• Yuka Sumi, Hiroshi Ogura, Yasushi Nakamori, Isao Ukai, Osamu Tasaki, Yasuyuki Kuwagata, Takeshi Shimazu, Hiroshi Tanaka, and Hisashi Sugimoto.
• Department of Traumatologyand Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. yukasumi020503@yahoo.co.jp
• Arch. Otolaryngol. Head Neck Surg. 2008 Jul 1; 134 (7): 750-6.

ObjectiveTo evaluate the clinical utility of catheter drainage for cervical necrotizing fasciitis (CNF) with and without descending necrotizing mediastinitis (DNM).DesignRetrospective analysis.SettingDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine.PatientsThirty-two patients with clinically and radiographically diagnosed CNF with and without DNM were included.InterventionsCatheters were introduced into the infected space through the patients' necks under sonographic and x-ray fluoroscopic guidance.Main Outcome MeasuresTreatments, clinical course, complications, and mortality were evaluated.ResultsCatheter drainage was successfully performed in all patients. The CNF was due to pharyngeal infection in 14 patients (44%) and dental infection in 14 other patients (44%). Mediastinal extension occurred in 14 patients (44%). Overall mortality was 3.1%; only 1 patient with DNM died due to Clostridium sepsis. Both pharyngeal origin and diabetes mellitus were significantly associated with the development of DNM. More intensive treatment is necessary for patients with CNF with DNM than for patients with CNF without DNM.ConclusionPercutaneous catheter drainage may be used as an effective treatment for CNF with and without DNM.

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