• Martin Lucenic, Katarina Tarabova, Peter Juhos, Patrik Laucek, Daniel Siska, Svetozar Harustiak, and Miroslav Janik.
• Bratisl Med J. 2022 Jan 1; 123 (4): 291-298.

ObjectivesAnalysing the results of patients with odontogenic descending necrotising mediastinitis (DNM) treated predominantly by transcervical approach.BackgroundOdontogenic DNM is a rare but serious complication of dental disease and dental procedures.MethodsRetrospective evaluation of 20 patients who underwent surgery for odontogenic DNM.ResultsThe mean age was 33.95±12.24 years, and 18 patients (90 %) were men. Type I and diffuse form of DNM were identified in 8 (40 %) and 12 (60 %) patients, respectively. The mean time between the onset of symptoms and surgery was 7.16±4.23 days. The transcervical approach was used in 16 patients, combined cervicotomy and subxiphoid incision in three patients, and cervicotomy and posterolateral thoracotomy was used in one patient. Four patients were reoperated. The mean mediastinal drainage duration and postoperative length of stay (LOS) were 17.05±10.27 days and 20.70±10.87 days, respectively. Fourteen (70 %) patients received mechanical ventilation with a mean duration of 8.86±9.55 days. Comorbidities were present in five (26 %) patients; there were complications in 17 (85 %) patients. In-hospital mortality reached 5 % (1 patient). Thirty-five teeth were extracted. Lower mandibular molars represented 21 (62 %) of extracted teeth. Submandibular and submental spaces were the most affected by the presence of deep neck infection (five and four cases, respectively).ConclusionThis study supports the role of transcervical mediastinal drainage as an alternative approach in the surgical treatment of odontogenic DNM (Tab. 4, Fig. 2, Ref. 30).

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