Role of transoral irrigation in mediastinitis due to hypopharyngeal perforation
✍ Scribed by Santos, Gil Hauer ;Shapiro, Barry M. ;Komisar, Arnold
- Book ID
- 102236044
- Publisher
- Wiley (John Wiley & Sons)
- Year
- 1986
- Weight
- 318 KB
- Volume
- 9
- Category
- Article
- ISSN
- 0148-6403
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✦ Synopsis
Mediastinitis resulting from perforations of the hypopharynx is a life-threatening complication associated with a high morbidity and mortality. In cases of perforation, which are not amenable to primary closure, transoral irrigation has been found to be an effective means of therapy. This technique rapidly controls sepsis, favoring the closure of perforations of the hypopharynx and cervical esophagus. Using this technique we have had no mortality attributed to mediastinitis in patients with mediastinitis due to perforation of the hypopharynx, cervical and thoracic esophagus. HEAD 81 NECK SURGERY 9:116-121,1986
Perforations of the hypopharynx can occur as a consequence of endotracheal intubation, transnasal or transoral instrumentation, or head and neck trauma.
When the diagnosis of perforation of the hypopharynx or cervical esophagus is made soon after it occurs, therapy may include exposure of the injured area, followed by wide drainage and primary repair. When 24 h or more has elapsed since the insult, primary repair has a high incidence of dehiscence and mediastinitis. The patient be-Presented at the Annual Meeting of the New York Head and Neck Society. From the Departments of Thoracic Surgery (Dr. Santos) and Otolaryngology (Drs. Shapiro and Komisar),