Highlights & Basics
- Retropharyngeal abscess is a type of deep neck space infection, which can be a life-threatening infection if not detected early.
- Potential threat to airways should always be considered.
- Symptoms may be nonspecific (e.g., fever, dysphagia), especially in children under 2 years old.
- CT scan of neck is the definitive investigation.
- Treatment includes use of intravenous antibiotics and surgical or radiologically guided drainage. Type of surgical drainage depends on the size and extent of the abscess; this can be endo-oral or external.
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Citations
Philpott CM, Selvadurai D, Banerjee AR. Paediatric retropharyngeal abscess. J Laryngol Otol. 2004 Dec;118(12):919-26.[Abstract]
Bochner RE, Gangar M, Belamarich PF. A clinical approach to tonsillitis, tonsillar hypertrophy, and peritonsillar and retropharyngeal abscesses. Pediatr Rev. 2017 Feb;38(2):81-92.[Abstract]
1. Jennings CR. Surgical anatomy of the neck. In: Gleeson M, Hilbert JS, eds. Scott-Brown's otorhinolaryngology, head and neck surgery. 7th ed. London: Hodder Arnold; 2008:1744-45.
2. Gaglani MJ, Edwards MS. Clinical indicators of childhood retropharyngeal abscess. Am J Emerg Med. 1995 May;13(3):333-6.[Abstract]
3. Wajn J, von Buchwald C, Arndal H. Late diagnosis of retropharyngeal abscess in an infant. Ugeskr Laeger. 1993 Jul 12;155(28):2211-2.[Abstract]
4. Wang LF, Tai CF, Kuo WR, et al. Predisposing factors of complicated deep neck infections: 12-year experience at a single institution. J Otolaryngol Head Neck Surg. 2010 Aug;39(4):335-41.[Abstract]
5. Grisaru-Soen G, Komisar O, Aizenstein O, et al. Retropharyngeal and parapharyngeal abscess in children - epidemiology, clinical features and treatment. Int J Pediatr Otorhinolaryngol. 2010 Sep;74(9):1016-20.[Abstract]
6. Woods CR, Cash ED, Smith AM, et al. Retropharyngeal and parapharyngeal abscesses among children and adolescents in the United States: epidemiology and management trends, 2003-2012. J Pediatric Infect Dis Soc. 2016 Sep;5(3):259-68.[Abstract][Full Text]
7. Wang LF, Kuo WR, Tsai SM, et al. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003 Mar-Apr;24(2):111-7.[Abstract]
8. Philpott CM, Selvadurai D, Banerjee AR. Paediatric retropharyngeal abscess. J Laryngol Otol. 2004 Dec;118(12):919-26.[Abstract]
9. Tebruegge M, Curtis N. Infections of the upper and middle airways. Principles and Practice of Pediatric Infectious Diseases. 2018:208-15.[Full Text]
10. Klug TE, Greve T, Andersen C, et al. Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens. Eur J Clin Microbiol Infect Dis. 2021 Jul;40(7):1461-70.[Abstract][Full Text]
11. Christoforidou A, Metallidis S, Kollaras P, et al. Tuberculous retropharyngeal abscess as a cause of oropharyngeal dysphagia. Am J Otolaryngol. 2012 Mar-Apr;33(2):272-4.[Abstract]
12. Abdel-Haq N, Quezada M, Asmar BI. Retropharyngeal abscess in children: the rising incidence of methicillin-resistant Staphylococcus aureus. Pediatr Infect Dis J. 2012 Jul;31(7):696-9.[Abstract]
13. Kirse DJ, Roberson DW. Surgical management of retropharyngeal space infections in children. Laryngoscope. 2001 Aug;111(8):1413-22.[Abstract]
14. Morrison JE Jr, Pashley NR. Retropharyngeal abscesses in children: a 10-year review. Pediatr Emerg Care. 1988 Mar;4(1):9-11.[Abstract]
15. Ungkanont K, Yellon RF, Weissman JL, et al. Head and neck space infections in infants and children. Otolaryngol Head Neck Surg. 1995 Mar;112(3):375-82.[Abstract]
16. Parhiscar A, Har-El G. Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol. 2001 Nov;110(11):1051-4.[Abstract]
17. Byramji A, Gilbert JD, Byard RW. Fatal retropharyngeal abscess: a possible marker of inflicted injury in infancy and early childhood. Forensic Sci Med Pathol. 2009 Dec;5(4):302-6.[Abstract]
18. Duval M, Daniel SJ. Retropharyngeal and parapharyngeal abscesses or phlegmons in children. Is there an association with adenotonsillectomy? Int J Pediatr Otorhinolaryngol. 2008 Dec;72(12):1765-9.[Abstract]
19. Elsherif AM, Park AH, Alder SC, et al. Indicators of a more complicated clinical course for pediatric patients with retropharyngeal abscess. Int J Pediatr Otorhinolaryngol. 2010 Feb;74(2):198-201.[Abstract]
20. Bochner RE, Gangar M, Belamarich PF. A clinical approach to tonsillitis, tonsillar hypertrophy, and peritonsillar and retropharyngeal abscesses. Pediatr Rev. 2017 Feb;38(2):81-92.[Abstract]
21. Wang KY, Lin HJ, Chen YH. Retropharyngeal abscess with descending necrotizing mediastinitis. J Emerg Med. 2012 Jul;43(1):114-5.[Abstract]
22. Uzomefuna V, Glynn F, Mackle T, et al. Atypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray. Int J Pediatr Otorhinolaryngol. 2010 Dec;74(12):1445-8.[Abstract]
23. Daniel R, Stokes P, Dhillon K, et al. The accuracy of lateral X-ray and computed tomography in diagnosis of paediatric retropharyngeal abscess: a systematic review. Aust J Otolaryngol. 2020;3:12. [Full Text]
24. McClay JE, Murray AD, Booth T. Intravenous antibiotic therapy for deep neck abscesses defined by computed tomography. Arch Otolaryngol Head Neck Surg. 2003 Nov;129(11):1207-12.[Abstract][Full Text]
25. Biron VL, Kurien G, Dziegielewski P, et al. Surgical vs ultrasound-guided drainage of deep neck space abscesses: a randomized controlled trial: surgical vs ultrasound drainage. J Otolaryngol Head Neck Surg. 2013 Feb 26;42:18.[Abstract][Full Text]
26. Yeow KM, Hao SP, Liao CT. US-guided percutaneous catheter drainage of a deep retropharyngeal abscess. J Vasc Interv Radiol. 1999 Nov-Dec;10(10):1365-9.[Abstract]
27. Freling N, Roele E, Schaefer-Prokop C, et al. Prediction of deep neck abscesses by contrast-enhanced computerized tomography in 76 clinically suspect consecutive patients. Laryngoscope. 2009 Sep;119(9):1745-52[Abstract]
28. Park R, Halpert DE, Baer A, et al. Retropharyngeal calcific tendinitis: case report and review of the literature. Semin Arthritis Rheum. 2010 Jun;39(6):504-9.[Abstract]
29. Patron V, Roudaut PY, Brosset P, et al. Right fourth branchial cyst presenting as retropharyngeal collection in a neonate. J Perinatol. 2012 Feb;32(2):153-5.[Abstract]
30. Ueda Y, Saita Y, Matsuzawa T, et al. Six patients with Kawasaki disease showing retropharyngeal low-density areas on computed tomography. Pediatr Int. 2010 Aug;52(4):e187-9.[Abstract]
31. Pelaz AC, Allende AV, Llorente Pendás JL, et al. Conservative treatment of retropharyngeal and parapharyngeal abscess in children. J Craniofac Surg. 2009 Jul;20(4):1178-81.[Abstract]
32. Rao MS, Linga Raju Y, Vishwanathan P. Anaesthetic management of difficult airway due to retropharyngeal abscess. Indian J Anaesth. 2010 May;54(3):246-8.[Abstract][Full Text]
33. Reynolds SC, Chow AW. Severe soft tissue infections of the head and neck: a primer for critical care physicians. Lung. 2009 Sep-Oct;187(5):271-9.[Abstract]
34. Khudan A, Jugmohansingh G, Islam S, et al. The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm. Ann Med Surg (Lond). 2016 Nov;11:62-5.[Abstract][Full Text]
35. Carbone PN, Capra GG, Brigger MT. Antibiotic therapy for pediatric deep neck abscesses: a systematic review. Int J Pediatr Otorhinolaryngol. 2012 Aug 23;76(11):1647-53.[Abstract]
36. Thompson JW, Cohen SR, Reddix P. Retropharyngeal abscess in children: a retrospective and historical analysis. Laryngoscope. 1988 Jun;98(6 Pt 1):589-92.[Abstract]
