In some cases, mailbox content can become unmanageable. I was performing IT Support in one of my consulting contracts and hapened on this issue. The in-house administrator typically filters through the Quarantine folder and deletes a couple of thousand messages per day.
In this case, the admin went on vacation and the duty was not reassigned...
Within Outlook, 4,000 messages at a time can be selected and deleted. This in turn creates processor usage on the desktop effectively making the system unuseable for 15-20 minutes... In OWA, 40 records can be selected in the same screen and permanently deleted in one motion by responding to an interactive prompt after each delete, or delete normally and empty the deleted items... Clearly, hours and hours of work.
Enter direct database access and manipulation. Enjoy the attached procedure!