THE SURGICAL APPROACH FOR DESCENDING NECROTIZING MEDIASTINITIS - REPORT OF 2 CASES

Descending necrotizing mediastinitis (DNM) is a potentially life-threa tening complication that can develop after an oropharyngeal infection. Patients with DNM are usually treated with mediastinal drainage throu gh a cervical or transthoracic approach, as well as by the systemic ad ministration of antibiotics. We report herein the cases of two patient s we recently treated for DNM. In the first patient, the DNM was limit ed to the upper mediastinum, and cervicomediastinal drainage was perfo rmed. In the second patient, the mediastinitis spread below the trache al bifurcation down into the lower mediastinum, and an abscess was dra ined through a thoracotomy approach. The principles of the surgical ap proach for DNR I are discussed, with a brief review of the literature following these case reports.