Okamoto T, Wakabayashi T, Hashimoto T, Aoki T, Tsuchida M, Hayashi J
Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Kyobu Geka. 2006 Nov;59(12):1110-3.
Descending necrotizing mediastinitis is a severe infection spreading from the cervical region to the mediastinal connective tissue. The mortality rate was high and appropriate treatment is necessary to obtain favorable results. The present study describes a case of a 69-year-old man with severe descending necrotizing mediastinitis due to parapharyngeal abscess. The patient was successfully treated with cervical drainage, surgical debridement of the mediastinum via small thoracotomy. Postoperatively, continuous mediastinal and pleural irrigation with saline was performed. Swallowing disturbance due to dissection of cervical muscles prolonged duration of hospital stay. Eventually, the patient recovered and was able to eat by muscle rehabilitation.
下行性坏死性纵隔炎是一种从颈部蔓延至纵隔结缔组织的严重感染。死亡率很高，必须采取适当治疗才能取得良好效果。本研究描述了一例69岁男性因咽旁脓肿导致严重下行性坏死性纵隔炎的病例。该患者通过颈部引流、经小切口开胸手术对纵隔进行清创成功治愈。术后，用生理盐水对纵隔和胸膜进行持续冲洗。颈部肌肉解剖导致的吞咽障碍延长了住院时间。最终，患者康复并通过肌肉康复训练能够进食。
