PURPOSE: The aims of this work were the retrospective analysis of a cohort of patients with acute mediastinitis treated at the authors' worksite over a 15-year period and the identification of factors that significantly affect the outcomes of the therapy. METHODS: During the period 2006-2020, 80 patients with acute mediastinitis were treated. Within the cohort, the following were observed: the causes and the type of acute mediastinitis, length of anamnesis, comorbidities, diagnostic methods, time from the diagnosis to surgery, types and number of surgical procedures, results of microbiological tests, complications, and outcomes of the treatment. RESULTS: The most common type of acute mediastinitis was descending mediastinitis (48.75%). A total of 116 surgical procedures were performed. Ten patients in the cohort died (12.5%). Patients older than 60 years were at a 6.8 times higher risk of death. Patients with more than two comorbidities were at a 14.3 times higher risk of death. The presence of yeasts in the culture material increased the risk of death by 4.4 times. CONCLUSION: Early diagnosis, removal of the cause of mediastinitis, sufficient mediastinal debridement, and multiple drainage thereof with the possibility of continual postoperative lavage are essential for the successful treatment of acute mediastinitis.
- MeSH
- akutní nemoc MeSH
- drenáž metody MeSH
- lidé MeSH
- mediastinitida * diagnóza etiologie chirurgie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
1. elektronické vydání 1 online zdroj (208 stran)
Na našem trhu ojedinělá publikace, která komplexně a prakticky zpracovává tento velmi významný způsob financování zahraničního, ale i tuzemského obchodu. Nové vydání reaguje na změny v praxi.
- MeSH
- cévní malformace MeSH
- hemangiom patofyziologie MeSH
- lidé MeSH
- lymfom patofyziologie MeSH
- nádory glandulární a epitelové * patofyziologie MeSH
- nádory obličeje * klasifikace patofyziologie MeSH
- nádory úst * klasifikace patofyziologie MeSH
- odontogenní nádory patofyziologie MeSH
- spinocelulární karcinom patofyziologie MeSH
- vaskulární nádory patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
INTRODUCTION: Impacted mesiodentes in the inverted position may interfere with the base of the nasal cavity or the nasal septum. They can rarely erupt into the nose as well. Traditionally they are extracted via intraoral approaches (transpalatal or vestibular). Also, an endoscopically assisted transnasal approach can be used. In this paper, the authors are the first to present a group of patients suffering from impacted mesiodentes who have been surgically treated using a modified maxillary vestibular approach with subperiostal intranasal dissection. MATERIAL AND METHOD: The prospective study was completed in the time period 12/2013-6/2017. The inclusion criteria were: 1. Mesiodens impacted in the inverted position extending to the base of the nasal cavity or into the nasal septum without concomitant pathological lesion and without eruption into the nasal cavity. 2. Localization of the mesiodens at the level of or dorsally to the roots of the upper middle incisors in the sagittal plane or ventrally to the roots of these teeth, but with the crown extending significantly posteriorly to the base of the nasal cavity.3. Indication for extraction because of clinical or orthodontic reasons. RESULTS: In total, 9 patients were enrolled into the group. In these patients, surgical extractions of 9 mesiodentes were performed using the alternative approach described above. All extractions were done according to a uniform surgical protocol. The mean age of the patients was 11.7 ± 3.1 years (age range 7-17 years). The crown's most cranial point exceeded the bone of the nasal cavity on average by2.0 ± 1.4 mm (in the range 0-5 mm). 8 mesiodentes were conical, 1 was tuberculate. Surgical procedure and postoperative healing were always without any complications. CONCLUSION: For the removal of midline supernumerary teeth, the modified maxillary vestibular approach with subperiostal intranasal dissection in comparison to the intraoral palatal approach provides less postoperative morbidity and a lower risk of complications (smaller surgical wound, minimal exposure of maxilla, minimal bone loss, reduced risk of damage to the roots of the upper incisors, lower risk of damage to the nasopalatine neurovascular bundle, good visibility in the surgical field, easier surgery, and finally no need of postoperative palatal splint). For oral and maxillofacial surgeons the presented technique represents a more traditional way of surgical tooth extraction than the endoscopically assisted transnasal approach.
- MeSH
- disekce metody MeSH
- dítě MeSH
- extrakce zubů metody MeSH
- lidé MeSH
- malokluze etiologie terapie MeSH
- maxila chirurgie MeSH
- mladiství MeSH
- nosní dutina patologie chirurgie MeSH
- ortodoncie korekční metody MeSH
- prospektivní studie MeSH
- řezáky abnormality diagnostické zobrazování chirurgie MeSH
- zaklíněný zub diagnostické zobrazování chirurgie terapie MeSH
- zuby přespočetné komplikace diagnostické zobrazování patologie chirurgie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
