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Risk Factors of Descending Necrotizing Mediastinitis in Deep Neck Abscesses
by
Chen, Shih-Lung
, Hu, Chih-Yu
, Chan, Kai-Chieh
, Lien, Kuang-Hsu
in
Abscess
/ Abscess - complications
/ Abscesses
/ Age
/ Airway management
/ Antibiotics
/ Blood
/ Blood cell count
/ C-Reactive Protein
/ Care and treatment
/ deep neck abscess
/ descending necrotizing mediastinitis
/ Diagnosis
/ Drug use
/ Dysphagia
/ Dyspnea
/ Health aspects
/ Hospitalization
/ Humans
/ Infections
/ Measurement
/ Mediastinal tumors
/ Mediastinitis - diagnosis
/ Mediastinitis - etiology
/ Mediastinitis - surgery
/ Mortality
/ Neck
/ Necrosis - complications
/ Neutrophils
/ Ostomy
/ Patients
/ Prevention
/ Retrospective Studies
/ risk factor
/ Risk Factors
/ Tomography
/ Tracheotomy
/ Vertebrae
2022
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Risk Factors of Descending Necrotizing Mediastinitis in Deep Neck Abscesses
by
Chen, Shih-Lung
, Hu, Chih-Yu
, Chan, Kai-Chieh
, Lien, Kuang-Hsu
in
Abscess
/ Abscess - complications
/ Abscesses
/ Age
/ Airway management
/ Antibiotics
/ Blood
/ Blood cell count
/ C-Reactive Protein
/ Care and treatment
/ deep neck abscess
/ descending necrotizing mediastinitis
/ Diagnosis
/ Drug use
/ Dysphagia
/ Dyspnea
/ Health aspects
/ Hospitalization
/ Humans
/ Infections
/ Measurement
/ Mediastinal tumors
/ Mediastinitis - diagnosis
/ Mediastinitis - etiology
/ Mediastinitis - surgery
/ Mortality
/ Neck
/ Necrosis - complications
/ Neutrophils
/ Ostomy
/ Patients
/ Prevention
/ Retrospective Studies
/ risk factor
/ Risk Factors
/ Tomography
/ Tracheotomy
/ Vertebrae
2022
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Risk Factors of Descending Necrotizing Mediastinitis in Deep Neck Abscesses
by
Chen, Shih-Lung
, Hu, Chih-Yu
, Chan, Kai-Chieh
, Lien, Kuang-Hsu
in
Abscess
/ Abscess - complications
/ Abscesses
/ Age
/ Airway management
/ Antibiotics
/ Blood
/ Blood cell count
/ C-Reactive Protein
/ Care and treatment
/ deep neck abscess
/ descending necrotizing mediastinitis
/ Diagnosis
/ Drug use
/ Dysphagia
/ Dyspnea
/ Health aspects
/ Hospitalization
/ Humans
/ Infections
/ Measurement
/ Mediastinal tumors
/ Mediastinitis - diagnosis
/ Mediastinitis - etiology
/ Mediastinitis - surgery
/ Mortality
/ Neck
/ Necrosis - complications
/ Neutrophils
/ Ostomy
/ Patients
/ Prevention
/ Retrospective Studies
/ risk factor
/ Risk Factors
/ Tomography
/ Tracheotomy
/ Vertebrae
2022
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Risk Factors of Descending Necrotizing Mediastinitis in Deep Neck Abscesses
Journal Article
Risk Factors of Descending Necrotizing Mediastinitis in Deep Neck Abscesses
2022
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Overview
Background and Objectives: Cervical space infection could also extend to the mediastinum due to the anatomical vicinity. The mortality rate of descending necrotizing mediastinitis is 85% if untreated. The aim of this study was to identify risk factors for the progression of deep neck abscesses to descending necrotizing mediastinitis. Materials and Methods: We retrospectively reviewed the medical records of patients undergoing surgical treatment of deep neck abscesses from August 2017 to July 2022. Computed tomography (CT) was performed in all patients. Before surgery, lab data including hemoglobulin (Hb), white blood cell count, neutrophil percentage, C-reactive protein (CRP) level, and blood glucose were recorded. Patients’ characteristics including gender, age, etiology, and presenting symptoms were collected. Hospitalization duration and bacterial cultures from the wound were also analyzed. Results: The C-reactive protein (CRP) level was higher in patients with a mediastinal abscess than in patients without a mediastinal abscess (340.9 ± 33.0 mg/L vs. 190.1 ± 72.7 mg/L) (p = 0.000). The submandibular space was more commonly affected in patients without a mediastinal abscess (p = 0.048). The retropharyngeal (p = 0.003) and anterior visceral (p = 0.006) spaces were more commonly affected in patients with a mediastinal abscess. Conclusions: Descending necrtotizing mediastinitis results in mortality and longer hospitalization times. Early detection of a mediastinal abscess on CT is crucial for treatment. Excluding abscesses of the anterior superior mediastinum for which transcervical drainage is sufficient, other mediastinal abscesses require multimodal treatment including ENT and thoracic surgery to achieve a good outcome.
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