Use of cervicothoracic anatomy as a guide for directed drainage of descending necrotizing mediastinitis.

Descending necrotizing mediastinitis is a potentially lethal infection originating from the oropharynx. Adequate abscess drainage is crucial to successful treatment. We present novel management of descending necrotizing mediastinitis using a series of anterior mediastinal incisions adjoined by Penrose drains. The success of this treatment was dependent on radiographic documentation of infection confined to the anterior cervicothoracic plane. (Ann Thorac Surg 2012;93:1293-4) (C) 2012 by The Society of Thoracic Surgeons