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European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 6, pp 1679–1683 | Cite as

Deep neck infections: risk factors for mediastinal extension

  • Petr Celakovsky
  • David Kalfert
  • Lubos Tucek
  • Jan Mejzlik
  • Milos Kotulek
  • Ales Vrbacky
  • Petr Matousek
  • Lucia Stanikova
  • Tereza Hoskova
  • Adam Pasz
Head and Neck

Abstract

The goal of the study was to find out the risk factors for the development of mediastinitis in patients with deep neck infections (DNI) and describe the differences in symptoms and clinical image between uncomplicated DNI and infections with mediastinal spread. Our study represents the retrospective analysis of 634 patients with DNI. The file was divided into two groups. There were 619 patients (97.6 %) in the first group who had an uncomplicated course of DNI without spread of infection into mediastinum (DNI group). The second group included 15 patients (2.4 %) with descending mediastinitis as a complication of DNI (mediastinitis group). The most frequent comorbidities were cardiac and pulmonary diseases, which were more frequent in the mediastinitis group comparing to DNI group. Dental origin of the infection was more frequent in DNI group than in the mediastinitis group. On the other hand, tonsillar origin of the infection was more frequent in the mediastinitis group than in DNI group. In both mediastinitis and DNI groups, the typical presenting symptoms were pain, oedema and dysphagia. Furthermore, dysphagia, dyspnoea, dysphonia and restriction of neck movements were more significant in the mediastinitis group than in DNI group. The incidence of airway obstruction, sepsis, pneumonia and death was significantly higher in the mediastinitis group than in DNI group. Due to our results, the predisposing factors for mediastinal extension of DNI are cardiovascular and pulmonary diseases. Mediastinitis is associated with higher morbidity and mortality than DNI. The most common complications are airway obstruction, pneumonia and sepsis.

Keywords

Deep neck infections Mediastinitis Risk factors 

Notes

Acknowledgments

This article was supported by the project (Ministry of Health, Czech Republic) for conceptual development of research organization 00179906.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

Ethical approval was not considered necessary as the patients data were collected retrospectively.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Petr Celakovsky
    • 1
  • David Kalfert
    • 1
  • Lubos Tucek
    • 2
  • Jan Mejzlik
    • 3
  • Milos Kotulek
    • 3
  • Ales Vrbacky
    • 4
  • Petr Matousek
    • 5
  • Lucia Stanikova
    • 5
  • Tereza Hoskova
    • 6
  • Adam Pasz
    • 6
  1. 1.Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine in Hradec KraloveUniversity Hospital Hradec Kralove, Charles University in PragueHradec KraloveCzech Republic
  2. 2.Department of Dentistry, Faculty of Medicine in Hradec KraloveUniversity Hospital Hradec Kralove, Charles University in PragueHradec KraloveCzech Republic
  3. 3.Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Health StudiesRegional Hospital Pardubice, University of PardubicePardubiceCzech Republic
  4. 4.Department of Oral and Maxillofacial Surgery, Regional Hospital Pardubice, Faculty of Health StudiesUniversity of PardubicePardubiceCzech Republic
  5. 5.Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital OstravaOstravaCzech Republic
  6. 6.Department of Oral and Maxillofacial SurgeryUniversity Hospital OstravaOstravaCzech Republic

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