| Context: The empyema, defned as a collection of pus in the pleural cavity, may be caused
as a result of primary complication of cervical or odontogenic infections and can spread
to the mediastinum through cervical spaces. Aim: The results of surgical treatment in the
patients with empyema were compared. Materials and Methods: The patients suffering
from empyema with odontogenic and post-pneumonia infections, treated surgically
in 2001-2009, were studied. Twelve patients of odontogenic empyema (Group 1), and
160 patients with post-pneumonia empyema infections (Group 2) were included in this
study. Two groups were compared according to the treatments of empyema. Data were
extracted from the medical records of the patients which include age, gender, type of
treatment, cure rate, mortality rate, hospital stay, and complications. Statistical analysis:
independent samples T test, Mann-Whitney U test and, Chi – square or Fisher Exact
test were used. Results: The treatment of Group 1 was carried out through cervical,
mediastinal and decortication approaches with cure rate of 75% and mortality rate of
25%. 36 patients of Group 2 were treated with minor surgical procedures. The remaining
ones were treated surgically with a total cure rate of 90.8% and mortality rate of 1.8%.
There were statistically signifcant differences on event rates of cure rate, mortality, and
hospital stay times between two Groups (p= 0.001, p=0.001, p<0.001), however, there
were no differences on postoperative complication rates of prolonged air leakages and
wound infections (p=0.715, p=0.057). Conclusion: Due to high mortality and low cure
rates of odontogenic empyema, early diagnosis and ample cervicotomy with mediastinal
drainage are needed, and hence, thoracotomy-decortication may signifcantly reduce the
mortality rate. |