[Infections of the deep neck spaces with accompanying mediastinitis]

Abstract

Background: Infections of the deep neck spaces with accompanying mediastinitis are still a therapeutic problem with a high mortality.

Patients: We report on three patients with deep neck space infections and accompanying mediastinitis who have been treated in the Departments of Otorhinolaryngology at the Universities of Bochum and Essen in the past 2 years. In two patients the infection originated from a peritonsillar abscess and in one patient from an odontogenic infection.

Therapy: One patient was successfully treated by a tonsillectomy and drainage of the parapharyngeal abscess in conjunction with a thoracotomy because of a mediastinal abscess and bilateral pneumothorax. The second patient was cured by a tonsillectomy, wide cervical drainage und cervical mediastinotomy. The third patient with pre-existent alcohol abuse died because of multiorgan failure despite wide cervical und mediastinal drainage.

Conclusion: In every deep neck infection a mediastinal involvement has to be taken into account. Fast diagnosis and treatment are essential for the prognosis of this life-threatening disease.