• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.90-96
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• 2015

Necrotizing fasciitis (NF) is an infection that spreads along the fascial planes, causing subcutaneous tissue death characterized by rapid progression, systemic toxicity, and even death. NF often appears as a red, hot, painful, and swollen wound with an ill-defined border. As the infective process continues, local pain is replaced by numbness or analgesia. As the disease process continues, the skin initially becomes pale, then mottled and purple, and finally, gangrenous. The ability of NF to move rapidly along fascial planes and cause tissue necrosis is secondary to its polymicrobial composition and the synergistic effect of the enzymes produced by the bacteria. Treatment involves securing the airway, broad-spectrum antimicrobial therapy, intensive care support, and prompt surgical debridement, repeated as needed. Reducing mortality rests on early diagnosis and prompt aggressive treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.623-629
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• 1999

The definition of fascial spaces are latent spaces between fascial planes. If infections which spread from dental origin to soft tissue are mild, they are restricted by fascial planes. But, when infections are severe, fascial spaces are often used as a natural pathway which spread to the deep cervical region. If they are not treated at early stage, they may result in the fatal complications as followings; airway obstruction, septicemia, cerebral abscess, and thrombophlebitis etc. The early treatment of fascial space abscess is very important for young children. These case reports present the successful result of fascial space abscess treatment through intracanal drainage without surgical excision. It is proven that the treatment through intracanal drainage has some benefits to the surgical excision, which are as follows: 1) It is economic to the patients or their parents avoiding admission. 2) The treatment procedure is more simple. 3) Childrens can avoid the fearful environment.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.375-377
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• 2003

Pneumomediastinum, also referred to as mediastinal emphysema or Hamman's syndrome, is defined as the presence of air or gas within the fascial planes of the mediastinum. Superior extension of air into the cervicofacial subcutaneous space via communications between the mediastinum and cervical fascial planes or spaces occurs occasionally, Pneumomediastinum frequently results from blunt tracheobronchial lesions and esophageal injuries. However, in most cases, the origin of pneumomediastinum remains unclear. an some cases, it is attributed to the Macklin effect. We report a case of patient with pneumomediastinum, that presented with Macklin effect on chest computed tomographic scan.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.246-250
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• 2010

Mediastinal emphysema, also referred to as pneumomediastinum or Hamman's syndrome, is defined as the presence of air or gas within the fascial planes of the mediastinum. Superior extension of air into the cervicofacial subcutaneous space via communications between the mediastinum and cervical fascial planes or spaces occurs occasionally. The mediastinal air may originate from the respiratory tract, the intrathoracic airway, the lung parenchyma, or the gastrointestinal tract. The presence of air in the mediastinum may be spontaneous, iatrogenic or due to penetrating trauma. Pneumothorax is defined as the presence of air or gas within the pleural cavity. A pneumothorax can occur spontaneously. It can also occur as the result of a disease or injury to the lung or due to a puncture to the chest wall. Pneumomediastinum and pneumothorax is a rare complication of head and neck surgery. Nevertheless, when it occurs, it is usually considered to result from direct dissection by the air at the time of injury or of surgery. Most of the cases of pneumomediastinum and pneumothorax that have been described in the oral and maxillofacial surgery literature result from air dissecting down the fascial planes of the neck. The authors report a case with subcutaneous emphysema, pneumomediastinum and pneumothorax after orthognathic surgery.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.61-64
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• 2011

Cervical necrotizing fasciitis is a rare but well known life-threatening soft tissue infection primarily affecting the superficial and deep cervial fascial planes. It may rapidly spread into the mediastinum along fascial planes. So, if proper diagnosis and prompt surgical debridement is delayed, the infection may cause descending necrotizing mediastinitis with extensive necrosis of overlying skin, destroying fascia and muscle. Therefore, the key to the successful outcome is early recognition and rapid initiation of definitive radical debridement. The authors report, along with a literature review, a case of cervical necrotizing fasciitis with atypical spreading into the lateral chest wall.

• Korean Journal of Bronchoesophagology
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• v.12 no.2
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• pp.42-46
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• 2006

Descending necrotizing mediastinitis (DNM) is defined as mediastinal infection that begins at the cervical region and spread through deep fascial planes into the mediastinum. This is a rare and life-threatening complication of deep neck space infection. As infection reaches the mediastinum, widespread cellulitis, necrosis, abscess formation and sepsis may occur. So, early diagnosis and immediate antibiotics and surgical treatment are required to improve the poor prognosis of DNM. We present four cases of deep neck infection causing a virulent mediastinitis with a literature review.

• Korean Journal of Bronchoesophagology
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• v.14 no.1
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• pp.38-41
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• 2008

Deep neck infection is an infection in the potential spaces and fascial planes of the neck, either with abscess formation or cellulitis. In the preantibiotics era most cases of deep neck infection were secondary to an oropharyngeal infection. Moreover, today manupulation of intubation tube and gastroenteroscopy may cause deep neck infection by iatrogenic trauma. We experience 1 case of deep neck infection which originate from pharyngeal penetrating injury following gastroenteroscopy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.222-230
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• 1991

Pyogenic orofacial infections are most commonly odontogenic in origin. Although such infections are usually self-limiting and spatially confined, purulent material may occasionally borrow deeply into contiguous fascial space or planes far from the initial site of involvement. The incidence of orofacial infection remains low in this modern era of preventive dental care and antibiotic therapy, but severe orofacial infections are most frequently observed in the medically compromised patients. We experienced 5 cases of severe orofacial odontogenic infection associated with medical diseases, and then concluded as follows : 1. The average hospitalized period was about 5 weeks, and the signs that indicated that the infections were controlled usually appeared in third week after incision and drainage. 2. The involved medical diseases were diabetes mellitus iatrogenic Cushing's syndrome, rheumatoid arthritis, malnutrition, etc. 3. The medical diseases should be treated coincidently with control of infection.

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.71-74
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• 2002

A 44-year-old man was admitted to our hospital because of high fever, neck swelling, and dyspnea. He was diagnosed as descending necrotizing mediastinitis (DNM) extended from oropharyngeal infection. Descending necrotizing mediastinitis(DNM) is a lethal process originating from odontogenic. oropharyngeal, or cervical infections that descends along the fascial planes into the mediastinum. DNM is relatively rare, but it is lethal disease with high mortality. Immediate and sufficient mediastinal drainage is indispensable for the disease. The principles of the surgical approach for DNM are discussed, with a brief review of the literature following these case reports.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.314-319
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• 2010

Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.