Successful thoracoscopic debridement of descending necrotizing mediastinitis

Ann Thorac Surg. 2004 May;77(5):1834-7. doi: 10.1016/S0003-4975(03)01260-8.


Descending necrotizing mediastinitis results from odontogenic, deep neck infection that spreads along fascial planes into the mediastinum. Although the optimal surgical approach remains controversial, nearly half of the cases require mediastinal debridement by thoracotomy. We report a case of successful thoracoscopic debridement for descending necrotizing mediastinitis due to odontogenic infection that failed to be drained by transcervical approach. Because of less invasiveness as compared with standard thoracotomy, the thoracoscopic approach should be used as early as possible in case of unsuccessful transcervical approach.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnostic imaging
  • Abscess / surgery
  • Debridement*
  • Drainage
  • Female
  • Humans
  • Mediastinal Diseases / diagnostic imaging
  • Mediastinal Diseases / surgery
  • Mediastinitis / diagnostic imaging
  • Mediastinitis / pathology
  • Mediastinitis / surgery*
  • Middle Aged
  • Necrosis
  • Pleural Effusion / surgery
  • Postoperative Complications / surgery*
  • Thoracoscopy*
  • Tomography, X-Ray Computed
  • Tooth Extraction / adverse effects*
  • Treatment Failure