Descending Necrotizing Mediastinitis Associated with an Infected Dentigerous Cyst

Abstract

Descending necrotizing mediastinitis (DNM) is a rare condition in which an infection from the head and neck propagates into the mediastinum. The most common cause of DNM is odontogenic infection. DNM is spread by the fascial planes from the neck into the mediastinum and requires an aggressive surgical drainage through cervical and thoracic approaches. We report on a 67-year-old male patient, who had acute mediastinitis related to an infected dentigerous cyst in the left parasymphyseal region. A multidisciplinary team approach was used to treat the patient. The team consisted of thoracic surgeons, maxillofacial surgeons, and a radiologist. After the drainage of the mediastinum and pleural cavity, the cyst was enucleated. The patient was discharged at the 42nd day of hospitalization. The aim of this article is to present diagnosis, management, and follow-up of an infected dentigerous cyst that caused DNM. © 2012 Elsevier Inc.