CONCLUSIONS: Early diagnosis and aggressive antimicrobial and surgical treatment are essential to successfully treat extensive cervico-mediastinal abscesses of odontogenic origin. Patient management should be performed by experienced clinicians well trained in managing possible complications. We recommend close clinical and radiological postoperative follow-up investigations with early surgical re-intervention if necessary. OBJECTIVES: While neck infections affecting the perimandibular space have a high prevalence and their clinical aspects have repeatedly been discussed, further spread of the inflammation and life-threatening situations have rarely been described. The objective was to determine clinical, diagnostic, and therapeutic aspects of severe neck infections of odontogenic origin. Emphasis was placed on grave descending deep neck space infections, sometimes resulting in mediastinitis as a life-threatening complication. PATIENTS AND METHODS: We reviewed 10 patients with severe odontogenic abscesses treated during an 8-year interval in a single center. RESULTS: The submandibular space was the most frequently encountered location of deep neck space infections. Mediastinitis was found in five patients. The most frequent causative bacteria were Streptococcus and Bacteroides species. All patients underwent intravenous antibiotic treatment and surgical therapy. Mediastinotomy was inevitable in five cases and thoracotomy in one case. All patients survived.
CONCLUSIONS: Early diagnosis and aggressive antimicrobial and surgical treatment are essential to successfully treat extensive cervico-mediastinal abscesses of odontogenic origin. Patient management should be performed by experienced clinicians well trained in managing possible complications. We recommend close clinical and radiological postoperative follow-up investigations with early surgical re-intervention if necessary. OBJECTIVES: While neck infections affecting the perimandibular space have a high prevalence and their clinical aspects have repeatedly been discussed, further spread of the inflammation and life-threatening situations have rarely been described. The objective was to determine clinical, diagnostic, and therapeutic aspects of severe neck infections of odontogenic origin. Emphasis was placed on grave descending deep neck space infections, sometimes resulting in mediastinitis as a life-threatening complication. PATIENTS AND METHODS: We reviewed 10 patients with severe odontogenic abscesses treated during an 8-year interval in a single center. RESULTS: The submandibular space was the most frequently encountered location of deep neck space infections. Mediastinitis was found in five patients. The most frequent causative bacteria were Streptococcus and Bacteroides species. All patients underwent intravenous antibiotic treatment and surgical therapy. Mediastinotomy was inevitable in five cases and thoracotomy in one case. All patients survived.
Authors: Patrício José de Oliveira Neto; Maximiana Cristina de Souza Maliska; Renato Sawazaki; Luciana Asprino; Márcio de Moraes; Roger William Fernandes Moreira Journal: Oral Maxillofac Surg Date: 2011-02-12
Authors: Alessio Danilo Inchingolo; Sabino Ceci; Luisa Limongelli; Alberto Corriero; Luigi Curatoli; Daniela Azzollini; Pietro Paolo Mezzapesa; Grazia Marinelli; Giuseppina Malcangi; Giovanni Coloccia; Mario Ribezzi; Maria Massaro; Ioana Roxana Bordea; Antonio Scarano; Felice Lorusso; Nicola Brienza; Gianfranco Favia; Nicola Quaranta; Francesco Inchingolo Journal: Case Rep Dent Date: 2022-07-12