| Deep neck infections (DNIs) can lead to serious complications, including mediastinal extension, necessitating prompt and
appropriate management. This study aimed to evaluate predisposing factors for mediastinal extension and characterize the
clinical features of DNIs. A cohort of 112 patients with descending necrotizing mediastinitis underwent either cervical
drainage alone (CD group) or combined cervical and mediastinal drainage (MD group). The two groups were compared
regarding demographic and clinical characteristics, as well as factors contributing to mediastinal extension. The majority of
patients (81%) required only cervical drainage, while 23% necessitated both cervical and mediastinal drainage. Although
gender distribution did not differ between groups, the MD group tended to be older and had a higher prevalence of
comorbidities. Multispace involvement, particularly retropharyngeal involvement, was more common in cases requiring
mediastinal drainage. Organism identification was significantly higher in the CD group. Furthermore, patients in the MD
group had a longer hospital stay and higher mortality compared to those in the CD group. Older age, involvement of
multiple spaces, particularly the retropharynx, and greater comorbidity were associated with mediastinal extension in DNIs.
These findings underscore the importance of early recognition and appropriate management of DNIs to prevent
complications such as mediastinal extension.ddd |
