[Descending necrotizing mediastinitis treated by mediastinal drainage through bilateral thorax; report of a case]

Abstract

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.