title: Intraoral drainage: recommended as the initial approach for the treatment of parapharyngeal abscesses.
abstract: OBJECTIVE
  We sought to compare the efficacy, safety, and cost of intraoral drainage (IOD) of parapharyngeal abscesses (PPAs) in the pediatric population with those of the more commonly used external neck drainage (END). PATIENTS AND STUDY DESIGN AND SETTING: An 11-year retrospective review was conducted of all patients admitted to a tertiary-care, university-affiliated, pediatric hospital with a diagnosis of PPA. Patients were divided into 2 groups according to the treatment received (IOD or END) and were followed to 1 month postoperatively. All children referred to our institution with a final diagnosis of PPA were included in the study.
  
  
  RESULTS
  Outcome measures were duration of anesthesia, duration of postoperative intravenous antibiotics (DPOIA), length of postoperative hospital stay (LPOHS), and occurrence of complications.
  
  
  RESULTS
  Fifteen patients underwent IOD, and 10 patients, END. IOD shortened anesthesia time by 31.7 minutes compared with END (P = 0.0003). IOD was associated with a decrease in DPOIA and LPOHS by 1.1 days (P = 0.1931) and 1.6 days (P = 0.0649), respectively. The cost of treatment was thereby reduced. No complications were encountered in either group.
  
  
  CONCLUSIONS
  IOD is a safe and effective treatment for PPA in the pediatric population. It leads to decreased morbidity, shortened anesthesia time, and reduced economic burden.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, McGill University, Mount Royal, Quebec, Canada.
authors.forename: Yannick G
authors.initials: YG
authors.lastname: Amar
authors.forename: John J
authors.initials: JJ
authors.lastname: Manoukian
mesh_terms: D000038:Abscess / Q000188:drug therapy / Q000191:economics* / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004322:Drainage / Q000191:economics* / Q000379:methods*; D005260:Female; D006287:Health Planning Guidelines; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D017063:Outcome Assessment, Health Care; D010608:Pharyngeal Diseases / Q000188:drug therapy / Q000191:economics* / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents