{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:17:13Z","timestamp":1784888233609,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2010,2,18]],"date-time":"2010-02-18T00:00:00Z","timestamp":1266451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cervical necrotizing fasciitis (CNF) associated with descending necrotizing mediastinitis (DNM) is a rapidly evolving and life-threatening condition. The aim of this retrospective study was to describe a treatment strategy for CNF with DNM and present a management algorithm for mediastinal extensions of CNF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients diagnosed and treated for CNF with DNM over 14 years in a tertiary referral centre were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventeen adult patients were included. The origin of infection was mainly oropharyngeal. The diagnosis of CNF\/DNM was based on clinical and computed tomography findings. All patients underwent cervicotomy for CNF. In ten patients, DNM was located above the carina and could be accessed by a cervical approach. In seven patients, DNM was below the carina, and necessitated sternotomy for anteroinferior mediastinal involvement and posterolateral thoracotomy for posteroinferior mediastinal involvement. All patients received broad-spectrum antibiotics. One patient died 3 days after surgery. The median hospital stay was 30 days. There was no recurrence during long-term follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Prompt diagnosis and early surgical treatment are essential for reducing mortality in CNF\/DNM. All patients should undergo extensive cervicotomy. The surgical approach to the mediastinum depends on the supracarinal or infracarinal location of the disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.6935","type":"journal-article","created":{"date-parts":[[2010,2,18]],"date-time":"2010-02-18T10:32:18Z","timestamp":1266489138000},"page":"609-615","source":"Crossref","is-referenced-by-count":51,"title":["Optimal treatment of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis"],"prefix":"10.1093","volume":"97","author":[{"given":"A","family":"Karkas","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, University Medical Centre of Grenoble, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Chahine","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, University Medical Centre of Grenoble, Grenoble, France"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Union Memorial Hospital, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Schmerber","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, University Medical Centre of Grenoble, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P-Y","family":"Brichon","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Medical Centre of Grenoble, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C A","family":"Righini","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, University Medical Centre of Grenoble, Grenoble, France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U823, Centre for Research \u2018Albert Bonniot\u2019, Grenoble, 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