Abstract

Descending necrotizing mediastinit is a primary complication of cervical or odontogenic infections that can spread to the mediastinum through the anatomical spaces. The mortality rate is high (50%) and urgent treatment is required. Mixed, aerobic and anaerobic microorganisms are isolated frequently. The patients are asymptomatic at the beginning that precludes an early diagnosis. The choice of treatment is cervical drainage and/or thoracotomy. Two patients with diagnosis of necrotising mediastinitis were treated at our institution. One of the patients was a 16-yearold girl and the other one was a 46-year-old man. The etiology for both patients was submandibular abscess caused by odontogenic infection. Cervical drainage and aggressive mediyastinal drainage were carried out for the female and multiple chest tube drenage and cervical drainage for the male patient. Although the female patient died on the ninth postoperative day, the man was discharged at twenty-seventh day. Mortality rate of descending necrotising mediastinitis is high. The most important factor that outlines the mortality is the spread of the disease and early aggresive treatment.