Vol.102 No.2 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 102 No. 2 February 2009
Three Cases of Advanced Deep Neck Infection
Extending to the Mediastinum
Kazuhiko Nario and Hiroshi Hosoi
(Nara Medical University)
Hisanori Sasai, Aya Kamakura, Masashi Kurokawa and Hiroshi Miyahara
(Osaka General Medical Center)
We encountered three cases of advanced deep neck abscess extending to the mediastinum. Delayed diagnosis and inadequate mediastinal drainage are the primary causes of a high mortality rate. In all three cases, there were delays in referral to the ENT department to diagnose the deep neck abscess extending to mediastinum because of chronic renal failure requiring hemodialysis, Alzheimer's disease and cerebral vascular dementia, respectively. Computed tomography was very useful to diagnose and analyze the infected compartments.
After diagnosis, we underwent surgery as soon as possible with the cooperation of thoracic surgeons. To drain the mediastinum, we chose thoracoscopic drainage, mediastinoscopic drainage and conventional thoracotomy, respectively, according to the site of abscess and general condition of the patient. In all cases, immediate postoperative management was performed in the intensive care unit and postoperative progress was satisfactory. If deep neck abscess is suspected, adequate diagnosis and immediate surgical procedures are necessary.
Key words :mediastinum, deep neck abscess, drainage, computed tomography