Clinical significance of secondary purulent mediastinitis from odontogenic and tonsillogenic origins

The aim of this study was to enhance early diagnostic methods and improve the efficacy of surgical intervention in patients with secondary purulent mediastinitis of odontogenic and tonsillogenic origin through the introduction of novel drainage techniques and surgical approaches. The study methodology involved an analysis of clinical cases of acute purulent mediastinitis of odontogenic and tonsillogenic origin, divided into two groups: the main group (40 patients treated with new methods) and the control group (20 patients treated with traditional methods). Surgical treatment in the main group included the drainage of purulent-necrotic foci via external approaches with active drainage systems. For odontogenic forms, a "P"-shaped approach was employed, facilitating effective pus drainage and providing an improved surgical field overview. For tonsillogenic forms, the Kanshin method was utilized to drain the posterior mediastinum. Treatment was further complemented by antibacterial therapy, electrolyte balance correction, and ventilatory support when required. The results demonstrated that the combined use of these surgical methods yielded high treatment efficacy. All patients who underwent timely surgical intervention and received antibacterial therapy exhibited positive outcomes, allowing their discharge from hospital in satisfactory condition. The study's conclusions underscore the critical importance of early diagnosis, the appropriate selection of surgical techniques, and the integration of multidisciplinary treatment approaches. Emphasis is placed on the necessity of active drainage of purulent-inflammatory foci, tailored surgical approaches based on the localization of the pathology, the application of modern diagnostic methods, and close collaboration between maxillofacial and thoracic surgeons to achieve optimal therapeutic outcomes.