RETURNYonago Acta medica 1992;35:117–126
Treatment of Deep Neck Infections Including a Case of Sternoclavicular Infection Leading to Deep Neck Infection and Mediastinitis
Keiichi Kadowaki and Hisaaki Ikoma*
Clinic of Otorhinolaryngology, Hamada National Hospital, Hamada 697 and *Department of Oto-Rhino-Laryngology, Faculty of Medicine, Tottori University, Yonago 683, Japan
Deep neck infection affects soft tissues and fascial compartments of the head and neck, and may rarely lead to lethal complications. This article summarizes the clinical features and methods of managing the course of disease in 8 patients with deep neck infection we have encountered over a 1-year period. The origin of disease was pharyngeal in 5 patients, and odontogenic, esophageal and sternoclavicular each in the other 3 patients. One of the 8 patients had a deep neck infection and mediastinitis that were presumably caused by the spread of infection from the sternoclavicular joint. This seems the 1st reported case of an infection of the sternoclavicular joint that involved deep neck infection and mediastinitis. The anatomy, etiology and treatment of deep neck infection are reviewed. When an early diagnosis of deep neck infection has been made, computed tomography is quite useful in determining the spread of the infection into the other areas and mediastinum, and in assessing vital response to therapy.
Key words: anaerobic bacteria; CT finding; deep neck infection; mediastinitis; sternoclavicular infection