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Deep neck infections: risk factors for mediastinal extension

  • Head and Neck
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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.

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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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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Charles University in Prague, Sokolska 581, Hradec Kralove, 50005, Czech Republic

    Petr Celakovsky & David Kalfert

  2. Department of Dentistry, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic

    Lubos Tucek

  3. Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Health Studies, Regional Hospital Pardubice, University of Pardubice, Pardubice, Czech Republic

    Jan Mejzlik & Milos Kotulek

  4. Department of Oral and Maxillofacial Surgery, Regional Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic

    Ales Vrbacky

  5. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czech Republic

    Petr Matousek & Lucia Stanikova

  6. Department of Oral and Maxillofacial Surgery, University Hospital Ostrava, Ostrava, Czech Republic

    Tereza Hoskova & Adam Pasz

Authors
  1. Petr Celakovsky
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  2. David Kalfert
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  3. Lubos Tucek
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  4. Jan Mejzlik
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  5. Milos Kotulek
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  6. Ales Vrbacky
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  7. Petr Matousek
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  8. Lucia Stanikova
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  9. Tereza Hoskova
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  10. Adam Pasz
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Corresponding author

Correspondence to David Kalfert.

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Celakovsky, P., Kalfert, D., Tucek, L. et al. Deep neck infections: risk factors for mediastinal extension. Eur Arch Otorhinolaryngol 271, 1679–1683 (2014). https://doi.org/10.1007/s00405-013-2651-5

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  • DOI: https://doi.org/10.1007/s00405-013-2651-5

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