Chronic retropharyngeal abscess

Chronic retropharyngeal abscess

This condition is now rare and is most commonly the result of an extension of tuberculosis (TB) of the cervical spine, which has spread through the anterior longitudinal ligament to reach the prevertebral space. In addition to the pharyngeal

Figure 52.29 Axial computed tomography scan of the neck demon

strating right parapharyngeal abscess.

swelling seen intraorally , there may be fullness behind the sternocleidomastoid muscle on one side. In contrast to an acute retropharyngeal abscess, this condition occurs almost solely in adults. Radiology usually shows evidence of bone destruction and loss of the normal curvature of the cervical spine. The spine may be quite unstable and undue manipulation may precipitate a neurological event. In contrast to an acute abscess, a chronic retropharyngeal abscess must not be opened into the mouth, as such a proce dure may lead to secondary infection. Drainage of the abscess may not be necessar y if suitable treatment of the underlying TB disease is instituted. If it is necessary , drainage should be carried out through a cervical incision anterior to the sterno cleidomastoid muscle with an approac h anterior and medial to the carotid sheath to enter the retropharyngeal space. The cavity is opened and suctioned dry after taking biopsy material. Occasionally , surgery is requir ed to decompress or stabilise the spinal cord if there is a progressive neurological deficit.

Figure 52.30 Infectious mononucleosis.

Chronic retropharyngeal abscess

This condition is now rare and is most commonly the result of an extension of tuberculosis (TB) of the cervical spine, which has spread through the anterior longitudinal ligament to reach the prevertebral space. In addition to the pharyngeal

Figure 52.29 Axial computed tomography scan of the neck demon

strating right parapharyngeal abscess.

swelling seen intraorally , there may be fullness behind the sternocleidomastoid muscle on one side. In contrast to an acute retropharyngeal abscess, this condition occurs almost solely in adults. Radiology usually shows evidence of bone destruction and loss of the normal curvature of the cervical spine. The spine may be quite unstable and undue manipulation may precipitate a neurological event. In contrast to an acute abscess, a chronic retropharyngeal abscess must not be opened into the mouth, as such a proce dure may lead to secondary infection. Drainage of the abscess may not be necessar y if suitable treatment of the underlying TB disease is instituted. If it is necessary , drainage should be carried out through a cervical incision anterior to the sterno cleidomastoid muscle with an approac h anterior and medial to the carotid sheath to enter the retropharyngeal space. The cavity is opened and suctioned dry after taking biopsy material. Occasionally , surgery is requir ed to decompress or stabilise the spinal cord if there is a progressive neurological deficit.

Figure 52.30 Infectious mononucleosis.