Abstract: Objective The objective of this study was to retrospectively analyze and summarize the clinical diagnosis and treatment experiences of patients with deep cervical multi-space abscess, mediastinal abscess, and empyema in order to improve the understanding and treatment levels of clinicians. Methods The clinical characteristics, related examination, treatment, and follow-up of two patients with odontogenic deep cervical multiple space and mediastinal abscess were retrospectively analyzed. A literature review was also conducted. Results Bacterial culture was performed on the pus of each patient. Klebsiella pneumoniae was cultured from the pus of Case 1. The patient was hospitalized for 65 days after retropharyngeal abscess drainage plus thoracoscopic mediastinal abscess incision, as well as drainage plus thoracoscopic empyema removal(bilateral)plustracheotomy under general anesthesia. In Case 2, the bacterial sensitivity test of the pus indicated intermediate streptococcal infection. Incision and drainage of oral abscess plus thoracoscopic incision and drainage of anterior mediastinal abscess plustracheotomy were performed under general anesthesia. The patient was hospitalized for 37 days. Conclusion Severe deep cervical multi-space and mediastinal abscess is rare in clinic, and its rapid development and high fatality rate deserves attention. Abscess incision and drainage and combined application of sensitive antibiotics are the main treatment methods. Tracheotomy is a necessary procedure to ensure postoperative safety, and also plays an important role in reducing complications and improving prognosis. Early diagnosis, rational application of sensitive antibiotics, timely incision and drainage, and multidisciplinary cooperation are the keys to diagnosis and treatment.

Key words: Deep cervical interstitial abscess, Mediastinal abscess, Tracheotomy, Odontogenic infection