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Parapharyngeal and Retropharyngeal Abscess in Children


Authors: P. Dytrych 1;  Z. Kabelka 1;  R. Katra 1;  M. Marková 1;  M. Kynčl 2;  M. Jurovčík 1
Authors‘ workplace: Klinika ušní, nosní, krční 2. LF UK a FN Motol, Praha Subkatedra dětské otorinolaryngologie IPVZ, Praha ;  přednosta doc. MUDr. Z. Kabelka Klinika zobrazovacích metod 2. LF UK a FN Motol, Praha 1;  přednosta doc. MUDr. M. Roček, CSc. 2
Published in: Otorinolaryngol Foniatr, 58, 2009, No. 2, pp. 79-82.
Category: Original Article

Overview

Parapharyngeal (PPA) and retropharyngeal abscess (RPA) are relatively rare, but serious deep throat infections, associated with potentially significant morbidity and mortality. In spite of the primary tendency to evacuate the area of the abscess the possibility of conservative approach in the treatment is still under professional consideration. In the three-year period of 2005 through 2007 the authors treated 13 child patients with this kind of diagnosis. The suspicion based on clinical picture was confirmed by imaging of the inflammatory focus by magnetic or CT with the use of a contrast medium. Four children with a lesion of a smaller size and abscess positioned high under the cranium base were successfully treated conservatively only. In 9 patients a surgical intervention was indicated. Six of them were treated by means of transoral incision and evacuation of the abscess. In three patients the transoral puncture proved to be negative (without aspirated purulence). Among these three patients two were cured up conservatively without the need of further intervention, in the third patient with multiple abscesses in parapharyngeal, retropharyngeal and paravertebral region, revision from external approach was performed. The intraoral incision of the same focus had to be performed twice in two patients. All these patients finally healed up completely. In six patients who were cured up without surgical evacuation of the abscess the foci proved to be of smaller size and less apparent clinical symptomatology. No postoperative complications have been encountered, and all patients of the group survive.

Key words:
parapharyngeal abscess, retropharyngeal abscess.


Sources

1. Al-Sabah, B., Bin Salleen, H., Hagr, A., Choi-Rosen, J., Manoukian, J. J.,,Tewfik, T. L.: Retropharyngeal abscess in children: 10 year study. Otolaryngol., 33, 2004, s. 352-355.

2. Berger, T. J..: Retropharyngeal abscess. 2006-03-28. Dostupný z www: http://www.emedicine.com/ped/topic2682.htm.

3. Boucher, C., Dorion, D., Fisch, C.: Retropharyngeal abscess. A clinical and radiologic correlation. Otolaryngol, 28, 1999, s. 134-137.

4. Choi, S. S., Vezina, L. G.,Grundfast, K. M.: Relative incidence and alternative approaches for surgical drainage of different types of deep neck abscesses in children, Arch. Otolaryngol Head Neck Surg., 12, 1997, s. 1271-1275.

5. Craig, F.W., Schunk, J.E.: Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management. Pediatrics, 6, 2003, s. 1394-1398.

6. Daya, H, Lo, S., Papsin, B. C., Zachariasova, A., Murray, H., Pirie, J., Laughlin, S., Blaser, S.: Retropharyngeal and parapharyngeal infections in children: the Toronto experience. Int. J. Pediatr. Otorhinolaryngol, 1, 2005, s. 81-86.

7. Hawkins, D. B., Austin J. R.: Abscesses of the neck in infants and young children. A review of 112 cases. Ann. Otol. Rhinol. Laryngol., 5, 1991, s. 361-365.

8. Hobbs, C. G. L., Pinder, D. K.: Parapharyngeal abscess: a diagnosis not to miss. Hospital Medicine, 2, 2003, s. 114-118.

9. Jeong- Hoon, O., Youngju, K., Chul Ho, K.: Parapharyngeal abscess: Comprehensive Management Protocol. ORL, 69, 2007, s. 37-42.

10. Komínek, P., Chrobok, V., Astl, J. a kolektiv: Záněty hltanu, Tobiáš, 2006, s. 245-250.

11. McClay, J. E., Murray, A. D., Booth, T.: Intravenous antibiotic therapy for deep neck abscesses defined by computed tomography. Arch. Otolaryngol. Head Neck Surg,, 11, 2003, s. 1207-1212.

12. Page, C., Biet, A., Zaatar, R., Strunski, V.: Parapharyngeal abscess: diagnosis and treatment. Eur Arch. Otorhinolaryngol., 265, 2008, s. 681-686.

13. Sichel, J. Y., Gomori, J. M., Saah, D., Elidan, J.: Parapharyngeal abscess in children: the role of CT for diagnosis and treatment. Int. J. Pediatr. Otorhinolaryngol., 5, 1996, s. 213-222.

14. Stárek, I. a kol.: Nádory parapharyngu, diagnostika a léčba. 1. vyd. Havlíčkův Brod, Tobiáš, 2006, s. 24.

15. Stone, M. E., Walner, D. L., Koch, B. L., Egelhoff, J. C., Myer, C. M.: Correlation between computed tomography and surgical findings in retropharyngeal inflammatory processes in children. Int. J. Pediatr. Otorhinolaryngol., 5, 1999, s. 121-125.

16. Vural, C., Gungor, A., Comerci, S.: Accuracy of computerized tomography in deep neck infections in the pediatric population. Am. J. Otolaryngol., 24, 2003, s. 143-148.

17. Zahraa, J. N., Al-Boukai, A. A.: Acute retropharyngeal abscesses in children. Saudi Med., 8, 2002, s. 899-903.

18. Zeleník, K., Komínek, P., Matoušek, P., Hladík, M.: Retrofaryngeální absces. Pediatr. pro praxi, 8, 2007, s. 389-390.

Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)
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