. 4, Fig. 2, Ref. 30).

Keywords: descending necrotising mediastinitis; odontogenic infection; surgical treatment; transcervical drainage
Published online: 16-Mar-2022
Year: 2022, Volume: 123, Issue: 4 Page From: 291, Page To: 298
doi:10.4149/BLL_2022_046


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