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A retropharyngeal abscess (Latin abscessus retropharyngeus) is an abscess of the soft tissues of the retropharyngeal space. It can be acute or chronic. Acute retropharyngeal abscess affects only young children and is now rare. On the other hand, in adults, a chronic retrograde abscess may occur, arising in the course of tuberculosis of the cervical vertebrae.
A retrofarial abscessoccurs in children in an acute form as a result of a throat infection, and in adults it takes the form of a chronic abscess (cold abscess, tuberculosis). The retropharyngeal (Henle) lymph nodes are found only in children and disappear over time. They fill the retropharyngeal space, which lies between the fascia of the back of the pharynx and the pre-vertebral plate of the neck fascia, covering the cervical spine and the pre-vertebral muscles. Lymph from the nasal cavity, pharynx, maxillary sinuses and adenoid drains into them. Therefore, infections in these areas may be complicated by the formation of a retropharyngeal abscess. Most often it is a staphylococcal or streptococcal infection. The downward retropharyngeal space passes into the superior mediastinum and then the posterior mediastinum. This creates an easy path for the infection to spread to the chest. This makes abscesses very dangerous.
Retardial abscess: symptoms
- deterioration of general condition
- soreness with neck movements
- characteristic head position - tilted back
- bulging of the side wall of the throat and neck
- palpable splashing
- difficulty swallowing, choking
- shortness of breath and hypoxia symptoms
- nasal obstruction, voice timbre change (closed nose)
- fever with chills
Retardial abscess: diagnosis
The differential diagnosis should take into account laryngitis, pharyngitis of the larynx. It is also important to distinguish an acute retropharyngeal abscess from a tuberculous cold precipitation abscess. In order to diagnose it, an X-ray of the cervical spine is taken. It is important due to different therapeutic procedures. A cold abscess must not be incised as this would result in a non-healing fistula. It should be emptied through punctures.
Retardial abscess: treatment
Patients require hospitalization at the ENT ward. Apart fromintensive parenteral antibiotic therapy, surgical emptying of the abscess is performed. The procedure is performed under endotracheal anesthesia in the Trendelenburg position. The abscess is incised and drained through the oral cavity.