A 44-year-old woman with Ludwig’s angina is intubated and ma…
A 44-year-old woman with Ludwig’s angina is intubated and managed in the ICU. Initial computed tomography of the neck shows bilateral submandibular space involvement without mediastinal extension. On hospital day 2, she develops worsening oxygen requirements and new chest pain. Repeat imaging demonstrates air and fluid extending into the superior mediastinum.Which of the following best explains the anatomical pathway of spread for this complication?