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Draft:Parapharyngeal abscess

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Parapharyngeal abscess

Introduction

Parapharyngeal abscess is a deep neck abscess. It is also known as abscess of pharyngomaxillary or lateral pharyngeal space. Parapharyngeal abscess involve the parapharyngeal space.[1] Parapharyngeal space is lateral to the superior pharyngeal constrictor and medial to the masseter muscle, this space is divided by styloid process into anterior and posterior compartment. This space contains the carotid artery, internal jugular vein, numerous nerves [2]

Epidemiology

Both sex are equally affected Any age group can develop a parapheryngeal abscess but it is most commonly seen in children and adolescents.[3] Immunocompromised adults are the high risk people.[4]

Aetiology

Infection can occur from:

  • Pharynx: acute and chronic infection of tonsil and adenoids
  • Teeth: dental infection occurs from lower last molar tooth
  • Ear: bezold abscess and petrositis
  • Other space: infection of parotid retropharyngeal space
  • External trauma: penetrating injuries of neck, injection of local anaesthetic[5]

Clinical features

Symptoms

Fever, sore throat, odynophagia (painful swallowing), swelling in neck [6]

Signs

Anterior space abscess can cause trismus (spasm of jaw muscle) and hard mass formation along the angle of the mandible, with medial bulging of the tonsil and lateral pharyngeal wall. Posterior space abscess causes swelling in posterior pharyngeal wall. Trismus (spasm of jaw muscle) is minimal. Posterior abscess may involve structures within the carotid sheath, causing rigors, high fever, bacteremia, neurologic deficit, massive haemorrhage caused by carotid artery rupture.[7]

complications

It is a life threatining condition , more fatal and required immediate medical care. it has high morbidity and mortality rate.

acute oedoma of larynx with respiratory obstruction thrombophlebits of jugural vein with septicaemia spread of infection to retrophrayngeal space spread of infection to mediastinum along the carotid space mycotic aneurysm with possible subsequent ruputre of the internal carotid artery massive haemorrhage [8]

References

  1. ^ https://radiopaedia.org/articles/parapharyngeal-abscess[full citation needed]
  2. ^ https://en.wikipedia.org/wiki/Parapharyngeal_space
  3. ^ Croche Santander, B.; Prieto Del Prado, A.; Madrid Castillo, M.D.; Neth, O.; Obando Santaella, I. (2011). "Abscesos retrofaríngeo y parafaríngeo: Experiencia en hospital terciario de Sevilla durante la última década". Anales de Pediatría. 75 (4): 266–72. doi:10.1016/j.anpedi.2011.03.010. PMID 21531183. {{cite journal}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)
  4. ^ Alaani, A.; Griffiths, H.; Minhas, S. S.; Olliff, J.; Drake Lee, A. B. (2004). "Parapharyngeal abscess: Diagnosis, complications and management in adults". European Archives of Oto-Rhino-Laryngology. 262 (4): 345–50. doi:10.1007/s00405-004-0800-6. PMID 15235797.
  5. ^ Dhingra, PL (2014). Diseases of Ear, Nose and Throat & Head and Neck Surgeries (6th ed.). Elsiver. ISBN 978-81-312-3431-0.[page needed]
  6. ^ http://www.msdmanuals.com/professional/ear,-nose,-and-throat-disorders/oral-and-pharyngeal-disorders/parapharyngeal-abscess[full citation needed]
  7. ^ http://www.msdmanuals.com/professional/ear,-nose,-and-throat-disorders/oral-and-pharyngeal-disorders/parapharyngeal-abscess[full citation needed]
  8. ^ http://link.springer.com/article/10.1007/s00405-004-0800-6/fulltext.html

Further reading

  • Sethi, Dharambir S.; Stanley, Ralph E. (2007). "Deep neck abscesses – changing trends". The Journal of Laryngology & Otology. 108 (2): 138–43. doi:10.1017/S0022215100126106. PMID 8163915.
  • Badran, K.; Karkos, P. D.; Acharya, M.; Daud, A. (2005). "Transtonsillar drainage of parapharyngeal abscess". European Archives of Oto-Rhino-Laryngology. 263 (1): 49–52. doi:10.1007/s00405-005-0955-9. PMID 15976992.
  • Oh, Jeong-Hoon; Kim, Youngju; Kim, Chul-Ho (2006). "Parapharyngeal Abscess: Comprehensive Management Protocol". ORL. 69 (1): 37–42. doi:10.1159/000096715. PMID 17085951.
  • Sethi, D. S.; Stanley, R. E. (2007). "Parapharyngeal abscesses". The Journal of Laryngology & Otology. 105 (12): 1025–30. doi:10.1017/S0022215100118122. PMID 1787355.
  • Page, C.; Biet, A.; Zaatar, R.; Strunski, V. (2007). "Parapharyngeal abscess: Diagnosis and treatment". European Archives of Oto-Rhino-Laryngology. 265 (6): 681–6. doi:10.1007/s00405-007-0524-5. PMID 18004583.
  • Page, C; Chassery, G; Boute, P; Obongo, R; Strunski, V (2010). "Immediate tonsillectomy: Indications for use as first-line surgical management of peritonsillar abscess (quinsy) and parapharyngeal abscess". The Journal of Laryngology & Otology. 124 (10): 1085–90. doi:10.1017/S0022215110000903. PMID 20403229.
  • Kalmovich, Limor Muallem; Gavriel, Haim; Eviatar, Ephraim; Kessler, Alexander (2012). "Accuracy of Ultrasonography Versus Computed Tomography Scan in Detecting Parapharengeal Abscess in Children". Pediatric Emergency Care. 28 (8): 780–2. doi:10.1097/PEC.0b013e3182627cff. PMID 22858751.
  • Klug, Tejs Ehlers; Fischer, Anne Sophie Lind; Antonsen, Christine; Rusan, Maria; Eskildsen, Helle; Ovesen, Therese (2013). "Parapharyngeal abscess is frequently associated with concomitant peritonsillar abscess". European Archives of Oto-Rhino-Laryngology. 271 (6): 1701–7. doi:10.1007/s00405-013-2667-x. PMID 23982668.
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