Key points
1. Skillful and planned airway management is critical in descending
necrotizing mediastinitis (DNM) secondary to deep neck infection (DNI)
as well as early diagnosis and extensive surgical drainage
2. The most commonly involved neck space in DNM was the pretracheal
space in 18 (90%) patients.
3. Early tracheotomy was undertaken in four patients and was a
statistically significant risk factor for mortality.
4. Early tracheotomy might enhance contamination of the pretracheal
space and prolonged the duration of hospital stay.
5. Keeping orotracheal intubation was safe and adequate after the
initial surgery in DNM secondary to DNI.