What is Retropharyngeal abscess?
It is a condition that occurs due to infection and suppuration of the retropharyngeal lymph nodes in the neck area
Surgical Anatomy : The retropharyngeal space lies behind the pharynx between the buccopharyngeal fascia and prevertebral fascia. It extends from base of skull to the tracheal bifurcation.
Types of retropharyngeal abscess:
1) Acute relropharyngeal abs,cess
2) Chronic retropharyngeal abscess
What is Aetiology of acute retropharyngeal abscess?
1) Age :Usually in children below 1 year of age
2) Sex: M > F
3) Oral infection or nasopharyngeal infection
4) Trauma by a sharp foreign body like a fish bone
5) Rarely pus from acute mastoiditis tracks along the petrous bone
to form retropharyngeal abscess
What is Aetiology of chronic retropharyngeal abscess ?
1) Tuberculous caries of the cervical spine which is central
2) Tuberculous infection of the retropharyngeal lymph nodes which
is usually on one side of the midline
What are the clinical features in acute retropharyngeal abscess?
1) Dysphagia especially in acute cases
2) Dyspnoea as abscess causes pressure symptoms on the larynx
3) Torticollis due to spasm of neck muscles
4) High grade fever
5) Tender cervical lymphadenitis
6) Croupy cough
7) Child has a quacking voice
8) Abscess presents as a bulge on the posterior pharyngeal wall
What are the clinical features of chronic retropharyngeal abscess?
1) Dysphagia present but not fever
2) Neck shows tuberculous lymph nodes
3) Restricted neck movements
4) Low grade fever, as seen in tuberculosis
What investigations are required for the diagnosis of retropharyngeal abscess?
1) Routine blood investigations.
2) X-ray cervical spine lateral view: It shows increase in the retropharyngeal space with straightening of the cervical spine.
3) CT Scan neck with chest shows extent of abscess superiorly
Treatment of retropharyngeal abscess
What are complications of retropharyngeal abscess?
1. Laryngeal oedema
2. Rupture and aspiration of the abscess