Thoracic complications of deeply situated serous neck infections

J Craniomaxillofac Surg. 1993 Mar;21(2):76-81. doi: 10.1016/s1010-5182(05)80151-9.

Abstract

Nine cases of complicated deep neck infections, occurring during a period of twelve years are presented. Complications observed were cervico-thoracic necrotizing fasciitis in 3 cases, purulent pleural effusion in 6 cases, pericardial effusion in 2, mediastinitis in 8 cases, jugular vein thrombosis and rupture of the innominate artery in one case each. Although 2 cases were managed initially with blind endotracheal intubation, all cases finally required tracheostomy. A cervico-mediastinal approach was useful for the early mediastinal involvement. Two patients died because of inadequacy of the multiple surgical procedures resulting in persistent infection and multi-organ failure and one because of uncontrollable bleeding after innominate artery rupture.

MeSH terms

  • Adolescent
  • Adult
  • Airway Obstruction / etiology
  • Airway Obstruction / surgery
  • Bacterial Infections / complications*
  • Brachiocephalic Trunk
  • Drainage
  • Empyema, Pleural / etiology*
  • Empyema, Pleural / surgery
  • Fasciitis / etiology
  • Focal Infection, Dental / complications*
  • Humans
  • Ludwig's Angina / etiology
  • Male
  • Mediastinitis / etiology
  • Middle Aged
  • Neck*
  • Necrosis
  • Pleural Effusion / etiology
  • Pneumonia, Aspiration / etiology
  • Rupture, Spontaneous
  • Thoracic Diseases / etiology*
  • Thoracic Diseases / microbiology
  • Thoracic Diseases / surgery
  • Tracheostomy