Surgical management of retropharyngeal abscesses.
CONCLUSIONS
Retropharyngeal abscess (RPA) is a rare, potentially life-threatening disease, requiring appropriate otorhinolaryngologic as well as radiologic diagnostics, and medical and surgical intervention by a transoral, transcervical or transnasal approach in a multidisciplinary setting.


OBJECTIVE
The risks and benefits of surgical intervention in patients with RPA were assessed. The main outcome measure was the clinical resolution of the abscess.


METHODS
A retrospective chart review was performed at a tertiary care university hospital over a period of 28 months. Eleven patients aged 1 to 68 years with the diagnosis of RPA were included.


RESULTS
All patients presented with restricted cervical mobility and all patients had CT and/or MRI scan on admission. The mean abscess volume was 9.4 cm(3). Surgical intervention was performed in all cases, including transoral (n=5), transcervical (n=3) or combined transoral and transcervical (n=2) drainage. In one patient RPA close to the skull base was drained by an MRI-guided transnasal approach. All patients recovered; however, there was one recurrence and in one case surgical tracheotomy was unavoidable during the course of disease. Growth of streptococcal species was verified in six of the examined abscesses. Abscessing lymphadenitis, infection of a cervical cyst, and previous ganglionar local opioid analgesia treatment were identified as causative factors.
Department of Otorhinolaryngology and Head and Neck Surgery, Heinrich-Heine-University Hospital, Moorenstrasse 5,Duesseldorf, Germany. patrick.schuler@med.uni-duesseldorf.de
Patrick J
PJ
Schuler
Mathias
M
Cohnen
Jens
J
Greve
Christian
C
Plettenberg
Jimmy
J
Chereath
Murat
M
Bas
Caroline
C
Koll
K
K
Scheckenbach
Martin
M
Wagenmann
Joerg
J
Schipper
Thomas K
TK
Hoffmann
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D017703:Retropharyngeal Abscess / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014140:Tracheotomy; D055815:Young Adult