ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2022
Deep neck infections with and without mediastinal involvement: treatment and outcome in 218 patients.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 31 citations in OpenAlex.
- Managing the Difficult Airway in Adults with Life-Threatening Cervical Infections: A Scoping Review.Healthcare (Basel, Switzerland) · 2026Review
- Temporal Trends in Pathogens and Clinical Outcomes of Adult Deep Neck Infections: An 18-Year Multicenter Cohort Study of 12,063 Cases.Microorganisms · 2026Article
- Recognizing Descending Necrotizing Mediastinitis in Adults: A Narrative Review of Diagnostic Dilemmas and Barriers.Cureus · 2026Review
- Article
- Predictors of mediastinitis in deep neck space infections - ten-year experience from tertiary referral center.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Global Burden of Deep Neck Space Abscesses: Epidemiology, Challenges, and Outcomes.Journal of personalized medicine · 2026Review
- Emergencies in Otorhinolaryngology: Diagnostic Evaluation, Assessment of Urgency, and Treatment.Deutsches Arzteblatt international · 2025Review
- Treatment Behaviors of Patients With Odontogenic Infections During the COVID-19 Pandemic.Cureus · 2025Article
- Management of Deep Neck Infection Associated with Descending Necrotizing Mediastinitis: A Scoping Review.Medicina (Kaunas, Lithuania) · 2025Article
- Clinical Conundrum: Swallowing Virtual Reality as a Novel Diagnostic Tool for Severe Dysphagia after Deep Neck Infection.Dysphagia · 2025Article
- Risk factors and preventive measures for severe orofacial and neck infections: a three-year observational study.BMC oral health · 2025Observational
- Deep Neck Infections: The Effectiveness of Therapeutic Management and Bacteriological Profile.Medicina (Kaunas, Lithuania) · 2025Observational
- Suppurative Cervicomediastinitis From the Perspective of the Head and Neck Surgeon in a Tertiary Treatment Unit.Cureus · 2024Article
- Implementation of Silver Nanoparticles Green Synthesized with Leaf Extract ofCurrent pharmaceutical biotechnology · 2024Article
- Differences in characteristics and infection severity between odontogenic and other bacterial oro-naso-pharyngeal infections.Head & face medicine · 2023Article
- Article
- Isolation ofIDCases · 2023Article
- Deep neck space infection extending to the mediastinum that was treated conservatively.BMJ case reports · 2022Article
- Video-assisted thoracoscopic surgery for a pediatric patient with descending necrotizing mediastinitis.Translational pediatrics · 2022Article
- Paediatric Deep Neck Infection-The Risk of Needing Intensive Care.Children (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeInfections of the deep neck, although becoming scarcer due to the widespread use of antibiotics, still represent a dangerous and possibly deadly disease, especially when descending into the mediastinum. Due to the different specialities involved in the treatment and the heterogenous presentation of the disease, therapeutic standard is still controversial. This study analyzes treatment and outcome in these patients based on a large retrospective review and proposes a therapeutic algorithm.
methodsThe cases of 218 adult patients treated with deep neck abscesses over a 10-year period at a tertiary university hospital were analyzed retrospectively. Clinical, radiological, microbiological and laboratory findings were compared between patients with and without mediastinal involvement.
resultsForty-five patients (20.64%) presented with abscess formation descending into the mediastinum. Those patients had significantly (all items p < 0.0001) higher rates of surgical interventions (4.27 vs. 1.11) and tracheotomies (82% vs. 3.4%), higher markers of inflammation (CRP 26.09 vs. 10.41 mg/dl), required more CT-scans (3.58 vs. 0.85), longer hospitalization (39.78 vs 9.79 days) and more frequently needed a change in antibiotic therapy (44.44% vs. 6.40%). Multi-resistant pathogens were found in 6.67% vs. 1.16%. Overall mortality rate was low with 1.83%.
conclusionDespite of the high percentage of mediastinal involvement in the present patient collective, the proposed therapeutic algorithm resulted in a low mortality rate. Frequent CT-scans, regular planned surgical revisions with local drainage and lavage, as well as an early tracheotomy seem to be most beneficial regarding the outcome.
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