Cervicotomy vs. thoracotomy: management of descending necrotizing mediastinistis due to odontogenic infections

Descending necrotizing mediastinitis is a condition characterized by inflammation of connective tissues in mediastinum. It is a very serious illness with a very high mortality rate and early diagnosis of DNM is very important to prevent morbidity and mortality. About 70% of the cases of DNM occur through the retropharyngeal pathway and 8% occur via the pretracheal route. Despite various surgical approaches for the treatment of DNM, the optimal approach still remains controversial. We present our experience of 6 patients of DNM with involvement of anterior and posterior mediastinum managed by cervicotomy and transverse cervical drainage with placement of corrugated drains and a pleural chest drain, we advocate a conservative approach with limited debridement and emphasis on drainage of infection in line with published case series

study of classification systems for maxillectomy defects

Maxillectomy is one of the most common procedures performed by oral and maxillofacial / head and neck surgeon. It is usually performed for ablation of maxillary tumors. Various classification systems exist in literature to describe the surgical defect, left behind after maxillectomy. There remains however confusion, in literature, regarding use of correct terminology and description of surgical defect. We performed a comprehensive literature search to identify all classification systems which have been described in the literature. We present a comprehensive review of these classification systems and also describe, based upon our own clinical experience, a simpler way of classifying and describing the Maxillary defects

Submental intubation in extensive maxillofacial trauma

Surgical repair of complex maxillofacial trauma presents a challenge to the surgeon and anesthesiologist. Where intubations via oral and nasal route cannot be performed, sub-mental route of endotracheal intubation is a very useful alternative. It obviates the need for tracheostomy and its related complications. We are presenting a case where we avoided tracheostomy in a patient with multiple maxillofacial fractures and opted for the sub-mental endotracheal intubation technique