Parapharyngeal abscess in children: five year retrospective study

Abstract

Lateropharyngeal and retropharyngeal abscesses are potentially life threatening infections in children

Aim: To review the etiologic, clinical, and imaging signs of lateropharyngeal and retropharyngeal abscesses in children as well as treatment-outcomes and complications using a surgical trans-oral approach.

Method: Retrospective analysis of 11 children, hospitalized in the last 5 years, with a diagnosis of lateropharyngeal (n = 8) and retropharyngeal (n = 3) abscesses, ages ranging from 0 to 12 years old. Charts and CT scans were reviewed.

Result: The average age of presentation was 3.3 years. Neck stiffness (64%) and odynophagia (55%) were the most common symptoms. Fever (64%), stiff neck (64%), bulging of the oropharyngeal wall (55%), mass in the neck (55%) and lymphadenopathy (36%) were the most prevalent physical findings. All these patients were submitted to surgical drainage using a trans-oral approach in the first 48 hours after admission. About 82% of the patients showed improvement after 48 hours, and 100% after 72 hours, without any complications.

Conclusion: Based on the good clinical outcomes and low incidence of complications, the present study suggests that antibiotic therapy complemented with a timely surgical treatment, is a valid treatment option in refractory parapharyngeal abscesses.

Figure 1

A. Latero and Retropharyngeal abscess (CT scan, axial view). B. Latero and Retropharyngeal abscess (CT scan, sagital view). C. Lateropharygeal abscess (CT scan, coronal view). D. Lateropharyngeal abscess (CT scan, axial view)

Figure 2

A. Lateropharyngeal abscess (MRI scan, sagittal view). B. Lateropharyngeal abscess (MRI scan, axial view)