De Freitas R P, Fahy C P, Brooker D S, Primrose W J, McManus K G, McGuigan J A, Hughes S J
Department of Otolaryngology and Head and Neck Surgery, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland.
Eur Arch Otorhinolaryngol. 2007 Feb;264(2):181-7. doi: 10.1007/s00405-006-0174-z. Epub 2006 Sep 29.
Descending necrotising mediastinitis can complicate oropharyngeal infection and has a high associated mortality. We present three cases treated in our department and propose a treatment algorithm based on our experience and literature review. The primary oropharyngeal infection was peritonsillar abscess in two cases and odontogenic abscess in one. Two patients underwent cervicotomy and later thoracotomy. The third underwent cervicotomy with transcervical mediastinal drainage and later required pericardial drainage via a subxiphoid incision. All recovered fully and were discharged within 6 weeks. To enable successful treatment, diagnosis needs to be prompt and surgical drainage adequate. Thoracic management of the chest is essential.
下行性坏死性纵隔炎可使口咽感染复杂化，且相关死亡率很高。我们介绍了在我们科室治疗的三例病例，并根据我们的经验和文献综述提出了一种治疗方案。原发性口咽感染在两例中为扁桃体周围脓肿，一例为牙源性脓肿。两名患者接受了颈部切开术，随后进行了开胸手术。第三名患者接受了颈部切开术及经颈纵隔引流，后来需要通过剑突下切口进行心包引流。所有患者均完全康复并在6周内出院。为了实现成功治疗，需要迅速诊断并进行充分的手术引流。胸部的胸腔管理至关重要。
