Mediastinitis is an inflammation of the mediastinum. Descending necrotizing mediastinitis (DNM) is the most common form of mediastinitis. Symptoms of severe oropharyngeal infection, radiological evidence of mediastinitis, documentation of necrotising mediastinitis at surgery, and a relationship between the infection and a necrotizing process are all diagnostic criteria. The worsening conditions of fever, neck and chest pain, and respiratory distress are presenting features. Without aggressive surgical drainage, DNM may become fatal. Early diagnosis and prompt therapy play a crucial role in the management of mediastinitis. We aimed to compare the clinical features of mediastinitis. DNM cases that were treated in our clinics in the last 10 years were retrospectively reviewed. Patients with DNM were divided into three groups according to tomographic images. Demographic characteristics, accompanying diseases, anatomical localization, medical and surgical management, other clinical features, and morbidity and mortality rates of patients were collected and compared with univariate analysis. The adequacy of neck exploration or the need for additional surgery was determined by preoperative and postoperative computerized tomography evaluation. The etiologic causes of DNM were oropharyngeal in 12 cases and dental in 18 cases. The mean age of the 19 men and 11 women was 37 years. Mediastinal localization according to a computerized tomography image was type I in 11 patients, type IIA in 6 patients, and type IIB in 13 patients. The most common accompanying disorders were diabetes mellitus in 16.6%, cardiac disease in 10.0%, and hepatic in 3.3%. Neck exploration was performed in almost all cases. When the physicians failed to manage the patient with a single neck exploration procedure, mediastinoscopy, tube thoracostomy, and thoracotomy were added. In the series, 7/30 (23%) patients died. The mean duration of an intensive care unit stay was 29 days. Bacterial growth was cultured in 14 patients including all nonsurvivors. Because the prognosis is poor and the disease is more likely to spread below the carina in delayed cases, regardless of the aetiology or type of mediastinitis, aggressive surgery should be performed immediately.

纵隔炎是纵隔的炎症。下行坏死性纵隔炎(DNM)是最常见的纵隔炎形式。严重口咽部感染的症状、纵隔炎的放射学证据、手术中坏死性纵隔炎的记录以及感染与坏死过程之间的关系都是诊断标准。发烧、颈部和胸部疼痛以及呼吸窘迫的恶化情况正在呈现特征。如果不进行积极的手术引流，DNM 可能会致命。早期诊断和及时治疗在纵隔炎的管理中起着至关重要的作用。我们旨在比较纵隔炎的临床特征。DNM对过去 10 年在我们诊所接受治疗的病例进行了回顾性审查。根据断层图像将DNM患者分为三组。收集患者的人口学特征、伴随疾病、解剖定位、内科和手术管理、其他临床特征以及发病率和死亡率，并进行 单 变量分析比较。颈部探查是否充分或是否需要额外手术由术前和术后计算机断层扫描评估确定。DNM的病因口咽部 12 例，牙科 18 例。19 名男性和 11 名女性的平均年龄为 37 岁。根据计算机断层扫描图像，纵隔定位为 I 型 11 例，IIA 型 6 例，IIB 型 13 例。最常见的伴随疾病是糖尿病占 16.6%，心脏病占 10.0%，肝病占 3.3%。几乎所有病例都进行了颈部探查。当医生无法通过单一的颈部探查手术来管理患者时，增加了纵隔镜检查、管胸腔造口术和胸廓切开术。在该系列中，7/30 (23%) 患者死亡。重症监护病房的平均住院时间为 29 天。在 14 名患者（包括所有非幸存者）中培养了细菌生长. 由于预后较差，并且在延迟病例中疾病更可能扩散到隆突以下，因此无论纵隔炎的病因或类型如何，都应立即进行积极的手术。