Clinical analysis of 70 cases of odontogenic descending necrotizing mediastinitis

doi:10.19438/j.cjoms.2018.02.015

China Journal of Oral and Maxillofacial Surgery ›› 2018, Vol. 16 ›› Issue (2): 171-175.doi: 10.19438/j.cjoms.2018.02.015

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Clinical analysis of 70 cases of odontogenic descending necrotizing mediastinitis

XIA Yun-hui¹, QU Lu-yao², LIANG Xiang³, JIANG Bin⁴, QIAN Wen-tao², CAI Xie-yi², ZHANG Wei-jie², GUAN Xin³

1.Department of Oral and Craniomaxillofacial Surgery, 2.Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology. Shanghai 200011;
3. Department of Thoracic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
4.Department of Stomatology, Shanghai Renji Hospital,Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China;

Received:2017-09-26 Revised:2017-11-22 Online:2018-03-20 Published:2018-04-08

Abstract

Abstract: PURPOSE: To analyze the clinical features of patients with odontogenic descending necrotizing mediastinitis (DNM) in order to provide prompt diagnosis and treatment. METHODS: A retrospective study was conducted on 70 patients receiving treatment for odontogenic DNM from January 2014 to December 2016. Demographics, etiology of infection, clinical symptom, laboratory tests, bacterial cultures, treatment and outcomes were collected and analyzed. Statistical analysis of the results was performed using SPSS 22.0 software package. RESULTS: There were 57 males and 13 females, with a mean age of 57.8±11.42 years. The most frequent teeth involved were the lower posterior molars (38.6%). Periapical periodontitis was the most frequent triggering cause in 50 cases. Treatments consisted of antibiotic therapy and aggressive transcervical drainage (63 cases) and thoracotomy (7 cases). The mortality was 5.7%. The risk factors for mortality were associated complications (P<0.005) and severe sepsis or septic shock(P<0.002). CONCLUSIONS: Success in management of odontogenic DNM is based on prompt identification of suspected symptoms, quick CT scanning and aggressive mediastinal drainage.

Key words: Odontogenic infection, Descending necrotizing mediastinitis, Mediastinal drainage

CLC Number:

R782.3

XIA Yun-hui, QU Lu-yao, LIANG Xiang, JIANG Bin, QIAN Wen-tao, CAI Xie-yi, ZHANG Wei-jie, GUAN Xin. Clinical analysis of 70 cases of odontogenic descending necrotizing mediastinitis[J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(2): 171-175.

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Clinical analysis of 70 cases of odontogenic descending necrotizing mediastinitis

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