Surgical treatment of patients with neck phlegmon complicated acute descending mediastenitis

Abstract

The analysis of direct results of treatment of 43 patients with deep phlegmons of the neck complicated by acute downward mediastinitis for 2014-2018. The age of the patients from 21 to 72 years, on average 36.3 ± 3.9 years. For diagnostics, X-ray of the chest organs, ultrasonography, computer tomography, according to indications of fibrobronchoscopy and fibroezofagogastroduodenoscopy were used. There were 19 (44.2%) patients with odontogenic phlegmon, suppurated lymphadenitis– 10 (23.2%), tonsilogen– 9 (20.9%), purulent thyroiditis– 2 (4.6%) patients. The disease was complicated by the anteriorupper acute downward mediastinitis in 22 (51.1%) patients, the upper ones were 7 (16.3%), total– 14 (32.7%). Established diagnostic signs that allow you to suspect the spread of purulent process on the mediastinum. The method of preventing the spread of purulent infection from interfascial neck gaps in the mediastinal cell line, which consists in retrosternal intramedyal administration of antibacterial agents, is proposed. With the use of this technique, a decrease in the incidence of acute purulent mediastinitis was noted in 7 (16.3%) patients.