E.S. KATANOV², V.Yu. MATVEEV^3,4, S.I. STOLYAROV¹, G.N. KRASNOV^1,2, N.A. MIZUROV²

¹Republican Clinical Hospital of the MH of RCh, 9 Moskovskiy Pr., Cheboksary, Russian Federation, 428000

²Chuvash State University named after I.N. Ulyanov, 15 Moskovskiy Pr., Cheboksary, Russian Federation, 428000

³Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

⁴Republican Clinical Hospital of the MH of RT, 138 Orenburskiy Trakt, Kazan, Russian Federation, 420064 

Katanov E.S. ― D. Med. Sc., Professor of the Department of Surgical Diseases, tel. (8352) 64-87-01, e-mail: katanove@mail.ru

Matveev V.Yu. ― Cand. Med. Sc., thoracic surgeon, Assistant of the Department of Surgical Diseases №1, tel. +7-917-286-41-27, e-mail: avmat@mail.ru

Stolyarov S.I. ― thoracic surgeon, tel. (8352) 58-21-46, e-mail: katanove@mail.ru

Krasnov G.N. ― Cand. Med. Sc., Associate Professor of the Department of Surgical Diseases, tel. (8352) 58-16-11, e-mail: gera_krasnov@mail.ru

Mizurov N.A. ― Cand. Med. Sc., Associate Professor of the Department of Surgical Diseases, tel. (8352) 58-16-11, e-mail: nik.mizurov@mail.ru

The article presents the results of treatment of 50 patients with acute odontogenic purulent mediastinitis with a primary lesion, males of working age (n=35, 70%). The most frequent cause of the disease was complicated periostitis, periodontitis and osteomyelitis of the mandible. The clinical characteristics of the patients, the reasons for the late treatment are presented. The resulting complications of mediastinitis (n=36, 72%) and methods for their treatment are analyzed. Operation of choice is bilateral transneck mediastinotomy by Razumovsky with draining the anterior and posterior mediastinum. If the total front access odontogenic mediastinitis develops, drainage by Sazonov must necessarily be implemented. The mortality rate was 30%.

In the authors’ opinion, the mortality rate for acute purulent odontogenic mediastinitis depends on timely hospitalization, diagnosis and early surgical treatment involving extracorporeal detoxification methods.

Key words: odontogenic purulent mediastinitis, treatment strategy, mediastinotomy, mediastinum.

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