title: Intraoral drainage under surgical microscopy with tonsillectomy for parapharyngeal abscesses.
abstract: BACKGROUND
  An intraoral approach combined with tonsillectomy has been used to access the parapharyngeal space. However, the utility of this technique for parapharyngeal abscesses in paediatric patients has not been investigated. This paper describes an intraoral drainage technique combined with tonsillectomy for treating children with a parapharyngeal abscess that obviates the need for skin incision.
  
  
  METHODS
  Clinical case records are presented, along with a description of the surgical procedure accompanied by a video clip.
  
  
  RESULTS
  Both cases encountered involved paediatric parapharyngeal space abscesses that extended to the skull base. The patients underwent an intraoral approach combined with tonsillectomy performed under surgical microscopy; this resulted in a good post-operative course without complications.
  
  
  CONCLUSIONS
  To our knowledge, no previous reports have addressed the use of surgical microscopy to help access the parapharyngeal space. The procedure described herein, performed under surgical microscopy, was specifically helpful in enabling access to these challenging spaces; it also meant that surgical procedures could be recorded clearly and findings shared with other medical staff.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Tohoku University Graduate School of Medicine,Sendai,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Okumura
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Tohoku University Graduate School of Medicine,Sendai,Japan.
authors.forename: H
authors.initials: H
authors.lastname: Hidaka
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Tohoku University Graduate School of Medicine,Sendai,Japan.
authors.forename: N
authors.initials: N
authors.lastname: Noguchi
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Tohoku University Graduate School of Medicine,Sendai,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Katori
mesh_terms: D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D009055:Mouth; D017703:Retropharyngeal Abscess / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Abscess; Microsurgery; Retropharyngeal Abscess; Upper Respiratory Tract Infections