Phlegmon of the parapharyngeal space (Phlegmonae spatii parapharyngealis) is an inflammation that usually occurs as a complication of bacterial infections in the throat and mouth. This phlegmon is very rare but is an immediately life-threatening condition. What are the causes and symptoms of parapharyngeal phlegmon? How is the treatment going?

Phlegmon of the parapharyngeal spaceappears as a complication of inflammation developing around the parapharyngeal space, such as: peritonsillar abscess, angina, purulent parotitis, inflammatory changes in the roots of the last molars jaw, inflammation of the top of the temporal bone pyramid, which is an ear-related intracranial complication.

Phlegmon of the parapharyngeal space is caused by the multiplication of mainly Streptoccocus ß-hemolitycus, Staphylococcus aureus and Bacteroides.

Phopharyngitis sometimes occurs in a limited form, as an abscess of the parapharyngeal space. It sometimes spreads towards the base of the skull and into the cranial cavity. Sometimes it goes down to the posterior mediastinum. It can also involve the sub-temporal fossa, pterygo-palatine fossa, floor of the mouth, mandibular fossa and soft tissues of the neck.

Phlegmon of the parapharyngeal space: symptoms

  • severe general condition
  • high fever
  • swelling and bulging around the lower jaw that may spread downwards to the neck
  • neck pain when touched and attempts to move it
  • szczękościsk
  • bulge of the side of the throat visible in the examination
  • sore throat - usually one-sided, on the developing side of the disease
  • pain when swallowing (odynophagia)
  • drooling
  • enlargement of the lymph nodes in the neck
  • breathing disorders
Worth knowing

The forehead space(Latinspatium parapharyngeum ) is an anatomical area in the shape of an inverted pyramid, the base of which is the base of the skull and the top is a corner greater hyoid bone.

Phlegmon of the parapharyngeal space: diagnostics

The basic examination in the diagnosis of parapharyngeal phlegmon is a CT scan. An indication for rapid interventionSurgical and drainage is the detection of purulent content in the parapharyngeal space (purulent discharge in close contact with the vessels). In addition, it is necessary to culture the collected purulent content to determine which microorganism is responsible for the infection and to which antibiotics it is susceptible.

Phlegmon of the parapharyngeal space: treatment

Phlegmon of the parapharyngeal space requires treatment in a hospital otolaryngology ward. Treatment of phlegmon consists in incision of pus and emptying them under anesthesia, fragments of necrotically changed tissues are also removed and, after making counter-incisions, drains are threaded through them to allow a constant drain of purulent contents. Sometimes this procedure has to be repeated several times.

During the procedure, pus is collected for culture to identify the organism that caused the phlegmon, and an antibiogram is made. Only after collecting the material for culture, intravenous antibiotic therapy is started. Occasionally it is necessary to insert an oesophageal tube to allow the patient to eat.

Phlegmon of the parapharyngeal space: complications

Phlegmon of the parapharyngeal space can lead to numerous complications such as internal jugular vein thrombosis, mediastinitis, arterial hemorrhage and even sepsis.

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ENT