Mediastinitis of odontogenic origin. A serious complication with 80 years of history

Abstract We performed a systematic review of the literature about Descending Necrotizing Mediastinitis (DNM) of odontogenic origin. In parallel, a retrospective review of this pathology was carried out in an Oral and Maxillofacial Surgery Service of a reference hospital for a population of 1,100,000 inhabitants. The main objectives were to determine changes in mortality and prevalence of this serious complication. The systematic review included 51 articles with eighty nine patients and our study seven patients. The period of time with the highest number of cases was between 2000-2009 (38 patients). The percentage of mortality observed was 20.2% in diffuse DNMs and 4.9% in localized DNMs. Thirty-one patients with DNMs in our review were admitted for more than 41 days. Despite evidence of a decrease on DNMs cases, publications have increased over the years, but it does not appear to be due to an increase in those that have an odontogenic origin. The survival of DNMs has improved since 1998, remaining stable since then. Despite the low prevalence of this disease, multicenter control studies are needed to achieve a better evidence about this entity.