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Asociación Colombiana de Otorrinolaringología y Cirugía de Cabeza y cuello, Maxilofacial y Estética Facial (ACORL)

2022, Number 2

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Acta de Otorrinolaringología CCC 2022; 50 (2)

Descending mediastinitis in the context of Ludwig’s Angina. Article review

Fuentes FAL, Romero MLF, Olivera AMP, Cortés LJA, Ulloque AHA

Language: Spanish
References: 50
Page: 151-158
PDF size: 185.13 Kb.


ABSTRACT

Introduction: Mediastinitis is defined as the usually infectious inflammatory process of the mediastinal connective tissue and the organs it surrounds. Specifically, descending mediastinitis corresponds to a rare complication, an infection of deep spaces of the neck, oropharynx, or oral cavity, which extends through the facial spaces of the neck, dissecting. Less frequent, this pathology can originate from parotiditis, skin infections of the neck or epiglottitis. Also, less frequent it can be generated in the context of trauma to the neck or oral cavity. This study intends to draw attention to the aspects that involve the ENT specialist in the management of patients with deep neck infections and their role in the diagnosis and effective treatment of descending mediastinitis as the main cause of mortality in these patients. Methodology: A search was carried out with the keywords “Airway” “Ludwig’s angina” in PubMed, no filtering was performed by date or type of study, finding a total of 147 articles, abstracts were read by the authors, selecting 50. A critical reading of the 50 articles full texts is carried out and the relevant information is extracted. Conclusion: This pathology of marked severity, carries a significant increase in mortality and its treatment, although it remains controversial in certain circumstances, it must be aggressive and timely, focusing the role of the otorhinolaryngologist on 4 pillars of treatment: surgical drainage, antibiotic therapy, hemodynamic support, and airway safety.


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