Abstract
From 1991 to 2000 we have examined four cases of descending necrotizing mediastinitis (DNM) which developed after oropharyngeal infections.
In all cases, mediastinitis spread below the upper mediastinum. In two, it spread to the anterior mediastinum, and in three to the posterior mediastinum.
DNM is usually treated by drainage, with antibiotics administered as a supportive therapy.
Two of our cases underwent cervicotomy and thoracotomy, and both patients showed significant improvement. Another cases underwent cervicotomy and pleurocentesis. On the other hand, the remaining patient, who only underwent cervicotomy, because further surgical treatment would have jeopardized his general health condition, died from septic shock.
It is essential that the best method of drainage for each patient be determined on an individual basis before each patient's general health deterioriates.
