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Descending Mediastinitis — NDEB AFK MCQ

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HardOral SurgeryDescending MediastinitisNDEB AFK

Which space infection can spread from a mandibular molar infection through the sublingual and submandibular spaces to potentially compromise the mediastinum?

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Correct answer: B — Deep cervical and retropharyngeal spaces (descending necrotising mediastinitis)

Odontogenic infections originating from mandibular molars can spread through the sublingual and submandibular spaces to the parapharyngeal and retropharyngeal spaces, and ultimately descend along the fascial planes into the mediastinum (descending necrotising mediastinitis). This is a life-threatening complication with mortality rates of 20-50%. Warning signs include dysphagia, stridor, neck oedema, chest pain, and systemic toxicity. CT imaging of the neck and chest is essential. Management requires aggressive surgical drainage, IV antibiotics, and ICU care.

Reference: Hupp – Contemporary Oral and Maxillofacial Surgery, 7th ed., 2019